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MS and Coughing — Managing Phlegm

Posted on April 06, 2022
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Sarah Winfrey

How It Affects Life | Causes | Management | Support

If you feel like you are coughing more since being diagnosed with MS or that you deal with a lot more phlegm, you aren’t alone. Here’s what you should know about how coughing and phlegm could be related to MS, as well as how to manage them.

How Do Coughing and Phlegm Affect Life With MS?

Many MyMSTeam members experience persistent coughs even without signs of infection. “My wife has a nagging cough she can’t shake off,” wrote one member. “It has been more than two weeks.” Another member explained, “I have not been able to get rid of this cough. I’m coughing to the point of vomiting.”

One member described experiencing particularly severe coughing: “I seem to have a cough straight from hell.” They went on to note, “I think this is an MS-related nuisance … . My diaphragm seems to have lost the ability to have a really productive cough.”

Other members experience phlegm without a cough. One asked, “Does anyone have problems with phlegm in their throat? It’s an everyday problem for me.” Another added, “I keep getting mucus in my throat! I’m constantly clearing my throat.”

It can make for a lot of discomfort. “I’m also having a lot of phlegm build up and get stuck in my throat, so it is very hard to spit it out,” described one member. “I feel like I am choking all the time.”

Some people try to cough phlegm up, but don’t have much luck. “I’ve had what feels like coughing spasms, sort of like my throat is trying to push something up, even when I haven’t swallowed anything,” one member described. “Occasionally, a small amount of phlegm comes up, but not much.” Another echoed this feeling, writing, “I have phlegm sometimes, and I can’t really cough it up.”

For a few people, coughing and phlegm occur only in relation to certain activities. As one member explained, “I notice the cough and phlegm only happen when I eat.”

What Causes Coughing and Phlegm in MS?

There are many reasons why people diagnosed with MS might deal with coughing and phlegm. Here are some of the most common causes.

Illness

People with MS may be more prone to developing respiratory infections — particularly chest infections like pneumonia. People diagnosed with MS who are struggling with coughing and mucus should be evaluated for infection.

People with MS may also get sicker than others when they become ill. This can mean that they produce more mucus, struggle more with postnasal drip, and cough more than other people with the same infection.

Lesions in the Nervous System

Sometimes, lesions caused by MS can occur in areas of the brain that coordinate respiratory muscle function, like in the chest and airways. This can make it more difficult to cough productively, leading to a weak cough. It can also make it harder to clear the throat effectively. This may make you feel like you are dealing with too much mucus or like you need to cough.

Brain lesions can also occur in areas responsible for nerve function in the mouth and throat. This can change the sensation of mucus in these areas, making it feel like there is too much phlegm or like mucus is always present.

Muscle Weakening

Living with MS can lead to a more sedentary lifestyle, which can have negative effects on posture and muscle strength. This can affect the muscles in the throat, chest wall, and more, making it harder to cough effectively. Maintaining cough strength can help remove excess mucus effectively. In fact, research has found that having low cough strength with MS correlates with higher levels of disability on certain scales.

How To Manage Coughing and Phlegm With MS

You can manage coughing and mucus in the throat with MS in many ways. While you can try to treat the problem at home, remember that it’s always important to see your neurologist or health care provider if you have a new or worsening MS symptom. They can help you manage this symptom and make sure you’re getting the care that you need.

Treat Infections

One key way to minimize phlegm is to treat respiratory illnesses effectively. Because people with MS may get more infections and get sicker from them, it’s especially important to contact your doctor if you become sick.

One member of MyMSTeam has a rule of thumb: “If it’s yellow or green, I call my doctor.”

While yellow or green phlegm doesn’t always indicate an infection, any change in the color, consistency, or quantity of mucus can indicate a change in your health. Other clues such as fever, exposure to an allergen, or facial pain can help your doctor determine the cause of the change and whether medication is needed.

To help prevent infections, ask your doctor which vaccinations are safe and effective for you. Also, if you are taking disease-modifying medications for your MS, ask your doctor if you should schedule vaccinations around your medications.

Try Drinking Tea

Some members recommend drinking tea to help soothe a cough or loosen mucus. One member wrote, “Hot tea helps break up the mucus.” Another advised, “Drink some tea with honey and lemon.”

Honey is a popular additive to tea. According to the Mayo Clinic, it can help soothe the throat and potentially help suppress coughing. One member recommended honey with tea, adding “That will help with coughing and will thin mucus in the nose and throat.”

Thin the Mucus

Mucinex is an over-the-counter medication that helps thin mucus. Thin mucus is easier to cough up and clear out of your throat. Some members swear by the medication. “I started using Mucinex, and it works really well for me,” said one member.

Get Care for Any Breathing Problems Immediately

If you are dealing with a severe or persistent cough, shortness of breath, or trouble breathing, contact your doctor or emergency health care services immediately. They will be able to identify and treat potential infections. They can also address the underlying cause of your cough and determine whether your MS is contributing to breathing problems.

Find Your Team

MyMSTeam is a social support network where more than 184,000 people with multiple sclerosis and their loved ones gather. You can read others’ stories, ask questions, and find out what works for people facing the same challenges you face.

Have you experienced chronic coughing and excess phlegm with MS? What have you found effective for managing these symptoms? Share your story and tips in the comments below or by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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