Clear, Yellow, Green, Brown and Red - The Mucus Rainbow and What Mucus Color Really Means
This past week, as they say, everyone was Irish. Not wearing green might get you pinched. And in celebration, beer and the Chicago River flowed green. I more often mark St. Patrick's day as the beginning of spring and the wrapping up of the cold and flu season. If you'll forgive the bad analogy, a season of flowing green mucous, much like that river in Chicago. In my experience, patients always seem to focus on the color of their mucous.
But does the color really matter?
The Mechanics of Mucus
Mucus production is a necessary process in our body. Though deemed gross, mucus keeps our body clean and serves as a defense for invaders. It traps dust, debris and other inhaled pollutants and carries them out of our bodies. Luckily, this also includes infectious agents like bacteria and viruses.
In fact, you might be surprised to learn that on a typical day, our body makes over 1.5 liters of mucus - most of which is swallowed and passed in the stool.
However, as part of our body's defense mechanism, warning signals caused by the release of histamine (triggered by allergy, infection or noxious stimuli) can cause the body to produce even more mucous. The process is pretty much the same whether it is an infectious agent trying to get a foothold, pollen hitting an allergic body, or some hot sauce on your burrito. Cells that circulate around your mucous membranes (also called "mast cells") get the trigger and release pockets of histamine that cause the mucous cascade.
The Mucous Rainbow
When mucous is produced, it is clear, however, various factors can cause this color to change.
Clear: In an intense reaction, mucous is always clear as it is "hot off the press" flowing quickly.
Yellow: During illness, dehydration is one of the biggest factors driving unwanted symptoms. Increased temperature causes fluid losses from the body as does mucus production in and of itself. This causes muscle aches and drying throughout the body. As mucous dries, it thickens and takes on a yellowish color.
Brownish or Redish: It is not uncommon that mucous membranes get irritated and bleed. This can cause a brown or reddish tint to the mucous.
Rust-Colored: Coughed up mucous that is rust-colored is a telltale sign of pneumonia.
Green: Green mucous means that white blood cells are active in the process causing the mucous. These white blood cells are activated often in response to infection and their enzymes give mucus a green hue. While many people think that this is a sign that they need an antibiotic to treat a bacterial infection, this is not necessarily true. While it is a good bet that there is an infection driving this change in mucus appearance, it could be viral or bacterial. And for viral infection antibiotics do nothing other than contribute to the growing problem of antibiotic resistance.
How Should Heavy Mucus Production be Treated?
We need mucous to moisten our membranes and provide protective defense, but too much is rather unpleasant in the face of allergy or infection.
Spicy Food: With noxious stimuli like spicy food, the mucus surge is usually short-lived until the offending agent is removed.
Allergies: Anti-histamines can block the effects of histamine in mucus production. For allergies, this works quite nicely but in general, anti-histamines do not provide much relief with infections and can even worsen things by thickening mucous.
Thick Mucus and Congestion: Medications such as guaifenesin can thin mucus making it more easy to blow out or pass. This can help relieve symptoms and help enhance the cleansing process in turning over produced mucous.
Public Outings with Excessive Congestion: Decongestant medications such as pseudoephedrine work to reduce mucus production by causing blood vessels delivering the fluid to the membranes to clamp down. While effective, they should be reserved to treat when congestion is not tolerable (such as being out in public). If you are on the couch and blowing your nose often is not a hassle, I recommend letting the mucus do its work.
For All Occasions of Excess Mucus: One of the most effective and safest methods of removing and reducing mucus is a sinus rinse with saline. This can be done with a saline spray or a neti pot. (See my past blog on neti pot use.) It is also important to note that when mucus is being produced excessively, hydration is important. Fluid intake should be increased to keep up with body water stores being diverted to mucus production.
Mucus production is a normal body function. In times of infection, allergy or noxious stimuli mucus production gets pushed into overdrive. Green mucus signifies that an infection is present, but this is not necessarily a bacterial infection that can be treated by antibiotic use. The most concerning mucus color is coughed up rust-colored mucus along with pneumonia symptoms. Various treatments are available to treat mucus production but this should be reserved for use when excessive mucus is not tolerable. When the mucus production is running excessive, drink plenty of fluids to prevent dehydration.