VoiceCouncil will no longer be updated. Articles will still be available for some time.

Endless Phlegm!

Doctor's Corner with Anthony Jahn

Dear Dr. Jahn,

I have a student that produces a lot of phlegm (heard as a “gravel-rattle” kind of sound) in his upper range of head voice. He’s not unwell (or been unwell) so it’s not connected to a virus or bacterial infection. It’s quite disconcerting as we’ve already worked on all the obvious things – trying to cut down on dairy foods, steaming, introducing more water, reducing stress, warming up gently etc. etc. but we haven’t seen any real improvement.


Dear Tracey,

Yes, phlegm is a chronic issue, one that is annoying to non-singers but a major problem for singers.

In brief, phlegm is just thickened mucus. Mucus is a secretion that is formed in the upper respiratory tract and normally cleared back from the nose and sinuses into the pharynx and swallowed.

We do this unawares, several times a minute, and generally manage to keep the upper aerodigestive tract moist and free of any debris.

When the mucus becomes excessive or too thick, phlegm forms, This is not easily cleared, but tends to accumulate and cause problems.

In the larynx, phlegm often collects on the vocal folds, at their point of maximal vibration (think of turning a skipping rope with a ring on it- the ring will wind up at the point of maximal excursion).

Since the vocal folds are thinnest, longest, and vibrate most delicately at higher pitches, the clump of mucus becomes most problematic in this range.

Here are some suggestions. First, thin the mucus by drinking about 64 oz ( that’s eight 8 ounce glasses) of water a day.

Next, wash the nose with a Neti pot twice a day to clear out excessive postnasal drip.

Next, look at any possible allergies. In addition to inhalant allergies, consider food allergies as well. Apart from dairy and gluten, consider sweets- excessive sugar.

Mucus, whether excessive in quantity or consistency, often adheres to areas of irritated mucous membrane. A common cause of inflammation in the laryngeal area is laryngopharyngal acid reflux – so this needs to be addressed with changes in diet and medical measures to reduce reflux.

Finally, excessive singing, either belting or pushing, can cause irritation of the vocal folds in the area of maximal vibration.

This is not nodes or a “prenodular condition”, simply irritation and mild swelling along the vibrating edge of the vocal fold.

Mucus often adheres to this area, something that a laryngologist should be able to see, and you, as a voice teacher, perhaps with input from a vocal therapist, should be able to address.

-Anthony F. Jahn, MD

Dr. Jahn welcomes your questions. You can send these to editor@voicecouncil.com

This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.

You can see more of Dr. Jahn’s work here.

  • MusicDirector

    The student might have a bit of an intestinal yeast problem, which creates more phlegm. I used to have this problem and did an anti candida diet and an anti-candida program (Yeast busters) and it helped a lot.

  • Anonymous

    Maybe the student secretly smokes weed. I know when I smoke pot it tends to create ungodly amounts of phlegm, exacerbated by air pollution. If so the only answer is to stop. Takes months for the lungs to fully clear.

  • I am no medic, so I pass on what I know with no qualification other than that it worked for me when I had or have excessive phlegm or mucous problems that affect my talking…..let alone my singing.
    Those who like me suffer from Hay fever will likely readily relate to the quandary.
    I found the use of a spray inhalant of 3% Hydrogen Peroxide to be beneficial in reducing phlegmatic congestion.
    More about this can be found at:-

  • OK……..so I am back!

    But then I am for what I feel is good reason to share my experience of today. How one writes up on such things as medical issues can be judged unsavoury or even disgusting so I will get to the point and avoid the nasties!

    Dawn today saw me rise with …shall we say a feeling of chestiness. However I neither felt the urge nor the real need to go to great lengths over the bathroom basin to clear myself of it.

    Little did I know that relief would come for me at precisely 3.30pm when my daughter and family dropped in for a late lunch of freshly prepared CRAB CURRY.

    After a hearty meal of it, all those natural herbs and spices went to work, and boy if I was was expecting something I was not quite expectorating what I did.

    It was the Curry! That delicious CRAB curry had worked to invoke natures own best response to phlegmatic lungs.

    It was an encore of expectoration that left me at the same time, shocked, yet thrilled and momentarily exhausted.

    So there you have it! The remedy for phlegmatic congestion as never revealed for the benefit of so many of my peers.

    If you have “Endless phlegm”, end your malady. Get your girlfriend, your wife, your Mum, your Granny……………..get ANYBODY!…. to make you a “Heaps Chilli Hot” Crab Curry.
    And once again …Breath Easy!

    Poppa ( cough! cough! choke! choke!……whooh!…’Scuse me!)

  • Poppa Madison

    For quite some years now I have had a major problem with this. I feel certain that the cause is Hay Fever caused by the pollens from the plants and Tropical grasses that grow in Queensland Australia, where I reside.

    I am reluctant to keep dosing myself with Anti-histamine concoctions as I already have to take a few prescribed medicines since having had open heart surgery just over a year ago.

    When I lived in the UK (where I was born) I never had Hay Fever. It was not until I got into my first Australian summer that the ailment showed up with a vengeance. So much so, that when I was on a camping holiday with my two young sons in 1974, I was almost falling asleep on my feet and losing so much fluid nasally and optically that I had to seek help at a Pharmacy in Cooma, a place we had planned to just pass through.

    I can never forget what happened next. The Chemist took one look at me and said, I think, a few Hail Mary’s, then handed me a little white pill.

    “Go and find somewhere where you can sleep and take this tablet!” were his parting words to me. It will make you sleep. It WILL MAKE YOU SLEEP! ”

    There was an ominous insistence in his tone.

    I took the boys to an off-road camping spot outside the town and set up the tent. I felt as if I had the most terrible influenza. It was about 4pm in the afternoon. Sipping water from my camping water bottle, I downed the tablet. Then I zipped up the tent and instructed my boys not under any circumstances to wander off anywhere. Then everything went blank as if I had been anaesthetized!

    When I awoke, it was 7.30am ! I could remember nothing. However, I felt good and was able to rise and face the day. My boys told me they had not left the tent since I closed it!

    Whatever was in that pill hit that Hay Fever like a tank going through a battlefield and I was able to continue with the holiday.


    © ♯♪♫ ♂PM



    Twitter: @PoppaMaddo

  • mile high too

    Not a funny joke at all.

    Maybe I was a second-hand smoker. Never even smoked for my life, but continuous heavy phlegm kills me any day. It got really worse over the years.

  • Kirk Leavesley

    I do over 200 shows a year and struggle with mucus for prolonged periods. I have tried many remedies, including those suggested by Dr Jahn. What works for me is Guaifenesin, which is found in Mucinex, or a Costco product called Kirkland Mucus Relief Chest Expectorant. It thins and loosens mucus allowing the body to clear it more effectively. Prior to taking the product, I checked with my Dr to ensure this was safe to take and he said it was OK.

  • Julian ellis

    Julian from Eugene, Oregon. I was diagnosed of Chronic Obstructive Pulmonary Disease (COPD) in 2012 at the age of 63. My COPD got significantly worse and unbearable because of my difficulty catching breath. Last year, i started on a natural COPD Herbal therapy from NewLife Herbal Clinic, i read a lot of positive reviews from patients who used the treatment and i immediately started on it. I had great relief with this herbal treatment. I breath very much better now, no case of shortness of breath or chest tightness since treatment, my lungs condition is totally reversed. Visit NewLife Herbal Clinic website ww w. newlifeherbalclinic. com. This treatment is a miracle!!

  • S

    How often do you take?

  • Faye K Berrey

    Faye K Berrey I was born with celiac, pernecious anemia, [blood disorder], lack of ozygen to the brain, which led to fybroalgia, gerds and more. I once had a cancer check for my esophagus. Now at eighty one I still suffer with excessive phlegum, extreme horsness, mussle weakness and at times my voice completely stops. I have experienced other throat problems; a rare [Eagle Syndron] condition which only 0.2 people in the world have ever experienced. The side effects were many, effecting my throat for more that fifteen years. Removal of a one and a half inch bone extending from up in my head into my toncile helped but my throat never totally healed. Needless to say, phlegum and hoarseness has been a major problem. Already hoarse, a pholyp was removed five years ago causing severe damage for two years. As my hoarseness and weakness healed a cancer prevention drug, taken for four days totally destroyed every part of my throat. A second pholype appeared and I refused surgery. Instead I sprayed my throat with Miracle 11 Neutralyzer for four days before seeing my throat doctor. He found no sign of the pholype. At this point, for the first time in five years I heard my doctor say, “Your throat is healed.” I still have severe hoarseness and phlegum but am believing that God continues to heal me. The sad part of my throat problems has been that God had plans for me to become a singer. I know no music, yet He has given me probably a thousand amazing songs since 1970 which has blessed those who have heard them. I have multipal series’ which I believe will someday be heard . I sang for about a year with a Country Opry group, [singers from Nashville] until my throat caused me to stop singing. while I can’t talk I can sing briefly at times. I say all of that to say this: FOR THE PHLEGME I watch my diet, even though most of what I ear or drink causes problems. For sinance mucus I use Cholodial Silver nose drops from Utopis Silver in TX. They use only pure silver and their products can be trusted. They will tell you how to create a generation for making your own. I make my own. Lying down I use the nose drops while attempting to clear my sinances. The mucas drains into my throat and I spit it out. As i continue to try to clear my [second] nose, a plug of thick mucus drains which completes the process. If I do a stomach exercise; expanding and drawing in of my stomach, plus exercising my tongue and throat I get even better results. Infection, headache and discomfort are gone. I realie this is long but I do hope that my experience and solution will help someone. Omega 3 has also helped. I have not been on perscription drugs for fifty years and am growing younger, not older every day. On Youtube, go to “Together; From The Rubble to hear my song [which I am redoing” put out during the Housten flooks.