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Black specs in phlegm after quitting Marijuana

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I have recently quit smoking Marijuana, after almost 8-9 years of daily use. Since then (About 1 week) I have had black specs coming up in phlegm that I keep coughing up. Is this a normal detox phase of my lungs/respiratory system or is this something I should be further concerned about. I will also mention I have never smoked Ciggarettes. As well, for the previous 2-3 years my smoking was purely out of a Water bong/Water pipe if that makes a difference.... before that it was usually rolled paper joints. I should mention as well I did just get over being quite sick, and then coughing up more-so at the end of that sickness, but that has since passed and I am still coughing up phlegm with black specs, albeit less often, but still a handful of times a day. I did have X-rays taken last week of my lungs and I was told they looked fine as well.

Thank you very much for any info you can provide on this,

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Thank you for choosing DoctorSpring

Sorry for the delay in the reply. Considering the nature of your consult, I had a discussion with our team Pulmonologist Dr.Jacob George and hence the delay.

We would like to know some additional details from you so that I can provide my best and learned opinion.

1. For how long are you having this black specs in mucous ?
2. Ever had blood streaks / coughing up of blood ?
3. Do you have a persistant cough ?
4. Any fever / weight loss / lethargy / breathing difficulty ?
5. Did you take any medications for this ? Antibiotics ?

You can reply as a followup
Thank you

Patient replied :

Thank you for the question -

1)I have only quit about a week ago.... so since then... At times in the past I have coughed a bit up directly after smoking, but since quitting it has become a regular occurrence for the past week or so.

2) I have had blood streaks for about 3 days total, this stopped 4 days ago. It started when I was quite sick with cold/flu like symptoms and a chest cough. I had a really rough cough one night trying hard to force some phlegm out and had some small strands of blood in the mucus. This happened maybe 2 times a day, for 3 days, the rest of the phlegm on those days only contained black specs, after about 3 days of that, there has been 0 blood since. This blood in the mucus stopped 4 days ago, and has not been back since.

3)Persistent is tough to say, I have just been quite sick and am coughing more than I normally do for sure, I am not sure if it is a bit of persisting symptoms from the cold, or part of this whole coughing up small black specks in the phlegm.

4)No fever, I have taken my temp and it was fine, I don't feel especially lethargic, and no trouble breathing besides the bits of phlegm being coughed up. (I am actually just starting training for a 10k run called The Sun Run that I have run every year for the past 5 years).

5)I was taking Doxycyline when a clinic near me first sent me for x-rays they were worried it might be pneumonia, as a result they prescribed it more as a precaution/prevention. I actually did not complete the full cycle of them (I stopped 4 days in) I know this is not recommended with Antibiotics due to immunity build up but it was giving me a bit of nausea / diarrhea so once I found out my X-rays were clear and normal and I didnt have pneumonia I chose to stop it.

I hope this is enough information... I guess the other bits I can provide is I am coughing up this black phlegm currently about once an hour... I will just be sitting at my desk working and notice phlegm in my throat, and then cough it up from there.

I hope this information helps you.

I do have a follow-up question myself. If we do find out that this is a normal behavior for my lungs, my questions would be.

A)How long should I expect this to last about before I should be concerned or follow-up.
B)Is there anything I can do to help the process, whether it's certain drinks or to avoid certain things... Now that I have quit smoking I really just want to get my lungs back to being as healthy as they can as quickly as possible.

**PS I did have my lungs listened to, 2 days ago at a clinic with a stethoscope and was told they sounded clear/fine.

Thank you for the additional details

The back specs are actually a combination of dried up cellular derbies , blood and mucous. This is not directly related to Marijuana, but to the smoke. All the smoking could have made the lining of your lungs more fragile, resulting in this.

This is expected to resolve in less than 2 weeks
If not it is better to take a full course of antibiotic like Azithromycin / Cephalosporin for a full course.
DO NOT cough forcibly.

For lung health - obviously no smoking, not even second hand smoke
Antioxidants can help - in form of green leafy vegetables and fruits (not supplements)
Lung epithelium is very dynamic. So if you keep it smoke free you can expect a good recovery. All the best

Hope this helps
Feel free to ask followups.
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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