Hi.
I am a 22yr old female and have recently found tiny specs of blood in my phlegm. They are bright red and are tangled in my mucous.
I am a little concerned and wondering if you could assist with a possible answer.
Your concern is appropriate. Coughing up blood is never normal, but in many instances in a young person, especially when there are specs of blood rather than gross blood, the bleeding originates in the nose or adjacent structures, and the cause is benign. Nevertheless, its having persisted for 4.5 months it cannot be ignored and it is unlikely that allergies would be the cause.
Given this and a reportedly clear x-ray, you should seek consultation with an ENT specialist for a careful, direct examination of your nose, throat, sinuses and larynx with the use of a fiberoptic laryngoscopy. He/she may also want to do a CT scan of your sinuses, with the appropriate precautions, given your pregnancy.
If the chest x-ray was not interpreted by a chest radiologist, you should request that this be done, for assurance that a perhaps subtle finding on the chest x-ray was not detected by your doctor. Review of this x-ray will obviate the need for a repeat x-ray.
If the ENT exam is normal, so it fails to reveal a bleeding site and the chest x-ray truly normal, you may want to seek consultation with a pulmonary specialist. You should also try to recall if you have previously had any experience similar to this, especially with menstruation.
Good luck.