Mysterious shortness of breath: What has helped you?

Posted by Gabe, Volunteer Mentor @gabrielm, May 31, 2018

I will try to make this as short as possible, but this has been going on for over 5 years, so it might be farily long. 

Beginning in summer of 2012, I began having shortness of breath (SOB) with no other symptoms. I felt a constant need to yawn, and every few breaths wouldn't satisfy the SOB. I would take a deep breath, and felt like it would get "stuck" before satisfying the air hunger feeling. About every 3-5 deep breaths would satisfy it, only for it to return a minute later. 

I got an endoscopy and other tests done, which revealed that I had some esophageal erosion due to acid reflux and a slight hiatal hernia and was diagnosed with GERD. I had always have bad heartburn, so I was prescribed with Prilosec, which I have been taking daily since them. I've tried stopping it a few times but the reflux always comes back a lot worse. 

Lung tests and x-rays were normal. Heart tests normal. Blood test revealed a slight anemia but otherwise pretty normal. 

I did some research reading forums where someone suggested taking vitamin B-12. Strangely, I took it and the SOB disappeared almost instantly. However, it only lasted a few days for it to return just as bad. I then started taking an iron supplement, which again made the SOB disappear quickly- same thing; symptom returned days later. 

After further research, I came across a breathing exercise method called the Buteyko method. Essentially you do a lot of breath holding to build up CO2 and reduce breathing as the theory is that I had chronic hyperventilation causing too much CO2 to exit my body. After applying the method and reducing my breathing, the SOB disappeared after only 2 days and I felt completely normal. I continued the method a few more days then no longer felt the need to pursue the exercises. I was normal for a whole year when the SOB once again returned with some chest tightness. I applied the method again and the symptom went away, this time with a little more effort; after about 3 weeks. I included physical exercise which also helped with my breathing. 

After that, I was normal for about 2 years. I mistakenly stopped or at least slowed down exercise and the SOB returned once again. I applied the method and began running for exercise but the SOB kept getting worse. It got so bad, I had multiple panic attacks and the feeling of completely empty lungs with the inability to satisfy it with deep breaths. I had to stop exercise altogether, apply the Buteyko method and do breathing exercises very carefully with very light and slow exercise. This helped, but it took many weeks for the SOB to improve. Then, it was almost normal when over a year ago as I was running, I couldn't get a deep breath to satisfy exercise-induced SOB. I have had SOB continuously since then (a year and a half). 

I once again started doing breathing exercises and slowly building up physical exercise, but I can't do any prolonged cardio activity because the SOB gets to a point where deep breathing will not satisfy it. While the breathing exercises have helped, they have had very little effect compared to previous efforts. It seems that every time the symptom returned, greater effort yields few results.

I suspect there is something, some underlying cause that is causing the SOB that has alluded me this entire time. 

So for the past few months to a year, the SOB is worse on some days, better on others, but never gone. There's no rhyme or reason or pattern for it. It's just there, sometimes affecting my sleep. I sometimes can't get a deep breath to satisfy it every now and then, but for the most part, a big gulp of air will satisfy it. But it returns seconds to minutes later. It's as though every breath doesn't deliver what it's supposed to, the SOB builds up, and then I have to take a big gulp of air to get rid of the feeling, pattern repeats. My breathing pattern is normal, however. I don't feel like anything physical is happening, but sometimes it feels like my airways and nostrils are slightly inflamed due to allergies, but when I don't feel inflammation the SOB is still there. 

Recent lung function tests show normal- I don't have asthma, or any other problems with my lungs. Heart tests are normal though I did have about a two week bout of heart palpitations which came and went. Haven't had any for a while- it just mysteriously started happening then stopped. Blood tests are normal, though tests always show a slight elevation of biliruben which my doc thinks is Gilbert's disease. 

I don't have sleep apnea (normal test), bloody oxygenation is normal, heart rate normal. 

I recently saw local naturopath (since mainstream docs aren't able to help) who immediately suspected a liver problem when I described my SOB, possibly liver inflammation. He used an electrodermal testing machine to test his theory which did seem to show a problem with my liver and gallbladder. He gave me digestive enzymes and a gallbladder formula to help clear a bile duct clog, thus reducing liver inflammation. He also determined with the machine that I have an egg sensitivity so I've been avoiding eggs. 

Been taking this and avoiding eggs for a couple of months, but there has been no noticeable improvement. Everything else is normal. Emotionally I'm normal- no anxiety, depression, etc. The SOB seems to be the only symptom of something, but always comes back worse, until a year and half ago when it came back and has remained since. I feel like I shouldn't have to do breath holding exercises every day just to maintain my breathing well enough to do every day things. 

Does anyone have any idea of a possible underlying cause?

2021/2022 UPDATE:
Since my original post about 3-1/2 years ago, a lot has happened, so I’d like to update the post to share with others who come across this what I’ve done since then.

I have maintained a weekly Buteyko method breathing exercise regimen where I do a few of these breathing exercises 3-4 times a week in the morning. This, in combination with daily light to moderate exercise (specifically weight lifting, with 1 or 2 days a week of walking and light jogging), I feel has kept the air hunger symptoms tolerable and manageable. I have mostly good days with some not-so-good days, but doing a breathing exercise and knowing that it’ll get better again helps me get through those times.

I also have sinus inflammation which can exacerbate the symptoms, but I’ve also managed this, which in turn reduces the severity of the air hunger symptoms.

So, while I haven’t found a cure nor is the problem completely gone, I have been able to maintain normalcy in daily life and manage the symptoms through the strategies I described.

This discussion remains active, alive and well through the comments section where others who have similar symptoms have shared what has helped them as well as suggestions for possible solutions to explore.

Interested in more discussions like this? Go to the Lung Health Support Group.

Hi! I am so happy I found this thread. I too am suffering from this mysterious SOB. I started this last September.! I have since been to Urgent Care, a naturopath, the ER, a primary care doctor and most recently an allergist. I did allergy testing and was allergic to about 30 of the 62 things I was tested for so they want to start me on immunotherapy shots made up of what I am allergic too. I am not 100% convinced it is just allergies causing this as I take Flonase and an allergy pill every day. They also prescribed me on two inhalers thaybdont so much. I am a mom if three and own my own busy business and feel just so exhausted dealing with this SOB. I am so looking forward to finding the underlying cause as all test have come back normal (lung X-ray, blood work, breathing test, EKG, oxygen levels). I am at a loss of what to do. I become super anxious when it gets bad and get panicky and short with my family. I am desperate to figure out how to get rid of it. I did get two bad respitory illnesses in November and December and was coughing and then throwing up. I will say once they were done my SOB went away for a bit after each one and then came back middle of January again out of nowhere.

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Hi all, unfortunately this is still on going and not being helped by looking out over the Indian Ocean 🙁 now I find that I can’t eat a plate of food without getting incredibly uncomfortable and it effecting my breathing. I am eating the most simple of food and not much of it. Still taking 20mg omeprazole but doesn’t really seem to be doing much and am still experiencing the feeling of needing to burp but not being able too. I do have peppermint oil but have read that this may worsen acid reflux (although I don’t feel I have any)? Daily thoughts are just focused on breathing properly or not as the case may be, and just getting home and not moving from doctors office until they figure this out.

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@katgts

Hi all, unfortunately this is still on going and not being helped by looking out over the Indian Ocean 🙁 now I find that I can’t eat a plate of food without getting incredibly uncomfortable and it effecting my breathing. I am eating the most simple of food and not much of it. Still taking 20mg omeprazole but doesn’t really seem to be doing much and am still experiencing the feeling of needing to burp but not being able too. I do have peppermint oil but have read that this may worsen acid reflux (although I don’t feel I have any)? Daily thoughts are just focused on breathing properly or not as the case may be, and just getting home and not moving from doctors office until they figure this out.

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I am so sorry to hear this. I am making an Appt with my doctor to look at a possibility of the hiatal hernia. Even if it isn’t the case for me I can rule it out. I rather rule out a few more options because starting weekly allergy shots. I have also noticed I usually don’t wake up with it but it comes in within an hour or two of waking which is kind of strange.

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@gabrielm hi, thought I would give you an update. I was seen by my doctor and she obtained some blood work and a xray this far. Chest xray was normal and i have not gotten my results from my bloodwork yet. She also put me on Protonix and I have to say I am 90% better and have been on it for 1 week. I do not feel so much the need to take a deep breath. I am also going to have an ultrasound of my thyroid bext week and let you know the results of that. TBH...it was hard for me to belive it was "silent reflux " because in my mind how did it get so bad that it effected my breathing without ANY other symptoms ie: heartburn, fullness and any other symptoms that people complain of. After a lot of reading on it that the pepcid damaged my esophageal never so therefore I felt nothing until my gasping for a deep breath and that made since to me. Now, is that the whole problem, I dont know because I am awaiting other test and it that comes back normal I will go see an ENT. I hope this helps and I will let you know the other results as I get them.

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@katgts i started with 20mg of prilosec too with no relief . My doctor put me on 40 mg of protonix, not only does it stops acid but it heals the esophagus. I am so much better after 1 week of taking it and staying on an alkaline diet. I would never thought in a million years it would have been silent reflux, because i didnt experience the typical symptoms people complain of. The only symptom was I was air hungry to fill my lungs up. I guess when i think of it I would have a sore throat and trying to clear my throat all the time. Thought it was allergies. Again I am still waiting for an ultrasound of my thyroid but for now the protonix is working and that a good indication that the problem is SILENT reflux not gerd. There is a difference.

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@tonyagregg

@katgts i started with 20mg of prilosec too with no relief . My doctor put me on 40 mg of protonix, not only does it stops acid but it heals the esophagus. I am so much better after 1 week of taking it and staying on an alkaline diet. I would never thought in a million years it would have been silent reflux, because i didnt experience the typical symptoms people complain of. The only symptom was I was air hungry to fill my lungs up. I guess when i think of it I would have a sore throat and trying to clear my throat all the time. Thought it was allergies. Again I am still waiting for an ultrasound of my thyroid but for now the protonix is working and that a good indication that the problem is SILENT reflux not gerd. There is a difference.

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@tonyagregg

@gabrielm hi, thought I would give you an update. I was seen by my doctor and she obtained some blood work and a xray this far. Chest xray was normal and i have not gotten my results from my bloodwork yet. She also put me on Protonix and I have to say I am 90% better and have been on it for 1 week. I do not feel so much the need to take a deep breath. I am also going to have an ultrasound of my thyroid bext week and let you know the results of that. TBH...it was hard for me to belive it was "silent reflux " because in my mind how did it get so bad that it effected my breathing without ANY other symptoms ie: heartburn, fullness and any other symptoms that people complain of. After a lot of reading on it that the pepcid damaged my esophageal never so therefore I felt nothing until my gasping for a deep breath and that made since to me. Now, is that the whole problem, I dont know because I am awaiting other test and it that comes back normal I will go see an ENT. I hope this helps and I will let you know the other results as I get them.

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@tonyagregg Thanks for the update. I hope you get on a fast track to recovery. My breathing problem remained after I was put in Prilosec. Interesting that the Protonix helped you. I might have to try that. But it could still be a hiatal hernia. I plan on getting that checked sometime.

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@gabrielm

@tonyagregg Thanks for the update. I hope you get on a fast track to recovery. My breathing problem remained after I was put in Prilosec. Interesting that the Protonix helped you. I might have to try that. But it could still be a hiatal hernia. I plan on getting that checked sometime.

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@gabrielm i tried 20 mg of prilosec and my doctor said she wanted me on something stronger and prescribed 40mg of protonix. The not only is it the strongest anti acid but it heals the esophagus. I hope you find an answe for yours. It doesnt hurt to try.

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@tonyagregg thank you so much! Will check this out with doc when I get home. Hope you are feeling back to normal soon!!

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@chrisdh5

Hi Gabriel

I see no one has responded in half a year and as I just stumbled upon your post, I saw fit to write a short answer to your problems.
Prolonged shortness of breath (accompanied by other symptoms as for instance lightheadedness/dizziness and headaches) are sometimes caused by, as you stated, chronic hyperventilation. This means that you either inhale too deeply or inhale too frequently for a longer time. GERD is known to cause shortness of breath when acid reaches airways, but as I read your story I do not think GERD is the cause for your prolonged experiences with SOB.

Based on the relief you feel when taking supplements of which you believe they help, in combination with positive effects of exercise and the overall prolonged experience of symptoms, chronic hyperventilation does seem a reasonable explanation for what you're experiencing. This, as I read your story (no obvious signs of disease/malfunctions concerning heart or lungs) leads me to believe your problems are not physiological at base. It is known that anxiety and/or depression can influence breathing severely. These mental issues are not always obvious in daily life. Many people don't know they're going through such issues. Have you considered looking in this direction? If you keep experiencing the same symptoms in the same manner, it could be fruitful to consult a therapist.

Since it has been 6 months, may I ask how you're doing now? Have you noticed improvements? If so, how did you improve your situation?

Best regards and I hope this answer helps!

PS I am not a doctor. I have however read (way too many) studies concerning this specific issue.

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@chrisdh5- Welcome to Mayo Connect. You probably are unaware of how to look for replies and posts on Connect so I can reassure you that Gabriel's post was addressed, and by me! Do you have a history of shortness of breath?

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