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.

@helpnywhereucan

Hello all! Wanted to pop in and share some information. I came down with SOB( named appropriately) after a cold. I struggled with thirst a few weeks prior but stupidly just tried to drink more water. Long story short my SOB got so bad I ended up in the ER. After blood work and chest scans I was sent home after being told I'm in great health other than a slight potassium deficiency. Years ago I had anxiety, gerd, fluid in my ears, allergies, insomnia...many of the symptoms you all mention but they all went away after I got my magnesium levels up. So I suspected my SOB was electrolyte related as well...more than likely the low potassium level was either brought on by or exacerbated the dehydration which messed with my electrolytes. They are really important when it comes to health. They control the body's acidity levels, heart rhythms, detoxification and a host of other things. The cold had worsened it all. I had refused the excessively high dose of potassium at the ER in favor of a slow and safer route which the ER doc okay'd because it was just slightly out of range. Potassium supplements can be dangerous as they can mess with your heart rhythms and I didn't want to end up back in the ER and I kind of know my body. I've always been sensitive to things. They gave me a list of potassium rich foods and I began incorporating them into my diet. Orange juice (I drink the low sugar version) is ridiculously high. Who knew? So are potatoes. I made smoothies with a banana, greens and hemp protein and I ate salads everyday. The lifestyle changes took a few weeks but I'm much better. Research electrolytes, nutritional deficiencies, and SOB. For many of us SOB can be helped by nutritional balancing. Sugar, caffeine, staying up at night on the computer etc, throws us off balance. A healthy diet, the proper amount of water, sleep etc. brings us back into balance. I also started a good multivitamin with vitamin C (it helps SOB), B vitamins and retinol. Not the drugstore version. I hate to see so many struggling with this awful condition. At one point I thought, I'd never have any quality of life. Stay hopeful, change your lifestyle. It gets better.

And use caution with supplements. Vitamins and minerals must remain in balance. Taking something in excess or without balance can mess things up. If you're not willing to research extensively, stick to foods and a good multivitamin. Thomas DeLauer and Morley Robbins have good articles on research that has been done in the fields of nutrition.
And one more thing...Keto and Paleo diets can also trigger electrolyte deficiencies.
Good luck everyone.

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@helpnywhereucan I have been ectremely short of breath lately. Thank you for this info. I will try these suggestions. I have been extremely short of breath lately. Thank you for this info. I will try these suggestions.

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Have you ever noticed that one nostril is partially blocked when when SOB happens?

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You are describing an issue I have been having EXACTLY. Yours is the only post about SOB the describes the deep breath getting "stuck" so preventing you from getting a satisfying full breath. Also, the fact that it comes and goes and is not associated with anxiety, it just happens randomly. And (although sometimes is worse than others) it is not unbearable SOB, I am able to live with it.

The weird thing is, all my tests are also normal except for a continuously slightly elevated bilirubin.

I am actually an ICU nurse so I have some knowledge about these things, and if a patient asked me about a correlation between SOB and bilirubin, I would also probably brush it off as anxiety. But since I know my symptoms are not anxiety related, I don't know what to think. It is not a normal clinical picture.

My theory right now is actually that the SOB is musculoskeletal in origin. I also have some minor upper back and rib slipping issues - and since your ribs play a crucial role in lung expansion, I thought maybe it has something to do with it. I find the most relief from the deep breaths getting "stuck" when I put athletic tape on my sides and physically pull on the tape outwards (while also leaning forward) to help my lungs expand. It's the only thing I can do to help if I want to take a deep breath.

Another (lesser, but still possible) theory is subconscious panic issues. It is possible to have physiological panic attacks even when you do not actually think you "feel" anxious. It has more to do with some kind of issue in your amygdala - making it a neuro issue. This would involve extensive neurological testing that still might not even result in a conclusive answer. (I have heard of people having this issue correlated with spontaneous anger issues as well - since the amygdala sort of controls emotions).

I have no answer at this point. But I was struck by our similar symptoms and the elevated bilirubin. The bilirubin is not something I have thought too much about.

Have you ever had any back/rib/sternal pain? Or anger problems?

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@ilikeearthtones- Good morning and welcome to Mayo Connect. My son had bilirubin when he was born. I had a yellowish tint to his skin. Bilirubin in cases of severe liver problems can cause SOB.
Here is some infor about this https://pmj.bmj.com/content/postgradmedj/73/865/759.full.pdf

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@windwalker

@helpnywhereucan I have been ectremely short of breath lately. Thank you for this info. I will try these suggestions. I have been extremely short of breath lately. Thank you for this info. I will try these suggestions.

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@windwalker- Terri I'm sorry to hear this. Have you been to the doctor? What do you think might be causing this?

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@saigurucharan

Have you ever noticed that one nostril is partially blocked when when SOB happens?

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@saigurucharan No. I do not have that issue of one blocked nostril.

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@merpreb

@windwalker- Terri I'm sorry to hear this. Have you been to the doctor? What do you think might be causing this?

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@merpreb Hi Merry. Thank you for your concern, but I am no stranger to SOB. It gets worse when the humidity levels rise. It is more difficult for me to move warm, thicker air in and out of my lungs. This is not uncommon for people with bronchiectasis, COPD, etc. I go back to the Mayo on June 5 & 6 for my annual lung function tests and cts. I usually do step up my game with more diligent breathing treatments with albuteriol, sodium chloride, and Tobramycin. Really, it's just the nature of the beast. I am also trying to be mindful of hydrating more.

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@windwalker- Terri- Because of my lung cancer I hate the humidity. It's like breathing through water. I'm housebound so much of the time in the summer. But I have new Pulmonologist and they promise to help me be more active! I get my next CT scan in early July at MGH. I hear you- it is the nature of the beast

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@ilikeearthtones

You are describing an issue I have been having EXACTLY. Yours is the only post about SOB the describes the deep breath getting "stuck" so preventing you from getting a satisfying full breath. Also, the fact that it comes and goes and is not associated with anxiety, it just happens randomly. And (although sometimes is worse than others) it is not unbearable SOB, I am able to live with it.

The weird thing is, all my tests are also normal except for a continuously slightly elevated bilirubin.

I am actually an ICU nurse so I have some knowledge about these things, and if a patient asked me about a correlation between SOB and bilirubin, I would also probably brush it off as anxiety. But since I know my symptoms are not anxiety related, I don't know what to think. It is not a normal clinical picture.

My theory right now is actually that the SOB is musculoskeletal in origin. I also have some minor upper back and rib slipping issues - and since your ribs play a crucial role in lung expansion, I thought maybe it has something to do with it. I find the most relief from the deep breaths getting "stuck" when I put athletic tape on my sides and physically pull on the tape outwards (while also leaning forward) to help my lungs expand. It's the only thing I can do to help if I want to take a deep breath.

Another (lesser, but still possible) theory is subconscious panic issues. It is possible to have physiological panic attacks even when you do not actually think you "feel" anxious. It has more to do with some kind of issue in your amygdala - making it a neuro issue. This would involve extensive neurological testing that still might not even result in a conclusive answer. (I have heard of people having this issue correlated with spontaneous anger issues as well - since the amygdala sort of controls emotions).

I have no answer at this point. But I was struck by our similar symptoms and the elevated bilirubin. The bilirubin is not something I have thought too much about.

Have you ever had any back/rib/sternal pain? Or anger problems?

Jump to this post

Is your air trapping happening on the inhale or exhale? Mine happens when I go to exhale. This is due to having COPD. Other lung diseases can also give you problems with air trapping or impede the ability to breathe normally, for example diaphragm issues. Air trapping can cause that SOB feeling, as well as panic/anxiety attacks. These attacks often occur with patients who have lung issues, and it is a result of a malfunction in the brain. A misfiring of neurons in the brain if you will. They don't know why this happens, but it does. I was told by a Mayo dr that the feeling of oxygen deprivation is the brain not registering the oxygen. I had one such attack and it landed me in the hospital for three days. I feel certain that deep seated subconscious things can bring on these symptoms as well. If you suspect that is your case; you may want to look into hypnotherapy.

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@merpreb

@windwalker- Terri- Because of my lung cancer I hate the humidity. It's like breathing through water. I'm housebound so much of the time in the summer. But I have new Pulmonologist and they promise to help me be more active! I get my next CT scan in early July at MGH. I hear you- it is the nature of the beast

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@merpreb I hibernate all summer long. I have started teaching art lessons two months ago (painting for beginners). So, that will give me something to do and have a social life as well. It has been fun so far. I am going to Tuscson & Vegas for a week to ten days next month; so the dry air will be a nice change also. Then, hopefully a trip to Maine & Toronto to visit a friends in August.

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