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.

50 units of Lantus daily and 1000 mg of metformin daily.

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@yaramarthe

Hey could you please tell me the exact dose for those medicine you took because I’m going through this right now please answer if you see this

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I don't mind sharing at all, but again in full disclosure... I am NOT a doctor. Sheer desperation drove me to the internet in search of answers.

This is the article that I found so helpful and it includes the medication recommendations and possible dosages to try.
https://hoffmancentre.com/mast-cell-activation-syndrome-histamine-immune-system-runs-rampant/ As is suggested in the article, I use Zyrtec (ceterizine), Claritin (loratadine), PEPCID (famotadine) and quercetin all 2x a day. (Regarding Quercetin effectiveness- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314669/ )

I definitely recommend keeping your doctor involved in all medical decisions, for safety of course, but if for nothing else just so they can document improvement.

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@anned

Hi @gabrielm I have never posted on one of these forums before but your original post describing the inability to get a good deep breath or a satisfying yawn intrigued me and I thought I would share my experience.

I am 41F and had these health conditions long before this started for me:
Life-long chronic asthma (usually triggered by illness)
Non- allergic rhinitis (so many symptoms always negative allergy tests)
Migraines
Prone to viruses and infections since childhood

Then came the mysterious SOB, chest tightness and unsatisfying yawns from out of no where. Makes me miserable. Like difficulty focusing on anything else and exhausted from not even sleeping well because of it.

Pulmonologist/immunologist prescribed Prednisone which, I think, helped some but the miserable inability to breathe deeply came right back when the meds were gone. Back to the same Dr and she trys adding a new inhaler to my daily regimen. I want that to help so much but nope, I still can't get no satisfaction. Back to the same Dr who starts sending me for every test imaginable. Lungs, heart, ENT, allergies, CT scans, lung function, stress test, a gazillion labs. Honestly nothing is showing up, my asthma is not that severe and seems pretty well under control. The only exception are the labs for my immune system were not great. She confirmed that I had been properly vaccinated as a child and then said the tests showed some kind of immuno-dysfunction. So she sent me to get a test vaccine to see what would happen. First labs after that were fine, I still had immunity. My doctor all throughout this has been thorough and kind, she says we have to wait to see over time to see if I retain my new immunity.

The pulmonologist believes me regarding the breathing problem, which is something at least. She has me start steroid nasal rinses. If you haven't done those every morning, you are really missing out, let me tell you. The pulmonologist wonders could it be vocal chord dysfunction and sends me to a voice therapist while we wait to retest. The voice therapist is great and compares notes with the ENT but rules out VCD. She however suggests Prilosec in case it's GERD. Sure why not? I'm just a test subject now anyway.

Meanwhile, I am still miserable and feeling like I can't breathe well, even though the results of the all the tests so far show I'm supposedly fine. It's slightly comforting to know you aren't dying when it feels like you are. Discouraged and desperate. I started searching online for clues. I try breathing exercises, calming exercises. Changing diet. Making sure I am not stressed. Drinking more water. And searching the most remote forums of the medical internet. I find a lot of people complain of similar symptoms but no one has an answer. Such a mystery. And then one day, I stumbled on to something. The article talked about Mast Cell Activation Syndrome. I was like, oh great another one of those internet conditions that people use as an excuse for why they can't eat gluten or dairy or any other foods that people all over the globe have consistently eaten for millennia. Nope I definitely don't want to have that. But the symptoms list included a bunch of stuff that I had always struggled with AND the feeling like you couldn't get a satisfying breath. Consider me curious. Not enough to buy the books sold by internet doctors but definitely wondering if there was anything that others had found worked to help the breathing thing. Remarkably the treatment seemed consistent across multiple sites and it wasn't some kind of expensive supplement or exclusive diet. It was a regimen of antihistamines. What??? No way that would do anything. But gosh...it can't hurt to ask the Dr., right?

So when I went back for blood work the Dr asked how I was doing? I said I was still feeling that struggle to breathe deeply and I couldn't remember the last time I had a satisfying yawn. And she stopped what she was doing and said, "the mind and the body are very connected. What has been going on at home lately? Have you thought about seeing a therapist?" I was immediately so frustrated and felt tears welling up in my eyes. Not the best way to prove I was emotionally and mentally sound. Lol However I got myself together and firmly said, "Look everything at home is fine. Except me, because I feel like I can't breathe. And not being able to yawn, as freaking crazy as that sounds, is what is making me miserable and it's not the other way around at all. But I assured her I was willing to try ANYTHING and would call a therapist. However, I finally mustered up the nerve to tell her I also had an idea I wanted to run by her. So I told her about my internet research. And learning about MCAS. That is all the doctor's very favorite thing, when their patients google the things they spent years and years and years of their lives studying. I'm sure she was just patiently humoring me and didn't think it was going to work. But she agreed that the extra doses of antihistamines wouldn't be dangerous even if they didn't help.

So I went home and got my meds together. I decided to do Claritin, Zyrtec and Zantac (instead of Prilosec) twice a day and just see what would happen. Yeah that was before we knew about Zantac's evil cancer causing properties. I ended up switching that out for Pepcid. Honestly I don't think I had my hopes all that high that it was going to help and for the first couple days I don't think it did. But a few days in and started noticing a sneaky good yawn. Not every time, but just here and there, every so often I would feel that satisfaction of a really good deep breath. At first I thought it was a fluke. But by the second week, it was happening more and more often. Ahhhh. Relief. I could breathe fully again.

Going back to the pulmonologist, I was like there's no way she is going to believe me. But she did! She didn't have great news for me about my immunity. And she wanted to start me on treatment for that. But when I described how much the antihistamines were helping me, she was really glad for me. I said I didn't think it even made any sense why they would have worked and she said oh it actually does make sense to me and then some Dr mumbo jumbo or other. I was ready to ditch the new inhaler right then and there and she could see I obviously felt much better and she told me she was really glad but we'd continue all that we were doing for the time being and hope it kept working.
So... over a year later... I'm happy to say it's still working. I have had some brief times where my breathing has been a little sketchy but I think it is connected to allergic type triggers. And overall I am doing so much better!!!! I am still using the asthma meds and have also added quercetin twice daily and Nasal Crom spray as needed.

Obviously I'm not a doctor. But OMG it's working for me. Nothing in this post is speculating that anyone else has the same diagnosis as I do or that what my doctor and I have tried for me will help you. What I hope to convey with this post, is that your health is worth fighting for. If at first you don't succeed, keep trying until you get the answers you need. And if your doctor is unwilling to help you adequately, then find a new doctor. You are paying them and nobody has time for that crap.

I would be glad to answer any questions y'all might have for me.

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Is the yawning gone?

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@yaramarthe

Is the yawning gone?

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If you try this out could you come back on here and let me know if you’ve felt any improvements? Good-luck trying it out! I hope it does something!

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@yaramarthe

Try a different diet I wrote about how I started feeling like this I'm not even joking any other juice I drink makes me yawn food that are hard to chew makes me yawn junk food toothe only relief I've gotten so far is eating eggs and toast for breakfast and mangoes. and dinner I have rice and fish wild caught and I only use onions, leef, and ionized salt after that if I'm hungry later on eat a gluten free toast with butter and I drink oat milk. And I've been on this diet for a month and my yawning felt better I only yawn three times after my second meal and if I dare to eat at a restaurant or other food I it makes me short of breath and I start having the yawning issue my mouth stays open the whole time and the yawn won't come out last 20 minutes its really bad. I think being exposed to something toxic really messed me up and Idk what to do now I'm allergic to everything now

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I don’t know how it is that I am just now seeing your post, but man I get that yawning feeling too with my mouth having to stay open and nothing coming out/getting no relief.... it’s the worst, but paying attention to what I eat will be something I try out. 🥺

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I am gonna reply again with new info. This got really bad for me last month. I was put on hydroxyzine to help...It helped alot but its not the cure...and shouldnt be used daily. I went online and looked up eat right for your blood type and saw that I shouldnt eat chicken, wheat, corn or cashews. I cut it all out and have been able to breathe so much better. I hope this helps someone

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Hello everyone
I am desperate with a problem that I have had for about seven months. I have a throat problem with frequent swellings, weekly episodes of shortness of breath, and a feeling of plugged ears. Medical tests indicate that there is a problem with my immune system. Eosinophils are very high (4700) and I have a history of over ten years of skin allergies. I think these allergies have now mutated into my body, causing the symptoms I describe. Doctors in Colombia have not been able to help me. Tests also indicate that I have chronic gastritis and gastric reflux laryngitis. I have been prescribed proton pump inhibitors, allergy pills like cetirizine and loratadine, but the symptoms are getting worse. I am desperate because I feel that in one of these episodes of shortness of breath, something serious may happen to me. The feeling of a lump in the throat is exasperating, as well as the sensation of having wounds. When the inflammation and the sensation of wounds in the throat is strong, I get muscle aches in the neck and shoulders. I cannot speak for more than half an hour at a time because the sensation of inflammation is unbearable. I had endoscopy and nasolaryngoscopy, but they only show a little swelling.
no tumors or bumps have been found. Please, I need help, I don't know what to do or what treatment can help me. I have lab test results that I can share. (Although they are in Spanish, I don't think there is any difficulty in interpreting them). Thank you very much for your collaboration and God bless you.

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@jorgeolmedom

Hello everyone
I am desperate with a problem that I have had for about seven months. I have a throat problem with frequent swellings, weekly episodes of shortness of breath, and a feeling of plugged ears. Medical tests indicate that there is a problem with my immune system. Eosinophils are very high (4700) and I have a history of over ten years of skin allergies. I think these allergies have now mutated into my body, causing the symptoms I describe. Doctors in Colombia have not been able to help me. Tests also indicate that I have chronic gastritis and gastric reflux laryngitis. I have been prescribed proton pump inhibitors, allergy pills like cetirizine and loratadine, but the symptoms are getting worse. I am desperate because I feel that in one of these episodes of shortness of breath, something serious may happen to me. The feeling of a lump in the throat is exasperating, as well as the sensation of having wounds. When the inflammation and the sensation of wounds in the throat is strong, I get muscle aches in the neck and shoulders. I cannot speak for more than half an hour at a time because the sensation of inflammation is unbearable. I had endoscopy and nasolaryngoscopy, but they only show a little swelling.
no tumors or bumps have been found. Please, I need help, I don't know what to do or what treatment can help me. I have lab test results that I can share. (Although they are in Spanish, I don't think there is any difficulty in interpreting them). Thank you very much for your collaboration and God bless you.

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Hi @jorgeolmedom and welcome to Mayo Clinic Connect! I understand you have had a difficult 7 months trying to identify what is happening with your health and arrive at a diagnosis and care plan to improve your symptoms and quality of life.

You will notice that I have moved your post to another discussion to allow you to connect with members like @gabrielm @chrisdh5 @jenniferhunter @merpreb and @tonyagregg who have all had experience in some or all facets of your current symptoms who may be able to help you.

You said that the medication you are on is not helping and your symptoms have become worse. Have you consulted again recently with your care team to let them know of your current status and continuing health concerns?

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@jorgeolmedom

Hello everyone
I am desperate with a problem that I have had for about seven months. I have a throat problem with frequent swellings, weekly episodes of shortness of breath, and a feeling of plugged ears. Medical tests indicate that there is a problem with my immune system. Eosinophils are very high (4700) and I have a history of over ten years of skin allergies. I think these allergies have now mutated into my body, causing the symptoms I describe. Doctors in Colombia have not been able to help me. Tests also indicate that I have chronic gastritis and gastric reflux laryngitis. I have been prescribed proton pump inhibitors, allergy pills like cetirizine and loratadine, but the symptoms are getting worse. I am desperate because I feel that in one of these episodes of shortness of breath, something serious may happen to me. The feeling of a lump in the throat is exasperating, as well as the sensation of having wounds. When the inflammation and the sensation of wounds in the throat is strong, I get muscle aches in the neck and shoulders. I cannot speak for more than half an hour at a time because the sensation of inflammation is unbearable. I had endoscopy and nasolaryngoscopy, but they only show a little swelling.
no tumors or bumps have been found. Please, I need help, I don't know what to do or what treatment can help me. I have lab test results that I can share. (Although they are in Spanish, I don't think there is any difficulty in interpreting them). Thank you very much for your collaboration and God bless you.

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@jorgeolmedom- I'd also like to welcome you to Mayo Clinic Connect. We are patients helping other patients. I certainly empathize with you. You seem to be having a lot of symptoms that do need to be dealt with. First, let me tell you that unless you have a heart problem or other very serious organ problems you won't die from being short of breath.

How long ago did you have an endoscopy? The throat is a small area and any swelling will hurt a lot. Also, there are nerve endings there so it might also feel worse.

Can you get to another part of your Country or come to the US? Also, have you been tested for COVID-19?

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@amandajro

Hi @jorgeolmedom and welcome to Mayo Clinic Connect! I understand you have had a difficult 7 months trying to identify what is happening with your health and arrive at a diagnosis and care plan to improve your symptoms and quality of life.

You will notice that I have moved your post to another discussion to allow you to connect with members like @gabrielm @chrisdh5 @jenniferhunter @merpreb and @tonyagregg who have all had experience in some or all facets of your current symptoms who may be able to help you.

You said that the medication you are on is not helping and your symptoms have become worse. Have you consulted again recently with your care team to let them know of your current status and continuing health concerns?

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Hi Amanda, thank you for your response. I consulted last week with my doctor and she recommeded to take prednisolone, which is a treatment for allergies but it is not helping. I suspect that by reducing my eosinofils I could get better, but yet I have not received any treatment for that

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