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.

@merpreb

@bowker17- welcome to Mayo Clinic Connect. Good morning. Many of us, myself included have suffered from anxiety for a long time. When you start having shortness of breath it's time to get tested.
To rule out any physical changes I suggest you seek a pulmonologist and get your lungs tested> Have you had any tests, lab work or scans to see what might be causing this?

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good morning, no just got standard oxygen level check and blood pressure heart rate standard doctor check, one doctor said it was long covid symptoms after i got covid in february and another thinks its anxiety related, i get heart palpitations frequently but i think its anxiety aswell

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Sounds like costochondritis. I have costochondritis. I mightve had covid in March 2020. Not sure since my main symptom was shortness of breath and pressure on my chest. I also have endometriosis. And suspect thoracic endometriosis now. I'm a female. Age 35.

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I have Hiatal Hernia and GERD and SOB daily with similiar feelings. I still am not certain it is the GERD but have been reseraching. Look into non acidic reflux. There is growing data that indicate that the symptim from GERD is all necessarily related to the acid. Non acidic regurg and the vapors that escape from your stomach over a long period of time could be a culprit. This is not diagnosis just some directions to look into.

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@nooz1985

Sounds like costochondritis. I have costochondritis. I mightve had covid in March 2020. Not sure since my main symptom was shortness of breath and pressure on my chest. I also have endometriosis. And suspect thoracic endometriosis now. I'm a female. Age 35.

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My symptoms started in late Mar 2020. Either way any virus can trigger a chronic health issues.

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Hello @rak and welcome to Mayo Clinic Connect, a community of members who get and give support. It sounds as if you have been doing extensive research to identify what may be behind your symptoms. You mentioned the timing of your symptoms starting and I wonder if you think it was a result of COVID?

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Hi everyone,

My SOB started on January 31, 2021. It pretty much started out of the blue and it has been on since then with varying intensity and with a bunch of other symptoms such as general shallow breathing (this does not happen all the time), the inability to sigh or yawn completely (frequent), tightness of chest, general discomfort in chest (this is really hard to describe. I just have that "sicky" sensation in my chest as if I had bugs living inside...). I do not cough though.

I have seen doctors (family doctor and lung specialist), my chest x-ray test came back negative, lung function test is normal, blood test is normal. Since I did experience a little bit of heart burn initially as well, my doctor prescribed me Pantoprazole (40Mg, twice a day). Although this helped me with the heartburn, it did not really help with SOB and all the other symptoms.
I also use inhalers, Flovent once or twice a day and Ventolin occasionally. They seem to help a little but not completely and not consistently. Besides, I also use a peak flow meter regularly and the values I blow are quite normal and consistent (average 650). So given that the chest test and lung function test are normal, my doctors do not believe I have an asthma. They do not think it is beneficial for me to get a CT scan either because they do not believe I have any lung issue due to the negative test results described above.
My doctor suspects that my symptoms are related to anxiety. While I have had generalized anxiety disorder for a long time, I simply cannot see how my anxiety can all of a sudden cause me to have SOB constantly and so persistently for over two months now. Basically, what my doctor suggested that I try to take Cipralex (antidepressant) and if that does not help, he would consider referring me to an ENT and gastroenterologist.
Do you guys think it would be still a good idea to insist on having a CT scan to completely rule out any lung issue? Or would you say there is no point getting exposed to radiation given that all my other results are negative?
I would appreciate your thoughts and comments regarding my situation.

thank you

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@gabe79

Hi everyone,

My SOB started on January 31, 2021. It pretty much started out of the blue and it has been on since then with varying intensity and with a bunch of other symptoms such as general shallow breathing (this does not happen all the time), the inability to sigh or yawn completely (frequent), tightness of chest, general discomfort in chest (this is really hard to describe. I just have that "sicky" sensation in my chest as if I had bugs living inside...). I do not cough though.

I have seen doctors (family doctor and lung specialist), my chest x-ray test came back negative, lung function test is normal, blood test is normal. Since I did experience a little bit of heart burn initially as well, my doctor prescribed me Pantoprazole (40Mg, twice a day). Although this helped me with the heartburn, it did not really help with SOB and all the other symptoms.
I also use inhalers, Flovent once or twice a day and Ventolin occasionally. They seem to help a little but not completely and not consistently. Besides, I also use a peak flow meter regularly and the values I blow are quite normal and consistent (average 650). So given that the chest test and lung function test are normal, my doctors do not believe I have an asthma. They do not think it is beneficial for me to get a CT scan either because they do not believe I have any lung issue due to the negative test results described above.
My doctor suspects that my symptoms are related to anxiety. While I have had generalized anxiety disorder for a long time, I simply cannot see how my anxiety can all of a sudden cause me to have SOB constantly and so persistently for over two months now. Basically, what my doctor suggested that I try to take Cipralex (antidepressant) and if that does not help, he would consider referring me to an ENT and gastroenterologist.
Do you guys think it would be still a good idea to insist on having a CT scan to completely rule out any lung issue? Or would you say there is no point getting exposed to radiation given that all my other results are negative?
I would appreciate your thoughts and comments regarding my situation.

thank you

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My symptoms and story are extremely similar to yours. All my test are “normal”and I’ve been diagnosed with asthma (worsened by anxiety). Treatment so far has been very successful, yet I still produce thick, sticky “mystery” phlegm on most days without cough. My pulmonologist (one of the best in Atlanta) has scheduled me for my first CT scan next week. It’s been explained to me that a CT scan is helpful in diagnosing more severe forms of asthma. I’m actually doing MUCH better now and thought about canceling the scan, but for peace of mind I’m committed to it (if something else is in play, I want to know about it). You may want to ask for one ... it can’t hurt and I wouldn’t worry about radiation from this lone scan.

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Hello and welcome to Mayo Clinic Connect, @gabe79. Not having something to point to with regard to your SOB has to be really confusing and likely frustrating. I am glad you are here where other members can share their experiences and provide you with support.

I see that @otter2154 has already reached out to share with you.

It sounds like you are not convinced that your anxiety alone is likely responsible for your symptoms. I am wondering if you have contracted COVID at any point and/or been tested for antibodies? I am not a medical professional, however, it just feel like perhaps if it has come out of the blue, so to speak, it may be worth exploring given the amount of respiratory complications that follow.

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@otter2154

My symptoms and story are extremely similar to yours. All my test are “normal”and I’ve been diagnosed with asthma (worsened by anxiety). Treatment so far has been very successful, yet I still produce thick, sticky “mystery” phlegm on most days without cough. My pulmonologist (one of the best in Atlanta) has scheduled me for my first CT scan next week. It’s been explained to me that a CT scan is helpful in diagnosing more severe forms of asthma. I’m actually doing MUCH better now and thought about canceling the scan, but for peace of mind I’m committed to it (if something else is in play, I want to know about it). You may want to ask for one ... it can’t hurt and I wouldn’t worry about radiation from this lone scan.

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Thank you Otter2154 for your response and your advice regarding CT scan. You mentioned how the treatment has been successful which is amazing news. Do you mind sharing what the treatment entailed?

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@amandajro

Hello and welcome to Mayo Clinic Connect, @gabe79. Not having something to point to with regard to your SOB has to be really confusing and likely frustrating. I am glad you are here where other members can share their experiences and provide you with support.

I see that @otter2154 has already reached out to share with you.

It sounds like you are not convinced that your anxiety alone is likely responsible for your symptoms. I am wondering if you have contracted COVID at any point and/or been tested for antibodies? I am not a medical professional, however, it just feel like perhaps if it has come out of the blue, so to speak, it may be worth exploring given the amount of respiratory complications that follow.

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Hi Amanda, thank you so much.Yes I did get Covid late November 2020 (I totally forgot to mention this in my first post) but I only had very mild symptoms such as sore throat, headache, and fatigue. I did not have any breathing issues whatsoever at the time. These symptoms were gone within a week (by early December) or so and had no Covid related symptoms at all until the SOB surfaced on January 31, 2021. Doctors were not sure if this could be a case of long Covid. thank you

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