1. < Lung Health
Mentor

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.

sal51 | @sal51 | Apr 13, 2021

I am a physician with knowledge of the condition many posters experience- knowledge based on seeing patients with it and experiencing it myself. I have previously posted but realize many haven't read all the posts. This post concerns those who have dyspnea/shortness of breath concerns that are unexplained after extensive evaluation and doesn't refer to those who are determined to have a cardiac or pulmonary cause. The general term given is dysfunctional breathing and there are different forms. The classic example is patients who hyperventilate (breath rapidly in excess of a normal rate of breathing); many posters experience air hunger or the feeling of not obtaining enough air which prompts them to take exaggerated inspirations/deep sighs; many mention yawning which is typical.
The exact underlying cause of this condition is not clear. It is generally agreed that there is a derangement in the ventilatory drive which is the natural control mechanism of breathing. There is an idea that you can become overly sensitive to CO2 leading to the increased ventilation rate or depth. There are various factors that impact the ventilatory drive but there are certainly psychological aspects to it which is why anxiety is often suggested as an underlying cause but it may not be as simple as someone being anxious and therefore short of breath. In my case, I have found underlying psychological stress about something to often be a factor. I feel many on here take issue with the introduction of a psychological basis for this symptom and perceive the doctor as blowing them off but it is a valid consideration, particularly when test after test for organic disease is reassuring. The fact that the condition may have origins psychologically should not be taken to mean the condition is not real because it definitely is and there are many somatic manifestations (physical symptoms) of psychiatric disease that are just as real as symptoms that have an organic basis.
Unfortunately, the general knowledge of this condition is lacking among most practitioners which leads to frustration in those experiencing it because it is difficult for most doctors to address patients who are so symptomatic but yet have no abnormalities on normal tests.
There is no agreed upon treatment and when you read through the posts, there are a wide variety of responses to a wide variety of treatments. Some have reflux and improve with treatment; some mention psychiatric medications; some do breathing exercises, some take various vitamins/supplements.
I suspect the most important aspect of improving is acceptance of the condition and a belief in whatever treatment that is pursued. The fact that typical tests are normal should provide reassurance- I understand that for many, normal tests leave them with unanswered questions/ wondering what's wrong but it is a good thing to not have heart or lung issues.
Some mention having had COVID as did I and breathlessness is one of the symptoms of long COVID so it will be interesting to see how this plays out as the understanding regarding COVID and its effects on people are better studied/understood. The primary question I would have is if you can see breathlessness in long COVID in patients who did not have lung involvement when they were actually sick with COVID.

REPLY
5 replies
j178452 | @j178452 | Apr 13, 2021
In reply to @itsnotanxiety "Just wanted to update all you guys, I had the first dose of the covid vaccine..." + (show)
@itsnotanxiety

Just wanted to update all you guys, I had the first dose of the covid vaccine (Pfizer) two days ago and am feeling better than ever.

I've been taking pantoprazole and famotidine for about 3 1/2 months now and felt a lot of relief with my throat tightness, and a bit with breathing and frequent yawning but it never completely kicked it.

I think I wrote a few months ago saying that all these symptoms (shortness of breath, excessive yawning) started after a case of viral pneumonia/chest infection after a friend/co-worker of mine traveled overseas to a wedding with people showing up from all across the world, came back and gave it to me and everyone he was around, I suspect it was covid. This was December of 2019. Never was able to get an antibody test because my doctor recommended against it saying at the time (early on in the pandemic) that they were not reliable and most likely last only a few weeks to maybe a couple of months. Interested to hear if anyone else has had the vaccine and felt better (?)

Jump to this post

I have had first shot of Pfizer and it’s made no significant different with my SOB and yawning symptoms. Glad you’re feeling better though!

REPLY
j178452 | @j178452 | Apr 13, 2021
In reply to @gabe79 "I do have dry cough every now and then, but just because it happens so rarely,..." + (show)
@gabe79

I do have dry cough every now and then, but just because it happens so rarely, I did not think much about it/did not take it seriously.

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Interestingly, I never had a dry cough prior to this daily SOB, but I did have SOB randomly for years now that I think about...only maybe once every couple of months though.

REPLY
j178452 | @j178452 | Apr 13, 2021
In reply to @gabe79 "I did not have asthma when I was a kid or later in life until this..." + (show)
@gabe79

I did not have asthma when I was a kid or later in life until this (sob) showed up 2. 5 months ago. My doctors do not believe this is asthma because 1. my lung function test (spirometry) was normal 2. i produce normal and consistent results on my peak flow meter (average 650), and 3. i have my symptoms at rest and not on exertion.
I live in Canada, northwest, in a very different climate than southwest.
No bilirubin, iron, or allergy test yet.

Jump to this post

Interesting. Thanks for sharing. If you can, try getting bilirubin and iron tested and if you’re comfortable with it, let us know if anything off the chart. Since someone else mentioned high bilirubin and I too have it I’m curious if you may as well. Ultimately we’ve got to be able to find a common denominator or clue as to what’s going on, which maybe will help with a diagnosis or at least treatment that will bring relief.

REPLY
j178452 | @j178452 | Apr 13, 2021
In reply to @sal51 "I am a physician with knowledge of the condition many posters experience- knowledge based on seeing..." + (show)
@sal51

I am a physician with knowledge of the condition many posters experience- knowledge based on seeing patients with it and experiencing it myself. I have previously posted but realize many haven't read all the posts. This post concerns those who have dyspnea/shortness of breath concerns that are unexplained after extensive evaluation and doesn't refer to those who are determined to have a cardiac or pulmonary cause. The general term given is dysfunctional breathing and there are different forms. The classic example is patients who hyperventilate (breath rapidly in excess of a normal rate of breathing); many posters experience air hunger or the feeling of not obtaining enough air which prompts them to take exaggerated inspirations/deep sighs; many mention yawning which is typical.
The exact underlying cause of this condition is not clear. It is generally agreed that there is a derangement in the ventilatory drive which is the natural control mechanism of breathing. There is an idea that you can become overly sensitive to CO2 leading to the increased ventilation rate or depth. There are various factors that impact the ventilatory drive but there are certainly psychological aspects to it which is why anxiety is often suggested as an underlying cause but it may not be as simple as someone being anxious and therefore short of breath. In my case, I have found underlying psychological stress about something to often be a factor. I feel many on here take issue with the introduction of a psychological basis for this symptom and perceive the doctor as blowing them off but it is a valid consideration, particularly when test after test for organic disease is reassuring. The fact that the condition may have origins psychologically should not be taken to mean the condition is not real because it definitely is and there are many somatic manifestations (physical symptoms) of psychiatric disease that are just as real as symptoms that have an organic basis.
Unfortunately, the general knowledge of this condition is lacking among most practitioners which leads to frustration in those experiencing it because it is difficult for most doctors to address patients who are so symptomatic but yet have no abnormalities on normal tests.
There is no agreed upon treatment and when you read through the posts, there are a wide variety of responses to a wide variety of treatments. Some have reflux and improve with treatment; some mention psychiatric medications; some do breathing exercises, some take various vitamins/supplements.
I suspect the most important aspect of improving is acceptance of the condition and a belief in whatever treatment that is pursued. The fact that typical tests are normal should provide reassurance- I understand that for many, normal tests leave them with unanswered questions/ wondering what's wrong but it is a good thing to not have heart or lung issues.
Some mention having had COVID as did I and breathlessness is one of the symptoms of long COVID so it will be interesting to see how this plays out as the understanding regarding COVID and its effects on people are better studied/understood. The primary question I would have is if you can see breathlessness in long COVID in patients who did not have lung involvement when they were actually sick with COVID.

Jump to this post

Really appreciate you taking the time to post this since I did not read your previous post/s. Most of the doctors I’ve seen that say anxiety shoo me out of the office quickly and make me feel like I’m losing my mind TBH.

Hopefully if the medical community is studying SOB In relation to long haul effects of COVID perhaps they will stumble on something helpful for those of us with non-COVID related SOB.

I just started therapy with a specialist that helps with anxiety so perhaps this will have some positive effect.

Are there any treatments you specifically recommend?

REPLY
peterson | @peterson | Apr 13, 2021
In reply to @sal51 "I am a physician with knowledge of the condition many posters experience- knowledge based on seeing..." + (show)
@sal51

I am a physician with knowledge of the condition many posters experience- knowledge based on seeing patients with it and experiencing it myself. I have previously posted but realize many haven't read all the posts. This post concerns those who have dyspnea/shortness of breath concerns that are unexplained after extensive evaluation and doesn't refer to those who are determined to have a cardiac or pulmonary cause. The general term given is dysfunctional breathing and there are different forms. The classic example is patients who hyperventilate (breath rapidly in excess of a normal rate of breathing); many posters experience air hunger or the feeling of not obtaining enough air which prompts them to take exaggerated inspirations/deep sighs; many mention yawning which is typical.
The exact underlying cause of this condition is not clear. It is generally agreed that there is a derangement in the ventilatory drive which is the natural control mechanism of breathing. There is an idea that you can become overly sensitive to CO2 leading to the increased ventilation rate or depth. There are various factors that impact the ventilatory drive but there are certainly psychological aspects to it which is why anxiety is often suggested as an underlying cause but it may not be as simple as someone being anxious and therefore short of breath. In my case, I have found underlying psychological stress about something to often be a factor. I feel many on here take issue with the introduction of a psychological basis for this symptom and perceive the doctor as blowing them off but it is a valid consideration, particularly when test after test for organic disease is reassuring. The fact that the condition may have origins psychologically should not be taken to mean the condition is not real because it definitely is and there are many somatic manifestations (physical symptoms) of psychiatric disease that are just as real as symptoms that have an organic basis.
Unfortunately, the general knowledge of this condition is lacking among most practitioners which leads to frustration in those experiencing it because it is difficult for most doctors to address patients who are so symptomatic but yet have no abnormalities on normal tests.
There is no agreed upon treatment and when you read through the posts, there are a wide variety of responses to a wide variety of treatments. Some have reflux and improve with treatment; some mention psychiatric medications; some do breathing exercises, some take various vitamins/supplements.
I suspect the most important aspect of improving is acceptance of the condition and a belief in whatever treatment that is pursued. The fact that typical tests are normal should provide reassurance- I understand that for many, normal tests leave them with unanswered questions/ wondering what's wrong but it is a good thing to not have heart or lung issues.
Some mention having had COVID as did I and breathlessness is one of the symptoms of long COVID so it will be interesting to see how this plays out as the understanding regarding COVID and its effects on people are better studied/understood. The primary question I would have is if you can see breathlessness in long COVID in patients who did not have lung involvement when they were actually sick with COVID.

Jump to this post

It is nice to hear the input of a doctor with asthma thank you

REPLY
peterson | @peterson | Apr 13, 2021
In reply to @j178452 "I don’t produce phlegm either. Do you have a random dry cough that pops up every..." + (show)
@j178452

I don’t produce phlegm either. Do you have a random dry cough that pops up every so often? I never had this and I randomly do every couple weeks or so...but I only cough like 1-2 times total in a day.

Jump to this post

Hi, I work in the healthcare field and I was tested twice weekly for COVID and I have had the vaccine so I don’t think that I caught COVID. I haven’t had my bilirubin tested and I do live in the South West where the weather is dry. When you have a asthma exacerbation does your heart rate still stay slow? How many beats per minute do you have?

REPLY
1 reply
j178452 | @j178452 | Apr 14, 2021
In reply to @peterson "Hi, I work in the healthcare field and I was tested twice weekly for COVID and..." + (show)
@peterson

Hi, I work in the healthcare field and I was tested twice weekly for COVID and I have had the vaccine so I don’t think that I caught COVID. I haven’t had my bilirubin tested and I do live in the South West where the weather is dry. When you have a asthma exacerbation does your heart rate still stay slow? How many beats per minute do you have?

Jump to this post

Hi there, when I get SOB (which today has been on and off all day/night) my bpm varies...it’s been as low as low 60s/high 50s but also 70s-80s. When sitting it jumps around sometimes from lower to higher end. Oxygen level at around 97-99%.

With that said, I don’t track it too much because I’ll admit just watching it gave me anxiety in the past when it dipped really low, which was often.

My doctor said my low bpm was fine for my size/age/gender though. Heart rate was low too if I remember correctly.

In past during anxiety attacks my heart would race, chest would feel tight, and I’d have SOB. I don’t really get that anymore. My heart rate doesn’t go up but sometimes has abnormal beats I notice which cardiologist acknowledged. My chest doesn’t really feel tight. Just SOB and can’t get deep breath and lots of yawning trying to get deep breath.

What about you for bpm and heart rate?

REPLY
Merry, Alumni Mentor | @merpreb | Apr 14, 2021
In reply to @sal51 "I am a physician with knowledge of the condition many posters experience- knowledge based on seeing..." + (show)
@sal51

I am a physician with knowledge of the condition many posters experience- knowledge based on seeing patients with it and experiencing it myself. I have previously posted but realize many haven't read all the posts. This post concerns those who have dyspnea/shortness of breath concerns that are unexplained after extensive evaluation and doesn't refer to those who are determined to have a cardiac or pulmonary cause. The general term given is dysfunctional breathing and there are different forms. The classic example is patients who hyperventilate (breath rapidly in excess of a normal rate of breathing); many posters experience air hunger or the feeling of not obtaining enough air which prompts them to take exaggerated inspirations/deep sighs; many mention yawning which is typical.
The exact underlying cause of this condition is not clear. It is generally agreed that there is a derangement in the ventilatory drive which is the natural control mechanism of breathing. There is an idea that you can become overly sensitive to CO2 leading to the increased ventilation rate or depth. There are various factors that impact the ventilatory drive but there are certainly psychological aspects to it which is why anxiety is often suggested as an underlying cause but it may not be as simple as someone being anxious and therefore short of breath. In my case, I have found underlying psychological stress about something to often be a factor. I feel many on here take issue with the introduction of a psychological basis for this symptom and perceive the doctor as blowing them off but it is a valid consideration, particularly when test after test for organic disease is reassuring. The fact that the condition may have origins psychologically should not be taken to mean the condition is not real because it definitely is and there are many somatic manifestations (physical symptoms) of psychiatric disease that are just as real as symptoms that have an organic basis.
Unfortunately, the general knowledge of this condition is lacking among most practitioners which leads to frustration in those experiencing it because it is difficult for most doctors to address patients who are so symptomatic but yet have no abnormalities on normal tests.
There is no agreed upon treatment and when you read through the posts, there are a wide variety of responses to a wide variety of treatments. Some have reflux and improve with treatment; some mention psychiatric medications; some do breathing exercises, some take various vitamins/supplements.
I suspect the most important aspect of improving is acceptance of the condition and a belief in whatever treatment that is pursued. The fact that typical tests are normal should provide reassurance- I understand that for many, normal tests leave them with unanswered questions/ wondering what's wrong but it is a good thing to not have heart or lung issues.
Some mention having had COVID as did I and breathlessness is one of the symptoms of long COVID so it will be interesting to see how this plays out as the understanding regarding COVID and its effects on people are better studied/understood. The primary question I would have is if you can see breathlessness in long COVID in patients who did not have lung involvement when they were actually sick with COVID.

Jump to this post

@sal51- Good morning doctor and thank you once again for saving the day with reassuring knowledge and personal experience. It stands to reason that if tests are confirming that there is no illness or disease that causes SOB that it is in the mind. It's definitely not reassuring and difficult to accept that our minds might be working behind our backs! How can people who have COVID-19 not have lung involvement or damage?

REPLY
1 reply
Merry, Alumni Mentor | @merpreb | Apr 14, 2021
In reply to @gabe79 "Sorry just one more comment. It seems like your symptoms are very similar to mine. And..." + (show)
@gabe79

Sorry just one more comment. It seems like your symptoms are very similar to mine. And all my doctors, even my pulmo friend think this is (most likely) anxiety related. Now this is my question: is it really possible that anxiety will trigger this condition from one min to another so much so that I will experience it pretty much constantly and chronically with varying intensity?? I am no doctor but i would think anxiety could only cause me to have occasional, intermittent symptoms depending on the level of anxiety. Since my SOB started 2.5 months ago, there has not been a single day when I was symptom free. Even on the best days, I can always tell that this issue is still there living inside me even if the symptoms are tolerable. Has anyone heard of cases when it was confirmed that anxiety was responsible for long term/chronic SOB (perhaps to the patient's suprise)?
My family dr suggested antidepressants treatment and as much as I wish it would resolve the issue, I simply cannot rationally believe it would and I am afraid it will be a waste of time.

Jump to this post

@gabe79- Good morning, it's nice to meet you. I know that it's very difficult to think that our minds work so secretly behind our backs. I think that because the medical community really doesn't have a defined cause for SOB that it would benefit all of us to keep an open mind.

If you were to take an antidepressant or other similar medications to help your SOB how would that be a waste of time? WHy not exhaust all possibilities?

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