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.

I have had this for 10 years now. No doctor has been able to diagnose it or help me at all. I can only give my experience and thoughts.
I am fairly certain it is the hiatal hernia. You sound healthy otherwise, which means it is probably a mechanical issue. It is pulling your stomach into a position where it is blocking your lungs. The reason the Buteyko breathing helps is because the movement of the diaphragm is helping your stomach drop down, creating space for your lungs. I guess it would be classified as a "sliding" hiatal hernia as it moves in and out of the esophagus, which is why it comes and goes.
I got mine 10 years ago from deadlifting. Put the bar down, and suddenly I couldn't take a deep breath. Went to multiple doctors and none of them could give me an answer. 5 years later I looked into hiatal hernias and it seemed the most likely cause. Got an endoscopy and they found a small one. Doctors have been dismissive of it being the cause, but apparently the stomach being out of position by even a small amount can cause numerous issues. Also I have been experimenting with different stretches, exercises and diet changes and I am pretty sure it is the cause.
I wish I could give you some hope, but I am still trying to figure it out as well. It seems to be uncharted territory. I've heard some say it can only be fixed through surgery, and others who say they managed to fix theirs. I don't know. But definitely look into it. it could be a number of different things but a hiatal hernia seems to be the simplest explanation.
From my experience: watch out for fatty foods (burgers, oils, butter, nuts, nut butters, etc) as digestion takes longer, leaving the valve at the top of the stomach open. Experiment with different exercises and see what triggers it (for me, squats and lifting things over my head triggers it). BE SURE TO BREATH OUT WHEN LIFTING- that's how I got mine, I was holding my breath while deadlifting and the pressure formed the hernia. Grunting/forcefully exhaling air helps. Leg raises while lying on your back, as well as Windshield Wipers (watch your lower back/be careful) seem to be effective ways to release the stomach for me. Apple cider vinegar mixed with a small amount of water also helps. That's just a few of the things I have found that help me.
You can find a lot more info around the internet. There is also a book by Theodore Baroody on hiatal hernias on Amazon.
Definitely something to look into. Hiatal hernias are apparently common and manifest in people in different ways. Hope this helps.

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@rj5x6000- Good morning and welcome to Mayo Clinic Connect. Ten years is a long time to have SOB. How did you figure out what caused it? Are you talking about exercise-induced asthma? I agree that Hiatal hernias are culprits a lot of times. So is being overweight, GERD, lung illnesses, and heart diseases. It seems that since this topic was opened it's been ubiquitous. I'm often at loss for words because there are so many reasons that it's difficult to pinpoint one possible "reason". I agree about Buteyko breathing. Also breathing exercises that can help strengthen up your diagram, back muscles and chest muscles that help open up the chest are beneficial.
https://www.youtube.com/watch?v=pOAL4u_u9GI (be curious about her other videos for this on her youtube site)

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@merpreb

@seancannan- Hello and welcome to Mayo Clinic Connect. This discussion is loaded with tips and all sorts of possible remedies. Will your wife be able to read them herself? This way she can respond or ask questions to people who are experiencing the same things. I can understand that she feels that she is losing her mind. What was she doing around the time that this started?

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I will have her make an account and she will be on. She has been to Primary care, pulmonologist, allergist, emergency room, urgent care. Every medication under the sun.

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@seancannan

I will have her make an account and she will be on. She has been to Primary care, pulmonologist, allergist, emergency room, urgent care. Every medication under the sun.

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@seancannan- That's great. Please have her read as many posts as she can.

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@rj5x6000

I have had this for 10 years now. No doctor has been able to diagnose it or help me at all. I can only give my experience and thoughts.
I am fairly certain it is the hiatal hernia. You sound healthy otherwise, which means it is probably a mechanical issue. It is pulling your stomach into a position where it is blocking your lungs. The reason the Buteyko breathing helps is because the movement of the diaphragm is helping your stomach drop down, creating space for your lungs. I guess it would be classified as a "sliding" hiatal hernia as it moves in and out of the esophagus, which is why it comes and goes.
I got mine 10 years ago from deadlifting. Put the bar down, and suddenly I couldn't take a deep breath. Went to multiple doctors and none of them could give me an answer. 5 years later I looked into hiatal hernias and it seemed the most likely cause. Got an endoscopy and they found a small one. Doctors have been dismissive of it being the cause, but apparently the stomach being out of position by even a small amount can cause numerous issues. Also I have been experimenting with different stretches, exercises and diet changes and I am pretty sure it is the cause.
I wish I could give you some hope, but I am still trying to figure it out as well. It seems to be uncharted territory. I've heard some say it can only be fixed through surgery, and others who say they managed to fix theirs. I don't know. But definitely look into it. it could be a number of different things but a hiatal hernia seems to be the simplest explanation.
From my experience: watch out for fatty foods (burgers, oils, butter, nuts, nut butters, etc) as digestion takes longer, leaving the valve at the top of the stomach open. Experiment with different exercises and see what triggers it (for me, squats and lifting things over my head triggers it). BE SURE TO BREATH OUT WHEN LIFTING- that's how I got mine, I was holding my breath while deadlifting and the pressure formed the hernia. Grunting/forcefully exhaling air helps. Leg raises while lying on your back, as well as Windshield Wipers (watch your lower back/be careful) seem to be effective ways to release the stomach for me. Apple cider vinegar mixed with a small amount of water also helps. That's just a few of the things I have found that help me.
You can find a lot more info around the internet. There is also a book by Theodore Baroody on hiatal hernias on Amazon.
Definitely something to look into. Hiatal hernias are apparently common and manifest in people in different ways. Hope this helps.

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rjx6000.. I too have a hiatal hernia and had gerd so bad. I went thru a lot of meds before the dr put me on one that really helped it. I also had a pain on my side off and on and that finally went away too. I'm stitting here trying to think what the name of the med was...... Anyway right now i am just on prilosec twice a day and things have been pretty calm....... I do also take align once a day, that helps too and that is over the counter med. As for the shortness of breath wish I could help you with that , I do have it but mine is contributed to COPD , Keep going to the dr and say I want answers and if he can't help you then go to another one. We know when things aren't right with us and want answers.......... Best of luck to you. I can try to find what med the dr put me on....... Not saying it will help you but it helped me........

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Am I relieved to see this forum! I've been Googling for the past fortnight with no relief - felt like I was being a drama queen. I'm a healthy 25 year old, generally exercising quite intensively 4-5 days a week with no underlying health conditions, never had heartburn or anything like that before. Although I've recently had a faecal calprotectin stool test come back, which was 280 when the upper limit is only 50. But I'm not sure this relates to my current condition?

It started over a fortnight ago, it'd usually only start up after dinner in the evenings, especially when lying on my back. But it has since progressed to constant throughout the day, however, it's generally a bit better in the morning and worse in the evenings. The sensation feels like I constantly need to gulp air, but quite often it doesn't 'connect' and this then leads me to slightly panic. I went to A&E 2 days ago as I was worried it was a heart or lung issue, they conducted an ECG, chest X-ray, blood work, oxygen and an assessment of my breathing. Everything was completely fine, no abnormalities or anything wrong - hence I felt like a bit of a full, the doctor said 'sometimes we psychologically think we aren't getting the breath, and we panic more' but it isn't that. I really do feel like I NEED that deep breath, it's so constant that my jaw has become really painful from all the yawning.

I've registered for a temporary GP (I'm back home and nowhere near my own GP) and have an appointment tomorrow. Any tips as to what to ask them to test me for or to assess? I'm really pulling my hair out, I want to go back to exercising and just feeling active and energised again. Right now I just feel constantly fatigued, like I constantly need to yawn, feel slightly nauseous in my stomach, lightheaded if I get up too quickly from sitting / lying down. Any feedback would be greatly appreciated!

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@alexm1994

Am I relieved to see this forum! I've been Googling for the past fortnight with no relief - felt like I was being a drama queen. I'm a healthy 25 year old, generally exercising quite intensively 4-5 days a week with no underlying health conditions, never had heartburn or anything like that before. Although I've recently had a faecal calprotectin stool test come back, which was 280 when the upper limit is only 50. But I'm not sure this relates to my current condition?

It started over a fortnight ago, it'd usually only start up after dinner in the evenings, especially when lying on my back. But it has since progressed to constant throughout the day, however, it's generally a bit better in the morning and worse in the evenings. The sensation feels like I constantly need to gulp air, but quite often it doesn't 'connect' and this then leads me to slightly panic. I went to A&E 2 days ago as I was worried it was a heart or lung issue, they conducted an ECG, chest X-ray, blood work, oxygen and an assessment of my breathing. Everything was completely fine, no abnormalities or anything wrong - hence I felt like a bit of a full, the doctor said 'sometimes we psychologically think we aren't getting the breath, and we panic more' but it isn't that. I really do feel like I NEED that deep breath, it's so constant that my jaw has become really painful from all the yawning.

I've registered for a temporary GP (I'm back home and nowhere near my own GP) and have an appointment tomorrow. Any tips as to what to ask them to test me for or to assess? I'm really pulling my hair out, I want to go back to exercising and just feeling active and energised again. Right now I just feel constantly fatigued, like I constantly need to yawn, feel slightly nauseous in my stomach, lightheaded if I get up too quickly from sitting / lying down. Any feedback would be greatly appreciated!

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Hey there - Sorry to hear about your SOB trouble. This is something that I've been dealing with for the last 6 months and I've tried everything under the sun to relieve my symptoms. Some theories you'll find in this thread include: GERD (very commonly referenced), anxiety/depression, hiatal hernia, hyperventilation disorders, asthma, allergies, vitamin deficiencies, or maybe even just forgetting how to breath. From what I've seen nobody has come up with a 'cure all' to completely remedy the issue. I'm right there with you when it comes your jaw hurting from yawning all the time. It's exhausting. Everyone in this thread could be suffering from a different issue since SOB is a symptom of dozens if not hundreds of conditions. My doctor put me on Lexapro... thinking it was anxiety related and it didn't help at all. Then I started taking Omeperazole under the idea that this might be reflux/GERD related. I will say that while I still have SOB it is significantly better now than in the first month when I was having panic attacks. I think the realization that you're not dying definitely helps to relax. A few other things that I've found helpful when your symptoms are at their worst are breathing methods (Buteyko Breathing, Wim Hof Breathing Method). When I'm on the verge of panic these techniques can really help... they're available on Youtube. Additionally, your lungs are primarily in your back so laying down and sitting down can make thing worse. During a bad spell you can lay on your stomach with a pillow under your stomach. I tend to find this helps relieve my immediate symptoms. I've also been doing a lot of stretches that help to stretch out the upper back. Try out the Child's Pose in Yoga. I tend to find my breathing is easier when I'm in that position and it can carry over to when I'm standing again. I would also recommend asking your doctor for an anti-anxiety medication such as Clonazepam. But ask for it with the intention of never taking it. It's meant for panic attacks but honestly it's just comforting to know that you have something available if things get out of hand. I've never taken them but having them in the house comforts me and potentially prevents panic attacks because I know I have an emergency medication. Hope this isn't too much information for you but hopefully it's a start to getting things under control. Just don't give up and keep experimenting with different foods, routines, exercises, stretches, and whatever you can do to keep improving if the doctors can't give you a definitive answer.

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Thanks for the incredibly quick and concise response! It's much appreciated. Do you do much high intensity training? As I've largely been doing high intensity training mixed with interval training for like 6 days a week throughout the lockdown period, my dad thinks I've 'pushed myself too hard' but I don't think it's that. I actually breathe better when exercising but today I had no energy to really move, I really panic about people being able to see me make these cringe gulps!

I'm looking into the breathing exercises, the only issue is that I've always been a heavy mouth breather (I know, gross) and I actually struggle to breathe just through my nose. Yeah, my friend is a doctor and he assumed it was GERD, so he advised me to take Gaviscon but it really hasn't done anything.

My symptoms are largely just the SOB, occasional uneasiness in my stomach that sometimes feels like slight gastro, lightheadedness and fatigue. It just seems so bizarre as it's come out of nowhere, originally I was panicking that it was a sign of inactivity but clearly not.

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When I came down with my SOB I wasn't doing any exercise at all. I was in Jamaica on my Honeymoon and started feeling it at dinner one night. I didn't know what was wrong with me... I was thousands of miles away from home... and there wasn't even a hospital in the town we were in. And that creates the chicken and the egg... what came first? The SOB or the anxiety? Is SOB causing me to have panic attacks and anxiety or is some sort of underlying stress causing me to have SOB? I started exercising regularly a couple months ago and haven't noticed a meaningful difference. I'd definitely mention it to your doctor though since the timeline does seem to coincide somewhat with the SOB. I know what you mean with the 'cringe gulps' my mother in law always asks if I'm boring her whenever I yawn... which is quite frequently. There's tons of people with similar symptoms and you can check those out on forums like this and Reddit. People post here pretty frequently and it's always interesting to hear new theories and relief techniques. I hope that collectively this can eventually be beaten. You'll also see a common theme in this thread that the SOB comes and goes. A lot of people may have it for a while and then it'll disappear for years and then come back again. Unfortunately, I have not been able to get a period of time without SOB yet but I can hope that they may eventually come.

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@alexm1994

Thanks for the incredibly quick and concise response! It's much appreciated. Do you do much high intensity training? As I've largely been doing high intensity training mixed with interval training for like 6 days a week throughout the lockdown period, my dad thinks I've 'pushed myself too hard' but I don't think it's that. I actually breathe better when exercising but today I had no energy to really move, I really panic about people being able to see me make these cringe gulps!

I'm looking into the breathing exercises, the only issue is that I've always been a heavy mouth breather (I know, gross) and I actually struggle to breathe just through my nose. Yeah, my friend is a doctor and he assumed it was GERD, so he advised me to take Gaviscon but it really hasn't done anything.

My symptoms are largely just the SOB, occasional uneasiness in my stomach that sometimes feels like slight gastro, lightheadedness and fatigue. It just seems so bizarre as it's come out of nowhere, originally I was panicking that it was a sign of inactivity but clearly not.

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Hi @alexm1994 - Sorry to hear what you're going through, but you are not alone. @robkern3 gave a great response. I would add that if you're looking for things to get tested for, a GP probably won't be able to do much him/herself, but they would refer you to specialists. You might be able to get tested for allergies, anything GI related, or more bloodwork. You could also get a lung function test, which I got, but was normal. But at least these tests may rule things out or give you more insight into your health.

Regarding exercise, you may be pushing yourself a bit too hard, but don't know for sure. I used to push myself very hard as well; running, biking, weightlifting, etc. Now I do moderate weightlifting, light jogging, walking- as much as my breathing will allow. You probably have to ease up on the exercise until your breathing gets better, but I wouldn't push yourself too hard.

I also struggled breathing just through my nose when I first implemented breathing exercises, but got used to it after a few days. It takes persistence, but your body will adjust to the new normal of breathing. I even taped my mouth shut while sleeping for a few weeks until I naturally breathed through my nose during sleep.

I hope you get it resolved. Let us know how any more tests come out and how you are doing.

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