Mysterious shortness of breath

Posted by gabrielm @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?

@alanp

Hi @tonyagregg — so happy I found your post. Back in January, I started to experience shortness of breath in the exact manner you're describing. Not all the time, but most days there's generally this feeling that I'm not breathing enough, and every few breaths I'm taking a big deep breath, where I'm not getting the last 5-10% of it. I'm yawning a lot too, even on days when I feel rested. I've seen my primary care physician, a cardiologist, and had a lot of other tests done to ensure it's not heart and/or lung related. I first started to experience symptoms when doing the squat exercise, and I'm inclined to think that it's some kind of myofascial pain syndrome (search "pain science trigger point" in Google) and have booked an appointment with an acupuncturist to see if that helps. It's weird though — I stopped exercising for about a month, but the breathing was still an issue. I tried a deep tissue massage, but that only aggravated my shortness of breath unfortunately. I'm also very healthy — I get into the sauna almost every day, do yoga regularly, and running / lifting as well. It's not life-changing at this point, but it's quite annoying and I'd love to get it figured out. Wishing you and the others who have chimed in this thread the best of luck. Will keep you all updated if I figure things out over here. Thanks for posting!

Jump to this post

I wish we could figure this out too! I thought I did have it figured out because after I stop eating nuts I was 99% better, but it returned like like many others have said. Some days are better than others. I have had every test possible and Aa came back normal. I think my next and last phase is to see an allergy doctor. I dont know about you, but I have notice that if I eat a lot it seems to be worse. I am totally fine while running, but a little later I am trying to get that deep satisfying breath. I will keep you posted and I hope we can figure this out.

REPLY
@tonyagregg

I wish we could figure this out too! I thought I did have it figured out because after I stop eating nuts I was 99% better, but it returned like like many others have said. Some days are better than others. I have had every test possible and Aa came back normal. I think my next and last phase is to see an allergy doctor. I dont know about you, but I have notice that if I eat a lot it seems to be worse. I am totally fine while running, but a little later I am trying to get that deep satisfying breath. I will keep you posted and I hope we can figure this out.

Jump to this post

I wonder if yours might have a greater chance of being related to acid reflux. I went to my cardiologist today and he pointed that out, but my symptoms have always been shortness of breath, trouble taking a deep breath, and chest pain, but I have no abdominal discomfort or anything related to eating.

REPLY
@tonyagregg

I wish we could figure this out too! I thought I did have it figured out because after I stop eating nuts I was 99% better, but it returned like like many others have said. Some days are better than others. I have had every test possible and Aa came back normal. I think my next and last phase is to see an allergy doctor. I dont know about you, but I have notice that if I eat a lot it seems to be worse. I am totally fine while running, but a little later I am trying to get that deep satisfying breath. I will keep you posted and I hope we can figure this out.

Jump to this post

It seems to be worse for me too after I have eaten a lot! Especially around dinner time. Also if I have eaten a lot and then immediately lay down, it feels like I have to yawn or breathe a certain way to get a satisfying breath. Have not noticed a difference with taking Zantac, but also have not tried that consistently yet.

REPLY
@wouldlovetohave

I've had this breathing issue as well, off and on for over a decade. At first I thought it was stress from college finals, then I thought maybe my being overweight was straining my lung capacity. But then I graduated college, took up running, and lost 60 pounds, but still occasionally have this issue. Currently I am a 30yo F, 5'7" and 165lb. @tonyagregg I also run seemingly without a hitch (5k every day), but then later I'm forcibly yawning, trying to expand my rib cage when I take in that gulping inhale (seems like maybe every 10th – 20th breath, if I had to guess.). Could this chronic hyperventilation be happening while I'm pushing myself on the treadmill each morning, and then gasping for air after dinner up until i fall asleep? (Today it started at noon and continued to now as I type in bed).

Jump to this post

So similar to my story! I am 5'8" 148 lb non drinker, never smoked and have always plared sports and worked out. I even work at the hospital and have sat down with many doctors about this and they dont have a clue. When I run I feel good and it may start some time later. It comes and goes, some days Better than others. I have checked my co2 thru a blood gas and my co2 and ph are normal. I really try to pay attention to what I eat or have done that day, on my bad days. I have notice when I eat a lot or eat certian things it gets worse. Have you linked to anything when you have bad days? My next step is to see a allergy doctor. Please lets keep tabs and compare to see what may trigger it and hopefully figure this out!! Thanks for your post.

REPLY
@katgts

hi all, it has been a while and thought I would check in. Since all my physical health checks have come back fine, doctors are leaning more and more towards GAD (generalised anxiety disorder). They tried me on Sertraline, which didn't sit well with me and have now changed me over to Mirtazapine. I think the breathing is getting slowly better, but it is still an issue, although nowhere near as bad as it was in the beginning. If it turns out that this is all because of anxiety that is fine by me and I will get a handle on it. I know a lot of you have had docs say the breathing issues could be because of anxiety but you feel there is something more because you don't feel anxious. I was exactly the same. I have not felt anxious at all, apart from 3 wks ago where I did suffer from a few panic attacks. But since I hadn't felt anxious since the beginning of this, I thought I couldn't possibly be anxious. I have since found out this could be wrong, ie just because you don't feel it, doesn't mean its not there. I wont go into detail as it would take a long time, but the last 10 yrs have been quite difficult and long story short ended up with me becoming my mothers sole carer while she battled breast cancer for the 3rd time in her life, and eventually I lived in hospital and hospice with her for 4 months until she sadly lost the battle March 2018 (she was only 64). Of course this was a horrible time and very stressful and I saw a therapist for a while during and after, but I thought on the whole I had handled my emotions pretty well. The breathing problem started 2 months before the 1st anniversary of her death, and the panic attacks started on the anniversary. I am not one to seek a magic pill to fix my problem, in fact I stay away from medications if I can, but if it is going to help me here, then I am all for it, but hope to resolve my possible anxiety issues and get off the Mirtazapine. I know anxiety may not be the case for anyone here, but if it is being suggested to you, it might be worth opening your mind to it and giving it a go, it can't hurt!

Jump to this post

Hi kat, I am just curious what were your main symptoms? Was it mostly just the breathing? All of my doctors have pinned it on anxiety as well, but similar to your experience it was hard for me to accept at first. My doctor does want to start me on a medication similar to sertraline, it is called lexapro, but I am hesitant to start a medication. Did you notice a significant improvement? Has it gotten better at this point now? And how long have you been on the mirtazapine for? Thanks again for your help, and I hope that this problem will eventually go away!!!

REPLY
@tonyagregg

So similar to my story! I am 5'8" 148 lb non drinker, never smoked and have always plared sports and worked out. I even work at the hospital and have sat down with many doctors about this and they dont have a clue. When I run I feel good and it may start some time later. It comes and goes, some days Better than others. I have checked my co2 thru a blood gas and my co2 and ph are normal. I really try to pay attention to what I eat or have done that day, on my bad days. I have notice when I eat a lot or eat certian things it gets worse. Have you linked to anything when you have bad days? My next step is to see a allergy doctor. Please lets keep tabs and compare to see what may trigger it and hopefully figure this out!! Thanks for your post.

Jump to this post

@tonyagregg I have also noticed when I eat a lot it gets worse. Do you know what foods in particular seem to aggravate it the most for you? I am going to start really focusing on keeping track of that as well. I just want more than anything to get to the bottom of this!

REPLY
@deanna1015

@tonyagregg I have also noticed when I eat a lot it gets worse. Do you know what foods in particular seem to aggravate it the most for you? I am going to start really focusing on keeping track of that as well. I just want more than anything to get to the bottom of this!

Jump to this post

Anything with nuts, chocolate and especially beef. Chicken doesnt bother me that much and caffeine. Lol…I know that seems like everything

REPLY
@tonyagregg

Anything with nuts, chocolate and especially beef. Chicken doesnt bother me that much and caffeine. Lol…I know that seems like everything

Jump to this post

@tonyagregg so far I’ve noticed caffeine makes it worse for me, but I am going to start keeping a log on it. I would love to hear what you find with your allergy doctor, perhaps much of the issue is related to food allergies after all! Keep us posted if you can!

REPLY
@tonyagregg

I wish we could figure this out too! I thought I did have it figured out because after I stop eating nuts I was 99% better, but it returned like like many others have said. Some days are better than others. I have had every test possible and Aa came back normal. I think my next and last phase is to see an allergy doctor. I dont know about you, but I have notice that if I eat a lot it seems to be worse. I am totally fine while running, but a little later I am trying to get that deep satisfying breath. I will keep you posted and I hope we can figure this out.

Jump to this post

@tonyagregg sorry to hear that it didn't completely go away. 🙁 My SOB is worse if I eat a big meal as well. There has to be something with that- maybe physically, like the diaphragm is restricted or something. I used to be better when exercising but for the past couple of years, it's about the same, and sometimes worse if I push myself too hard.

REPLY

@wouldlovetohave– Good morning and welcome to Mayo Connect. I have SOB from lung cancer and can understand how intimidating this is.
I'm glad that you have searched for a solution for your SOB. Have you ever heard of exercise induced asthma? You symptoms appear very similar. check this out:
https://www.mayoclinic.org/diseases-conditions/exercise-induced-asthma/symptoms-causes/syc-20372300
What doctors have you seen and tests done to help rue out causes?

REPLY
@gabrielm

@tonyagregg sorry to hear that it didn't completely go away. 🙁 My SOB is worse if I eat a big meal as well. There has to be something with that- maybe physically, like the diaphragm is restricted or something. I used to be better when exercising but for the past couple of years, it's about the same, and sometimes worse if I push myself too hard.

Jump to this post

@gabrielm I was so excited that for several days I felt normal just to be let down again 😔 . I have ran this by several doctors I work with and they cant give me any answers which is so disappointing. My next step is to see an allergy doctor, because I have notice some things I eat makes it worse and like you said if I push myself hard during exercise my breathing will be a lot worse that day. I want stop until I have exhausted everything to figure this out. I will be in touch.

REPLY
@deanna1015

It seems to be worse for me too after I have eaten a lot! Especially around dinner time. Also if I have eaten a lot and then immediately lay down, it feels like I have to yawn or breathe a certain way to get a satisfying breath. Have not noticed a difference with taking Zantac, but also have not tried that consistently yet.

Jump to this post

@deanna1015– Good afternoon. It sounds like you have classic GERD. I have it and if I lie down after eating, esp. if I eat a lot, I get your symptoms. I think that it's time to see a GI guy, are you ready?

REPLY

YES! @tonyagregg @deanna1015 @gabrielm @merpreb The strongest trend I always noticed was that it was mostly happening on days I over-eat! However there were the rare occasions when that was not the case, so I thought perhaps I have a body image anxiety that I'm not particularly aware of. (I was overweight most of my life, until I started running every day. Perhaps I have anxiety about gaining the weight back? After all, there's never been more pressure to be physically fit and picture perfect). It's definitely not GERD for me though, because despite struggling to breathe up until falling asleep, I have none of the other GERD symptoms.

REPLY

@wouldlovetohave – that's all I had, one symptom. Wouldn't it be better to let Dr diagnose you?

REPLY
@merpreb

@wouldlovetohave – that's all I had, one symptom. Wouldn't it be better to let Dr diagnose you?

Jump to this post

I've got a physician in the household. This doesn't seem like something any one physician/specialist can unravel, so I thought I'd try a larger sample pool.

REPLY
Please login or register to post a reply.