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?

Thanks @merpreb and yes you are absolutely right re the smoking and I am using this as a reason to quit. I had a lung function test where they measured all kinds of things (without inhaler) 2 days ago and my intake/output and whatever else they look at was all perfect. So docs are stumped and just telling me they think it will go away as suddenly as it came on. I hope they are right, otherwise back to see them I go in 2wks with your suggestions (thank you, really!). They all said there is no reason I cannot fly and that 2wks of nothingness and clean air might just do the trick. I think they are clutching at straws now!

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@katgts– Please let me know how things go when you get home and if you get breathless you may need to slow down and take it very easy. I hope that you have a wonderful time!

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@merpreb

@ashleyh and @katgts Good morning and welcome to Mayo Connect! First, congratulations on your new marriage @katgts and to you @ashleyh in July. I hope that we aren't looking at a new disease for newly married women, lol! In all seriousness I understand not being able to catch your breath as I am a lung cancer survivor. It can be very frightening to say the least. I am glad of one thing though, both of you have had testing done so a lot of things have been ruled out. It sounds as if you both might have inflamed and narrowing airways of the lungs. But this is just a guess. I'm not a medical professional so I can't diagnose you. After my first lung cancer and exercising for the first time in many years I also felt this.
@ashleyh– Just before you felt like you couldn't breathe what were you doing? And how shortly after you returned home did this begin? Did you do a lot of exercising that you weren't use to, scuba diving, etc? Did your doctors give you any inhalers?
@katgts– It seems as if you might have exercise-induced asthma, or more properly, exercise-induced bronchoconstriction.
Were you given an inhaler to help your breathing?

This link might help as this is only a guess on my part: https://www.mayoclinic.org/diseases-conditions/exercise-induced-asthma/symptoms-causes/syc-20372300
https://wexnermedical.osu.edu/blog/out-of-shape-or-exercise-induced-asthma
Both of you should get back in touch with your doctors and see if they think that you need inhalers. If you did not see a pulmonologist then I suggest you find one and bring your test results with you.

@katgts– If you experience any worsening while flying or when you land please seek medical attention. Inhalers can be a God send!

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@merpreb thanks so much for getting back to me! I did try ann inhalor, but no luck with that. They ruled out asthma. I didn't really do anything out of the ordinary on my honeymoon. We went on a cruise and I flew on a plain. This all started the day after I got back. I did move into a new house. We remodeled a 1960s home, so I was wondering if I could be allergic to something in it. But like I said, we redid the entire house.

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@ashleyh– Ah ha! The mystery unfolds! Yes, you seriously might have allergies to something in the house. Perhaps call an allergist. They have ways of testing for the most common allergies. You might be surprised!

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@merpreb

@ashleyh– Ah ha! The mystery unfolds! Yes, you seriously might have allergies to something in the house. Perhaps call an allergist. They have ways of testing for the most common allergies. You might be surprised!

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@merpreb I'll definitely do that! I'll keep you updated! 🙂

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@katgts

I’m so glad I came across this discussion! I have had the same thing for 3 weeks. I was sitting at home when suddenly I couldn’t take deep breaths. The only thing out of the norm for that day was I went to the gym for a 2nd time in years but was only on the cross trainer at the lowest setting for 30mins. This inability to take deep breaths came on suddenly about 3 hours later. I have been to numerous doctors and emergency rooms. Bloods, chest films, ECG, ECHO, lung function all came back normal. No doctor can tell me what this is. I was told pleurisy, so was on high dose of ibuprofen for a week which gave me bloating and doctor put me on omeprazole. But the ibuprofen didn’t help apart from the first day or two. They then tried antibiotics just in case but no luck. anxiety has also been ruled out. It feels like there is something in the upper part of my chest blocking the air. It also blocks burps from coming up and I am taking peppermint oil and lozenges to relax it. If I change positions it helps and I can breath but very quickly that position will stop working and I have to find another one. Sort of feels like now I have a weight on my chest, possibly from the constant effort to try and expand my chest. I am going on my honeymoon today and was hoping this would pass by now but looks as though I won’t be doing any swimming, nice long walks etc as just walking up one flight of stairs makes it hard to catch my breath. If anyone comes up with a miraculous cure in the next few days I would be over the moon to hear!

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@katgts @ashleyh I have allergies and asthma and do allergy shots for many things including my cats, so I thought that was under control. Apparently, it was not, and I would have repeating bouts of excess phlegm that would build up and get stuck in my lungs causing the same pressure and ache in my chest, and then it would turn into a chest infection and get my resting heart rate over 100 beats per minute. The problem seemed to be that the swelling of airways from allergies was preventing the normal clearing of my lungs by the cilia (hair cells) that line the airways to move the mucous. I don't smoke, and smoke causes the cilia to become paralyzed impeding phlegm expulsion. I also have thoracic outlet syndrome which causes tight tissue and fascial restrictions because it prevents proper movement of the rib cage and I do PT for that.

My suspicion is that for @katgts, there may be a fascial restriction that wraps around the esophagus and trachea since these are right next to each other passing through the neck and chest. Something must be restricting the burps. A hiatal hernia can also do this. A physical therapist who does myofascial release work can help if fascia is the cause. A gastroenterologist might be able to figure out if there is a hernia. Lung tissue is also fascia with blood vessels for oxygen absorption, and this fascia is an interconnected web that threads through everything in the body. I have resolved my lung issues with better allergy prevention, and I wear a disposable surgical mask when I'm near my cats, and that works, a good one made by 3M #1820 which is as good as a HEPA filter. I also have several HEPA filters running in my house. I have created a discussion about myofascial release (MFR) with a lot of information. Fascia does not show up on imaging, so these problems go unnoticed, and many doctors are not aware of this type of physical problem, and of course, everything looks normal.

Here are some links-
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/
https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

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Thank you @jenniferhunter! If it doesn’t self resolve by the time I get back I will ask docs to look into that as a possible cause.

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@katgts @ashleyh Thanks for sharing your struggles. I hope it helps us to all convene here to help each other find a solution. I made the original post a while back, but I still deal with the SOB. I will say that it's been better and more stable, but it goes up and down somewhat here and there. So I'm still hoping to find an answer. As I said in the original post, EVERYTHING came back normal from blood tests, to asthma tests, to lung function tests, sleep studies, regular checkups, heart check, lung/chest x-ray, swallow test, etc., etc. It may have to do with a hiatal hernia that I was diagnosed with some years ago, but I don't know how that would play into SOB. I also do have allergies I've been dealing with for a while now, but I still had the breathing problems even when I didn't have allergies.

Anyway, good luck to you and I hope you find an answer. Please do post here and talk about your progress- I'm sure someone here can help with something at some point. We WILL get to the bottom of this, I'm confident! 🙂 BTW, congrats on your recent marriage!

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@gabrielm

@katgts @ashleyh Thanks for sharing your struggles. I hope it helps us to all convene here to help each other find a solution. I made the original post a while back, but I still deal with the SOB. I will say that it's been better and more stable, but it goes up and down somewhat here and there. So I'm still hoping to find an answer. As I said in the original post, EVERYTHING came back normal from blood tests, to asthma tests, to lung function tests, sleep studies, regular checkups, heart check, lung/chest x-ray, swallow test, etc., etc. It may have to do with a hiatal hernia that I was diagnosed with some years ago, but I don't know how that would play into SOB. I also do have allergies I've been dealing with for a while now, but I still had the breathing problems even when I didn't have allergies.

Anyway, good luck to you and I hope you find an answer. Please do post here and talk about your progress- I'm sure someone here can help with something at some point. We WILL get to the bottom of this, I'm confident! 🙂 BTW, congrats on your recent marriage!

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@gabrielm thank you so much! Yes! We will all get to the bottom of this! The good thing is we know our tests are okay, so all of the "serious" things are ruled out. Hoping everyone finds relief soon!

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Thanks @gabrielm ! Good luck everyone, hopefully it clears up for us all soon!

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I write this as I sit in the hallway at school because this symptom is so embarrassing. For about 2 years now I have had the same symptom that’s been described in this discussion. It feels like progressively it is getting worse and occurring all day, every day no matter what I am doing. It started out randomly one day. I had moments where I wouldn’t feel it but it was always there now for the past few months it has been at its absolute worse. What I feel is a sort of tightness in my throat that can only be relived by taking a deep breath or gasp for air however this is not always possible. This symptom creates a lot of anxiety on me and makes it hard to live my every day life. I have been seeing a therapist for a few months now and they have tried to get me on anxiety medication but I am hesitant to do so. If anyone here has any advice on how to cope with this or at least bring it down please, I am begging for some ideas. I read on this forum about the buteyko breathing method. How do you do this? Does B-12 vitamin actually work? Anything that can help me get back to the way I was would help tremendously. I am only 21 and I feel as if this issue is causing me to become almost incapable of living my life

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@lwilliams06

I write this as I sit in the hallway at school because this symptom is so embarrassing. For about 2 years now I have had the same symptom that’s been described in this discussion. It feels like progressively it is getting worse and occurring all day, every day no matter what I am doing. It started out randomly one day. I had moments where I wouldn’t feel it but it was always there now for the past few months it has been at its absolute worse. What I feel is a sort of tightness in my throat that can only be relived by taking a deep breath or gasp for air however this is not always possible. This symptom creates a lot of anxiety on me and makes it hard to live my every day life. I have been seeing a therapist for a few months now and they have tried to get me on anxiety medication but I am hesitant to do so. If anyone here has any advice on how to cope with this or at least bring it down please, I am begging for some ideas. I read on this forum about the buteyko breathing method. How do you do this? Does B-12 vitamin actually work? Anything that can help me get back to the way I was would help tremendously. I am only 21 and I feel as if this issue is causing me to become almost incapable of living my life

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@lwilliams06 Hello and welcome. I'm glad you reached out. Don't be embarrassed, just start being a detective and ask questions about why this is happening. There can be many reasons for shortness of breath, and if you breathe mostly using the upper muscles in the rib cage and neck, that actually increases anxiety. You might have allergies or asthma contributing to the problem, and it's important to find out. I know that is stressful too, and no one want s to find out there is something "wrong", but as you go on on life, things change, and you'll find a way to manage. None of us are perfect, and we shouldn't expect perfection in things we cannot change, but instead think about how we can adapt and make it better. Knowledge is power, and the more you know about yourself, the more you can feel at ease with change. This is a life long process, but you will affect your future and aging with the choices you make now. I remember feeling sad about the diagnosis of asthma, but by changing a lot of things, I don't have problems breathing. You may want to start with an appointment with a primary care physician. That can rule out out problems and find others. Not knowing is also stressful, as I'm sure you are aware, and knowledge will help you overcome this challenge. It's also easy to think that you have what someone else has because you have similar symptoms. That may or may not be true as there are many overlapping symptoms with different causes, and that is what a doctor does; they question and sort through the possibilities and test to figure out the answer. We can't control everything. It's something we as humans have to accept, but given that, we can do our best and believe that we can make a difference. You are young which is in your favor. I don't know if you have had any injuries that could be part of this or muscle or tissue tightness, but there are things to do that help if this is the case. I hope this helps you think about this.

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