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.

@windwalker

Is your air trapping happening on the inhale or exhale? Mine happens when I go to exhale. This is due to having COPD. Other lung diseases can also give you problems with air trapping or impede the ability to breathe normally, for example diaphragm issues. Air trapping can cause that SOB feeling, as well as panic/anxiety attacks. These attacks often occur with patients who have lung issues, and it is a result of a malfunction in the brain. A misfiring of neurons in the brain if you will. They don't know why this happens, but it does. I was told by a Mayo dr that the feeling of oxygen deprivation is the brain not registering the oxygen. I had one such attack and it landed me in the hospital for three days. I feel certain that deep seated subconscious things can bring on these symptoms as well. If you suspect that is your case; you may want to look into hypnotherapy.

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Terrii- On the exhale. But my breathing is so much better this year. Earlier last year I had a pulmonary artery repaired due to an accidental nick. It was a new technique devised just for me! My surgeon taught it to his students! I'm part of history, lol.
I have 2 lobes gone and 2 radiations to my left and right upper lobes (SBRT). I also have COPD and Emphysema.

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@windwalker

@merpreb Hi Merry. Thank you for your concern, but I am no stranger to SOB. It gets worse when the humidity levels rise. It is more difficult for me to move warm, thicker air in and out of my lungs. This is not uncommon for people with bronchiectasis, COPD, etc. I go back to the Mayo on June 5 & 6 for my annual lung function tests and cts. I usually do step up my game with more diligent breathing treatments with albuteriol, sodium chloride, and Tobramycin. Really, it's just the nature of the beast. I am also trying to be mindful of hydrating more.

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I have been diagnosed (3 years) with exercise induced asthma that gets to be problematic when the humidity rises. I have been exercising all winter in a controlled environment at the gym. Last week, I went to the walking path at the park, and Crash! I could feel my breathing become labored and I needed to take frequent stops to catch my breath. I did use my albuterol inhaler in advance of my walk, but I am disappointed that I struggled so much. I 'thought' that I had this under control last year, so this really has dealt me a blow.
I think I am going to call my pulmonologist about resumong my daily inhaler which we dropped during the winter months at my request because I had several episodes of oral thrush)

Last summer I used a spacer with my emergency inhaler, and found it to be helpful.
Do you, or anyone esle, have suggestions about use of an emergency inhaler? Do you get better results with a spacer? Are spacers product specific?

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@ilikeearthtones

You are describing an issue I have been having EXACTLY. Yours is the only post about SOB the describes the deep breath getting "stuck" so preventing you from getting a satisfying full breath. Also, the fact that it comes and goes and is not associated with anxiety, it just happens randomly. And (although sometimes is worse than others) it is not unbearable SOB, I am able to live with it.

The weird thing is, all my tests are also normal except for a continuously slightly elevated bilirubin.

I am actually an ICU nurse so I have some knowledge about these things, and if a patient asked me about a correlation between SOB and bilirubin, I would also probably brush it off as anxiety. But since I know my symptoms are not anxiety related, I don't know what to think. It is not a normal clinical picture.

My theory right now is actually that the SOB is musculoskeletal in origin. I also have some minor upper back and rib slipping issues - and since your ribs play a crucial role in lung expansion, I thought maybe it has something to do with it. I find the most relief from the deep breaths getting "stuck" when I put athletic tape on my sides and physically pull on the tape outwards (while also leaning forward) to help my lungs expand. It's the only thing I can do to help if I want to take a deep breath.

Another (lesser, but still possible) theory is subconscious panic issues. It is possible to have physiological panic attacks even when you do not actually think you "feel" anxious. It has more to do with some kind of issue in your amygdala - making it a neuro issue. This would involve extensive neurological testing that still might not even result in a conclusive answer. (I have heard of people having this issue correlated with spontaneous anger issues as well - since the amygdala sort of controls emotions).

I have no answer at this point. But I was struck by our similar symptoms and the elevated bilirubin. The bilirubin is not something I have thought too much about.

Have you ever had any back/rib/sternal pain? Or anger problems?

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@ilikeearthtones I have thoracic outlet syndrome and for me, it causes one side of my chest to be too tight which doesn't expand enough, and it causes muscles spasms into the chest and ribs that can twist which does create pain to the sternum or the back where ribs connect to the spine. Stress can bring that on easily. It is a physical problem and my physical therapist helps by releasing the diaphragm and doing myofascial release. It mostly involves neck and chest muscles being too tight and compressing nerves and blood vessels to the arms. I do my part in self treating at home with stretching. TOS is easily missed and misunderstood by a lot of doctors. Here are some links. The discussion on Myofascial release will give you a lot of resources. This MFR therapy helps me a lot.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://www.painscience.com/articles/respiration-connection.php
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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@rosemarya

I have been diagnosed (3 years) with exercise induced asthma that gets to be problematic when the humidity rises. I have been exercising all winter in a controlled environment at the gym. Last week, I went to the walking path at the park, and Crash! I could feel my breathing become labored and I needed to take frequent stops to catch my breath. I did use my albuterol inhaler in advance of my walk, but I am disappointed that I struggled so much. I 'thought' that I had this under control last year, so this really has dealt me a blow.
I think I am going to call my pulmonologist about resumong my daily inhaler which we dropped during the winter months at my request because I had several episodes of oral thrush)

Last summer I used a spacer with my emergency inhaler, and found it to be helpful.
Do you, or anyone esle, have suggestions about use of an emergency inhaler? Do you get better results with a spacer? Are spacers product specific?

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@rosemarya It sounds to me like you may have allergies. Mold spores in the air will increase a lot with humidity and might be your trigger. I've had the same experience with crashing. I have allergies to lots of inhaled things including mold. I do allergy shots, use antihistamines, and use inhalers and use HEPA filters in my home. I do have better asthma control when the allergies are under control.

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I do get the blockage, sometimes both nostrils. As soon as I take magnesium first my sinuses unblock then the SOB diminishes substantially. I also get the uncomfortable feeling of the breath getting stuck. I'm fairly sure my issues were related to nutrient deficiencies. The body relies on certain substances to perform it's functions. If it doesn't have them, havoc ensues. For example, the mineral potassium is responsible for the contraction and expansion of the lungs (see my previous post. I do not recommend supplementing potassium unless under a doctor's care as the pills can be dangerous. But there are plenty of potassium rich foods available to us on a daily basis that we can consume with no side effects). Magnesium and potassium are closely related. If one is deficient in one, they will have issues with the other. Magnesium is also responsible for controlling both allergic and inflammatory responses. My theory is that once my magnesium dropped, the potassium did as well which set off a string of responses including poor lung expansion and contraction. Some people have said it works in reverse: you can't absorb magnesium if potassium levels are low. Once the magnesium drops the sinuses are either inflamed or over-reacting to every day substances in the air (allergies). I don't have an exact theory and didn't need one. Just wanted to feel better and by going the nutritional route I do. I can have longer stretches without a case of SOB and when it does happen, it's very manageable. Initially, I had to lurch forward or double over to breathe. One day when it first began I was driving. I almost wrecked my car.

Here are some other things I found during my search for a cure that might help someone:
In regards to c02 and overbreathing. Holding breath for a period will help balance that, so will bag breathing. For me it was a temporary fix and can also mess with your acid/base balance. If you're desperate you can try it but I wanted to get to the root cause. Slow to moderate exercise will correct c02 balances with time. I walk daily. It's recommended that you not over exercise as this causes your body to skew in favor of oxygen. If your overbreathing is related to anxiety. Magnesium will help that.

For those with trouble breathing in humidity. I had that years ago and it was completely eliminated once my magnesium levels were balanced. What felt like spasming vocal chords as well. Anxiety, gerd all gone too.

Some may have SOB due to b12 deficiencies. B12 has an effect on oxygen. Not a doctor but if it resonates with whoever is reading this post, you might want to check into that.

Vitamin C - find a vitamin that uses the buffered version or all natural form as ascorbic acid contributes to acidity in the body and that can throw your body off balance.

For some SOB could be an issue related to acid/ base balances in the body. This level needs to be tightly controlled. Do your research.

Everyone is different. You have to find what works for you. For me nutritional balancing is the route I took and I now see light at the end of the tunnel. I hardly notice it when it does happen. A good quality multivitamin that has balanced nutrients and a good diet that includes greens, fruits and greens powders, low sugar and potassium rich foods has been extremely beneficial for me. Sleep is important as well as water. Dehydration causes an electrolyte imbalance. A healthy lifestyle has been my weapon of choice. Do your research and find the will to make lifestyle changes. Hasn't been super easy but it has worked. See my previous post for more details. Hope this helps someone.

Lastly, if you're in the middle of an attack of SOB, calm down, sit and lean forward. You might need to stretch your body slightly upward. It will provide some relief.

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Hi everyone,
I'm not sure if anyone is still using this but I just stumbled onto it. I'm currently experiencing the same symptoms. I'm still in the process of going to all my doctors and seeing if they can determine a cause. I'm really hoping that this forum would be a good support. Sometimes(most times) it's super scary and reading of others going through it makes me feel not so alone.

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@jillian22

Hi everyone,
I'm not sure if anyone is still using this but I just stumbled onto it. I'm currently experiencing the same symptoms. I'm still in the process of going to all my doctors and seeing if they can determine a cause. I'm really hoping that this forum would be a good support. Sometimes(most times) it's super scary and reading of others going through it makes me feel not so alone.

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@jillian22 - we are here for you!
Let us know how we can help.

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@jillian22

Hi everyone,
I'm not sure if anyone is still using this but I just stumbled onto it. I'm currently experiencing the same symptoms. I'm still in the process of going to all my doctors and seeing if they can determine a cause. I'm really hoping that this forum would be a good support. Sometimes(most times) it's super scary and reading of others going through it makes me feel not so alone.

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Welcome to Mayo Connect, @jillian22, @ilikeearthtones, @saigurucharan, @joedelko, @helpnywhereucan. I am visiting this discussion briefly. Like you, I joined Connect because I was looking for support when I felt alone with my own health conditions. I believe that you will find support and comfort here.

As a mentor, I am happy to help you get started and I want to invite you to know that you are welcome to join in any discussion with your own questions and experiences. It is by sharinig our experiences that we find and share support with other patients who are like us.

I If you want to know more about Connect, and how it works, I am sharing this link - https://connect.mayoclinic.org/page/about-connect/

Jillian22, What kind of symptoms are you currently experiencing? As @burrkay wrote, "We are here for you".

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I guess we should try eating nutrient rich food and practice pranayama - Indian way of breathing exercises which can cure almost anything. But don't start as if you are well experienced, start very slowly until you get used to it. Once you get used to it, you will get addicted to this practice. Any spiritual sadhana adds to the benifit of pranayama

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@jillian22

Hi everyone,
I'm not sure if anyone is still using this but I just stumbled onto it. I'm currently experiencing the same symptoms. I'm still in the process of going to all my doctors and seeing if they can determine a cause. I'm really hoping that this forum would be a good support. Sometimes(most times) it's super scary and reading of others going through it makes me feel not so alone.

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hello @jillian22 Yes, having SOB is frightening. I had an episode of SOB so bad that it caused an anxiety panic attack. I thought I would die, literally. Are coughing and producing phlegm as well?

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