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?

Hi @criley2k. First of all, I'm so sorry that you have been dealing with this for so long. I know how you feel! It's been 7 years for me since it all began. I find it strange that your muscles are weak from the breathing condition. I wonder if there is something else going on that's causing all of this (breathing + muscle weakness). With all of the doctors you've seen, I assume they've done a bunch of tests that show everything normal.

My respiration has not reset to normal, but it has been somewhat stable for the past 2 years or so. I still struggle with the air hunger, but it's not as bad it was when it started. I do moderate daily exercise which includes about a 2 mile walk and then moderate weight lifting. These seem to help keep it stable. I also do "maintenance" Buteyko exercises about every other day (I do Steps in the morning). I have stopped measuring my CP because, like you, I couldn't really get it up and keep it that way. So I just make sure I can do 90 – 100 steps and if it gets to where I can do 90 and no more, I increase frequency to daily and that seems to get the Steps score up to around 100 after a few days. So that's how I maintain Buteyko. It doesn't help enough for me to do it daily or more than once per day. It provided great relief in the beginning, but like you experienced, it has since provided diminishing returns.

I am able to do pretty much everything normal – I can function at work just fine with not much thought to my breathing. Sleeping is hit or miss; some nights I can sleep just fine in my bed and others I struggle to breathe so I have to sleep sitting up on the couch. I can do my walking just fine, but weightlifting I'm limited by my air hunger. The harder I push, the stronger the air hunger so I can't push too hard when I do exercise. Cardio is pretty much out. Every now and then I'll do a very light jog if I can handle it, but I use my breathing as a gauge. I don't push it too hard like I used to. That seems to make it worse.

So now, I'm not even sure that it's "hyperventilation". I really feel like I don't hyperventilate. In observing my own breathing, it is very normal. It's just that the air hunger starts to creep in after a few breaths, regardless of how fast or slow I'm breathing. So something, in my opinion, is causing this feeling of persistent air hunger that nobody can put their finger on. My hunch is that it could be gastro related. Many of us on this forum seem to have some sort of GI issues. Though correlation does not equal causation, I can't ignore the number of people that have what we have also have GI issues.

So that's where I am today. It's tolerable and stable, but still a bit uncomfortable. It's been this way for a couple of years. Your natural remedies are very interesting. Same thing happened to me when I took vitamin B12 and iron, as I'm sure you read in the OP. Don't know why it would've helped for a short while, then come right back.

Keep in touch, I'd like to know of any progress and I'll share any of mine as I continue to search for answers.

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@gabrielm

Hi @criley2k. First of all, I'm so sorry that you have been dealing with this for so long. I know how you feel! It's been 7 years for me since it all began. I find it strange that your muscles are weak from the breathing condition. I wonder if there is something else going on that's causing all of this (breathing + muscle weakness). With all of the doctors you've seen, I assume they've done a bunch of tests that show everything normal.

My respiration has not reset to normal, but it has been somewhat stable for the past 2 years or so. I still struggle with the air hunger, but it's not as bad it was when it started. I do moderate daily exercise which includes about a 2 mile walk and then moderate weight lifting. These seem to help keep it stable. I also do "maintenance" Buteyko exercises about every other day (I do Steps in the morning). I have stopped measuring my CP because, like you, I couldn't really get it up and keep it that way. So I just make sure I can do 90 – 100 steps and if it gets to where I can do 90 and no more, I increase frequency to daily and that seems to get the Steps score up to around 100 after a few days. So that's how I maintain Buteyko. It doesn't help enough for me to do it daily or more than once per day. It provided great relief in the beginning, but like you experienced, it has since provided diminishing returns.

I am able to do pretty much everything normal – I can function at work just fine with not much thought to my breathing. Sleeping is hit or miss; some nights I can sleep just fine in my bed and others I struggle to breathe so I have to sleep sitting up on the couch. I can do my walking just fine, but weightlifting I'm limited by my air hunger. The harder I push, the stronger the air hunger so I can't push too hard when I do exercise. Cardio is pretty much out. Every now and then I'll do a very light jog if I can handle it, but I use my breathing as a gauge. I don't push it too hard like I used to. That seems to make it worse.

So now, I'm not even sure that it's "hyperventilation". I really feel like I don't hyperventilate. In observing my own breathing, it is very normal. It's just that the air hunger starts to creep in after a few breaths, regardless of how fast or slow I'm breathing. So something, in my opinion, is causing this feeling of persistent air hunger that nobody can put their finger on. My hunch is that it could be gastro related. Many of us on this forum seem to have some sort of GI issues. Though correlation does not equal causation, I can't ignore the number of people that have what we have also have GI issues.

So that's where I am today. It's tolerable and stable, but still a bit uncomfortable. It's been this way for a couple of years. Your natural remedies are very interesting. Same thing happened to me when I took vitamin B12 and iron, as I'm sure you read in the OP. Don't know why it would've helped for a short while, then come right back.

Keep in touch, I'd like to know of any progress and I'll share any of mine as I continue to search for answers.

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@gabrielm– Good morning.SOB or air hunger can be caused by many things. An, although there might be many causes I have learned that practicing breathing exercises has helped me open up my chest wall so that I can breathe easier. My new Pulmonologist has also changed 2 of my medications to 1 called Trelegy. Everyone I have spoken to on Connect who have also been given this have felt much better.
https://www.healthline.com/health/how-to-increase-lung-capacity#diaphragmatic-breathing
I love "correlation does not equal causation." As yet there is no firm consensus on why people who have COPD often get GERD but there does seem to be a connection.
https://www.verywellhealth.com/how-common-is-gerd-in-copd-914675
Since we last spoke you seem to have improved your breathing control. I agree that you probably do not hyperventilate. How did you determine this?

@criley2k– Welcome to Connect. Not being able to take a deep breath or have SOB is quite scary. But hyperventilation is different than SOB. Hyperventilation is when you start to breathe very fast. Low carbon dioxide levels lead to narrowing of the blood vessels that supply blood to the brain. This reduction in blood supply to the brain leads to symptoms like lightheadedness and tingling in the fingers. Severe hyperventilation can lead to loss of consciousness. For others, this condition occurs as a response to emotional states, such as depression, anxiety, or anger. When hyperventilation is a frequent occurrence, it’s known as hyperventilation syndrome. There are many different causes for hyperventilation. Stress usually does it for me.
How have you come to determine that you are hyperventilating?

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Hello everyone–I'm still experiencing shortness of breath. I did start lexapro 8 weeks ago, out of desperation but it has not improved my SOB. I am wondering if anyone has tried an elimination diet and had any benefit. I am thinking about trying the Whole30, which is just that–it eliminates dairy, soy, sugar, grains. Today my SOB feels like it is almost stemming from my throat. It's like an odd sensation from the top of my throat all the way down. I also feel a continued strange sensation in my upper left side of my chest. (I have seen the cardiologist several times–he thinks I'm crazy—and he is confident my issue is not heart related). I am experiencing pretty severe health anxiety as a result of this. Today I tried to focus on not taking deep breaths in to alleviate the air hunger but it didn't seem to help…
Has anyone discovered that silent reflux was actually the cause of the SOB? OR that an elimination diet was helpful?
Thanks!

REPLY
@nycmom

Hello everyone–I'm still experiencing shortness of breath. I did start lexapro 8 weeks ago, out of desperation but it has not improved my SOB. I am wondering if anyone has tried an elimination diet and had any benefit. I am thinking about trying the Whole30, which is just that–it eliminates dairy, soy, sugar, grains. Today my SOB feels like it is almost stemming from my throat. It's like an odd sensation from the top of my throat all the way down. I also feel a continued strange sensation in my upper left side of my chest. (I have seen the cardiologist several times–he thinks I'm crazy—and he is confident my issue is not heart related). I am experiencing pretty severe health anxiety as a result of this. Today I tried to focus on not taking deep breaths in to alleviate the air hunger but it didn't seem to help…
Has anyone discovered that silent reflux was actually the cause of the SOB? OR that an elimination diet was helpful?
Thanks!

Jump to this post

My shortness of breath is all but gone. It still happens occasionally if I get dehydrated or get sloppy with my diet. I didn't do a specific diet but changed to a primarily plant based way of eating. I really focus on getting minerals in my diet via greens, powders and drinking lots of water…alkaline and mineral. I also take potassium and magnesium. I think I posted previously where someone cured their SOB with baking soda because it neutralizes acids in the body. This may not work for everyone. It took a minute to figure it out but at this point I think I'm good. Lost a few pounds too. Keep searching guys. Something will work. You can't lose hope. You might also want to research magnesium bicarbonate water. Lots of info about it on line. Helps with acidity.

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@helpnywhereucan

My shortness of breath is all but gone. It still happens occasionally if I get dehydrated or get sloppy with my diet. I didn't do a specific diet but changed to a primarily plant based way of eating. I really focus on getting minerals in my diet via greens, powders and drinking lots of water…alkaline and mineral. I also take potassium and magnesium. I think I posted previously where someone cured their SOB with baking soda because it neutralizes acids in the body. This may not work for everyone. It took a minute to figure it out but at this point I think I'm good. Lost a few pounds too. Keep searching guys. Something will work. You can't lose hope. You might also want to research magnesium bicarbonate water. Lots of info about it on line. Helps with acidity.

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Thank you so much. I have been intrigued by the alkaline idea. Did you give up all things acidic like coffee, alcohol etc? One reason I don't want to do Whole30 is that it tends to be quite meat heavy since you can't have tofu or beans and I don't think my body responds well to a lot of meat. How long did you have shortness of breath?

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@helpnywhereucan

My shortness of breath is all but gone. It still happens occasionally if I get dehydrated or get sloppy with my diet. I didn't do a specific diet but changed to a primarily plant based way of eating. I really focus on getting minerals in my diet via greens, powders and drinking lots of water…alkaline and mineral. I also take potassium and magnesium. I think I posted previously where someone cured their SOB with baking soda because it neutralizes acids in the body. This may not work for everyone. It took a minute to figure it out but at this point I think I'm good. Lost a few pounds too. Keep searching guys. Something will work. You can't lose hope. You might also want to research magnesium bicarbonate water. Lots of info about it on line. Helps with acidity.

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@helpnywhereucan– Good morning. Your news is so good. How did you hear about drinking baking soda and the ph of your water and diet?

Liked by joangma

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Everyone, how many have you had dry nose and shortness of breath?

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@saigurucharan

Everyone, how many have you had dry nose and shortness of breath?

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@saigurucharan I have dry nose and SOB but I'm on O2 24/7 .

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@saigurucharan– Welcome to Mayo Connect. I always have a dry nose because I either have the AC on or the heat. It's filtered air because of my lung cancer and SOB. I use an over the counter steroidal nose spray and I use a netty pot, but more frequently a saline nasal spray that helps keep your nose wetness more balanced. And it's harmless, you can use it as frequently as you need it. Do you know what the cause of your SOB is?

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@bb729

@saigurucharan I have dry nose and SOB but I'm on O2 24/7 .

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@bb729– Have you tried nose gel? It's good, really good and soothes irritated nasal passages.

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@nycmom

Thank you so much. I have been intrigued by the alkaline idea. Did you give up all things acidic like coffee, alcohol etc? One reason I don't want to do Whole30 is that it tends to be quite meat heavy since you can't have tofu or beans and I don't think my body responds well to a lot of meat. How long did you have shortness of breath?

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It started @ February. It was terrible. I would have fits of it that were so bad I could hardly do anything but focus on the fact I couldn't breath. Tears, no sleep, bag breathing, emergency room…where I was told I was in perfect health other than a slight potassium deficiency that wouldn't cause SOB. Primary care gave me a script for anxiety that I never took. I knew it wasn't caused by anxiety. I did have slightly low iron. I spent nights researching everything I could, determined to leave no stone unturned. If you read my previous posts, at times I'm sure I sounded like a mad scientist trying different things in order to figure it out. I came to the conclusion that my issue was tied to minerals/ electrolyte deficiency. I had struggled over the years with things that are related to acidity…heartburn, stinky underarm odor, morning stiffness etc. When you are acidic, your body burns through minerals. I tended to be high strung, constantly busy, couldn't shut my mind off at night (or during the day for that matter). If you read up on minerals, they provide a buffer for acids created by our lifestyle. I considered myself to have a decent diet beforehand but the little voice inside always knew I wasn't getting enough veggies. And now with our soil so depleted in minerals, it's bound to happen to a lot of us.

I started with a good plant based multivitamin. Vitamins can be acidic so you have to be careful with the ones you take. I like plant based ones better or ones with calcium and magnesium in sufficient quantities because those minerals are alkaline. I didn't drink alcohol or coffee so those weren't an issue for me. Then, I focused on getting sufficient quantities of potassium. I started eating more greens, vegetables and taking powder greens like wheatgrass, Kale powder etc. I drink carrot juice, eat potatoes….sweet and white…to maintain my potassium levels. I eat low fat, "healthier" potato chips. They're a good balance of sodium and potassium. I have a banana in my smoothie every morning that includes other healthy things. I drink low sugar orange juice for potassium and I also take one small dose of a potassium supplement per day. I choose to get it from food. Potassium is a very alkalizing mineral, but be careful with supplementation. If taken in large quantities it can cause heart arrhythmia for some people. I tested the limit and found out it's true, Lol. I had a few scary minutes.

Little by little I started switching to more of a plant based diet. As I read up on the Alkaline/ Acid in the body it resonated more and more with me. Now I try to juice daily, eat more salads, make veggie burgers and plant based meals. For example I boil a bag of frozen butternut squash, let it cool, throw it into a blender with almond milk, bone broth and a few cashews and some seasoning, blend it up, pour it into a bowl and voila, soup in minutes. I mash garbanzo beans, add in a tablespoon of spelt flour, a little quinoa, onions and fry it in a little oil for a tasty burger along with my soup. It's a lifestyle. I'll do anything to not have that wretched SOB come back. So far it's working! I make healthy/ alkaline deserts. My new fav are brown rice krispie treats.

Bicarbonates are also important when it comes to buffering acids. Fruits and vegetables help the body maintain bicarbonate levels. Mineral water also has bicarbonates. If all else fails there's plain old baking soda in water. I don't tolerate it very well. Neutralizes my stomach acid and gives me gas. Sigh. Some people take a pinch daily, some take it with lemon. I try to include more baked goods with baking soda in the recipe. When we were kids no one heard of acid reflux. I think it's because we ate more vegetables and fruit and more baked goods…they all contained a little baking soda. We also drank water out the tap and not man made water. Tap water contains minerals and bicarbonates. Just my theory anyway. I do still filter my water.

Lemon water is also alkalizing. I keep lemons in the kitchen. I cut back on my oatmeal consumption since oatmeal is slightly acidic. I replaced it with quinoa. Tastes just as good and is more alkaline.

Meat is acidic but some people need the protein. I still eat it here and there (no more than once per day. I do meatless Mondays and fish on Friday) but quite frankly haven't missed it that much. I'm starting to see food as medicine in a way. If it's going to turn on me, I'll try to pass or only indulge a little. I now only eat natural sugars…honey, agave, maple syrup. Sugar is highly acidic.

So yeah…it's a commitment but I'm getting used to it. Sliced cucumbers, onions and tomatoes sit on my plate now, just like they used to sit on my mom's and as a teen I'd think how gross…I'll be at the nearest fast food joint. Caught up with me big time.

So my advice to anyone dealing with SOB, find what works for YOU. It could be an issue with a pathogen, could be vitamin D levels or something else. But I say a solid eating foundation is a good place to start. It might seem overwhelming at first but just pick one thing and start there and see if you have any improvement. Best of luck to all of you.

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@nycmom

Hello everyone–I'm still experiencing shortness of breath. I did start lexapro 8 weeks ago, out of desperation but it has not improved my SOB. I am wondering if anyone has tried an elimination diet and had any benefit. I am thinking about trying the Whole30, which is just that–it eliminates dairy, soy, sugar, grains. Today my SOB feels like it is almost stemming from my throat. It's like an odd sensation from the top of my throat all the way down. I also feel a continued strange sensation in my upper left side of my chest. (I have seen the cardiologist several times–he thinks I'm crazy—and he is confident my issue is not heart related). I am experiencing pretty severe health anxiety as a result of this. Today I tried to focus on not taking deep breaths in to alleviate the air hunger but it didn't seem to help…
Has anyone discovered that silent reflux was actually the cause of the SOB? OR that an elimination diet was helpful?
Thanks!

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Good morning @nycmom– It sounds as if you might have GERD. Have you had an appointment with a GI doctor yet?

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@merpreb

@helpnywhereucan– Good morning. Your news is so good. How did you hear about drinking baking soda and the ph of your water and diet?

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I researched for hours when my SOB first started and began to piece together the puzzle for myself after doctors told me I was in perfect health. I knew something deeper was going on. Our bodies need minerals/ electrolytes for optimal performance and our diets, coffee, wine etc is depleting them. Without minerals we will suffer from heartburn, muscle and joint stiffness, or worse. Unfortunately we've been conditioned to pop a pill instead of asking the deeper question…what does my body need? So the symptoms get worse for many of us because we only masked the issue. For long term health and disease prevention we have to give our body what it needs.

If anyone is at their wits end with SOB click on my name and read back through the posts. I posted on things I came across even if I didn't think they were related to my issue in hopes it might help someone else. If something resonates with you, try it or speak to your doctor about it.

Here's information on the acid/ alkaline balance:
https://acidalkalinediet.net/acidosis.php
Baking soda has been used to cure acidity since I was a baby so that's nothing new but here's a link to someone's personal testimony:
https://healthunlocked.com/early-ckd-support/posts/130359759/shortness-of-breath-sufferers-do-you-have-acidosis-and-dont-know-it

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@merpreb @bb7777
If you have dry nose, that is definitely a culprit. I am not a doctor, but I have had issues with SOB too. I read about ayurveda (and also I am an Indian(from India)) and used ghee(which is called clarified butter, but I don't know if I can rely on US produce) in my two nostrils. Usually, people use Nasya Oil, but I just applied ghee to my little finger and rubbed inside my two nostrils. You will see mucous being produced in a very few minutes after application(nothing to panic about). If your SOB gets fine after that, then it is all about just a dry nose and lack of mucous in your membranes. Try it, it doesn't harm you at all, because it is all natural.
You can get ghee in any indian stores, go for a high quality organic cow ghee.

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@saigurucharan

@merpreb @bb7777
If you have dry nose, that is definitely a culprit. I am not a doctor, but I have had issues with SOB too. I read about ayurveda (and also I am an Indian(from India)) and used ghee(which is called clarified butter, but I don't know if I can rely on US produce) in my two nostrils. Usually, people use Nasya Oil, but I just applied ghee to my little finger and rubbed inside my two nostrils. You will see mucous being produced in a very few minutes after application(nothing to panic about). If your SOB gets fine after that, then it is all about just a dry nose and lack of mucous in your membranes. Try it, it doesn't harm you at all, because it is all natural.
You can get ghee in any indian stores, go for a high quality organic cow ghee.

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For SOB, all you have to do is, stop stressing about it, stop thinking so much, relax and tell to yourself that you aren't going to die and focus on different things. Because, stress makes it worse and causes other side-effects like acidity, burps etc, which makes us think more about our self-induced gastritis.

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