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.

@alureon

Well, it's been a while since I last posted and I wish I had good news and could say that I have solved this problem. I have not.

I have been willing to try ANYTHING to cure myself of this. I have tried expensive medical tests, weird meditations, and intense exercise regimens, all to no avail. The cat scan of my lungs came back and showed nothing other than I had histoplasmosis at one time. According to the pulmonologist my breathing problems could not possibly be a result of anything shown on my cat scan. My breathing tests showed ruled out asthma and COPD, although I could have figured that from the months of taking inhalers that did absolutely nothing. I am now off all drugs, and my condition is still the same. I was instructed to blow in a "peak air flow meter" for a month to note any changes. There were none. I can blow hard enough to max out the meter in most cases, regardless of how I am feeling. I can conclude that I do not have an obstructive condition.

I have adopted an aggressive exercise regimen to condition my heart and lungs. Although I am 31 and not overweight, I figured perhaps conditioning my heart and lungs more would help. I have been running for about a year, but for the past month or two I have started running 10 miles every week. No noticeable improvement. A few weeks were good, but the past week has been bad with the exact symptoms we are all too familiar with. My diet has included one bag of mixed vegetables and fruits for the past year and a half. I have quite a healthy diet, and making diet modifications seem to yield no differences as well. The magnesium someone suggested also did not seem to make an improvement, although it did give me an upset stomach the next day. Also I have read about "low potassium" a few times. My bloodwork showed that my potassium actually was above the upper limit because of the amount of fruits and vegetables in my diet, so that would not be it.

I do like what one gentleman mentioned - it's not SOB but "air hunger". That rings true to me. I'm not short of breath really, I just feel the need to gasp for more air. I can resist the urge with seemingly no consequences, but why is the urge so persistent when it has been shown that medically nothing is wrong with me?

I feel for all of you, and I read all of your posts. I'm usually on my phone and I find it cumbersome to type long posts, so I typically just like posts that resonate with me. Wishing all of you the best in fighting whatever this is.

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That's the thing with mine, it's more of an air hunger. Everytime I get checked out my oxygen is fine, like near 100%, but I still cannot get a deep breath to go down and I find myself gasping for breath. With me they just found myocarditis, which is inflammation of the heart muscle, and all the symptoms seem to fit that. I suppose you must have been evaluated for heart things as well.

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@kakas

That is cortect.

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That is very confusing. I just do not get our medical system.

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@alureon

Well, it's been a while since I last posted and I wish I had good news and could say that I have solved this problem. I have not.

I have been willing to try ANYTHING to cure myself of this. I have tried expensive medical tests, weird meditations, and intense exercise regimens, all to no avail. The cat scan of my lungs came back and showed nothing other than I had histoplasmosis at one time. According to the pulmonologist my breathing problems could not possibly be a result of anything shown on my cat scan. My breathing tests showed ruled out asthma and COPD, although I could have figured that from the months of taking inhalers that did absolutely nothing. I am now off all drugs, and my condition is still the same. I was instructed to blow in a "peak air flow meter" for a month to note any changes. There were none. I can blow hard enough to max out the meter in most cases, regardless of how I am feeling. I can conclude that I do not have an obstructive condition.

I have adopted an aggressive exercise regimen to condition my heart and lungs. Although I am 31 and not overweight, I figured perhaps conditioning my heart and lungs more would help. I have been running for about a year, but for the past month or two I have started running 10 miles every week. No noticeable improvement. A few weeks were good, but the past week has been bad with the exact symptoms we are all too familiar with. My diet has included one bag of mixed vegetables and fruits for the past year and a half. I have quite a healthy diet, and making diet modifications seem to yield no differences as well. The magnesium someone suggested also did not seem to make an improvement, although it did give me an upset stomach the next day. Also I have read about "low potassium" a few times. My bloodwork showed that my potassium actually was above the upper limit because of the amount of fruits and vegetables in my diet, so that would not be it.

I do like what one gentleman mentioned - it's not SOB but "air hunger". That rings true to me. I'm not short of breath really, I just feel the need to gasp for more air. I can resist the urge with seemingly no consequences, but why is the urge so persistent when it has been shown that medically nothing is wrong with me?

I feel for all of you, and I read all of your posts. I'm usually on my phone and I find it cumbersome to type long posts, so I typically just like posts that resonate with me. Wishing all of you the best in fighting whatever this is.

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@alureon, sorry to read what you're going through. For me, intense exercise made my condition worse. I remember when my breathing was fine for a while and then I increased my running and ran faster and harder, my air hunger came back suddenly and with a vengeance. I had to stop exercise for a while and start very slow again and work my way back up. I now go for a run maybe once or twice a week, and mostly do light to moderate weightlifting about 5 times per week. My runs are really mostly walks with short bouts of jogging in between. I just listen to my body and if I feel the SOB coming on stronger I walk the rest of the way home or stop if I'm on the treadmill. But weightlifting seems to help me the most because I can control my breathing and work out as intensely or light as my breathing will allow. You might consider incorporating light weightlifting using only nasal breathing rather than hard running with maximum breathing. At least for me, I've learned that it doesn't seem to have anything to do with lung capacity since my lung capacity tests have all come back normal. Intense exercise doesn't help to expand my lungs, even if it did, the SOB would still be there.

Regarding the SOB vs. air hunger, yes I think we all have the air hunger feeling where we can't satisfy a feeling of a need for air. I guess for me shortness of breath means air hunger, where as "out of breath" equates to a normal feeling of a lack of air while exercising, but in that case it's not uncomfortable because heavy breathing still satisfies the need for air. Semantics, I know, but in my mind shortness of breath means just that, that you're "short" of breath since the "need" doesn't go away even when you take a deep breath.

Anyway, I hope you improve soon. Keep us updated. I don't think it will hurt to try something different; taming the exercise and doing shorter and lighter sessions while incorporating weight lifting and using light, slow breathing. That's what at least maintains my breathing at a manageable level.

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Has anyone heard of or researched eosinophllic asthma? It is a form of asthma that is not related to an immune response so inhalers won't work. I also read that low magnesium levels can be a trigger for it as it is with asthma in general.

I pulled this from an article I found:
Magnesium sulfate is a bronchodilator. It relaxes the bronchial muscles and expands the airways, allowing more air to flow in and out of the lungs. This can relieve symptoms of asthma, such as shortness of breath. Doctors mainly use magnesium sulfate to treat people who are having severe asthma flare-ups.
Nov 20, 2018 ~~~ https://www.medicalnewstoday.com/articles/323755.php

I found this article as well: https://www.clinicaladvisor.com/home/meeting-coverage/aanp-2015-annual-meeting/magnesium-helps-prevent-manage-asthma-attacks/

I tend to choose more natural methods (food and supplements) wherever possible but there appears to be some medications available to treat eosinophllic asthma for people who prefer that route.

I will also add that Magnesium is a tricky mineral. Certain forms will cause digestive upset. Certain forms are acidic. It can really be a challenge to find the one that works for you. Magnesium rich foods might be a better option for some. Do your research on the symptoms of magnesium deficiency and see if you have any of them. Then research supplementation. If you decide to supplement, know that it might take a little trial and error before you find the right one, at least that was the case for me. It is recommended that you start slow with magnesium supplements and build up over time. Patience is required as it will take some time before the magnesium builds up in your system. And as for potassium, I recommend getting it from foods. Potassium supplements can be dangerous. Read about it and see if it resonates with you. As the above poster stated, that wasn't her issue.

As I said previously, the human body is very complex and no two of us will be alike. It appears SOB might be anxiety related for some of us. For some of us it may be related to diet. For some it might be an allergic response. Listen to your gut on this stuff. What works for one won't necessarily work for another. Keep researching and trying different things until you find what is right for you. Don't allow this to take your life.

Blessings

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Looks like there's also a form of asthma classified as intrinsic asthma (non- allergic). Could also explain why some of us contracted shortness of breath after a cold or exercise. Just posting whatever I come across related to this issue in hopes that someone might find what they need.

Here is a link to an article. The terms 'intrinsic asthma' might also be worth an internet search.

https://www.healthline.com/health/intrinsic-asthma#causes-and-triggers
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@helpnywhereucan

Has anyone heard of or researched eosinophllic asthma? It is a form of asthma that is not related to an immune response so inhalers won't work. I also read that low magnesium levels can be a trigger for it as it is with asthma in general.

I pulled this from an article I found:
Magnesium sulfate is a bronchodilator. It relaxes the bronchial muscles and expands the airways, allowing more air to flow in and out of the lungs. This can relieve symptoms of asthma, such as shortness of breath. Doctors mainly use magnesium sulfate to treat people who are having severe asthma flare-ups.
Nov 20, 2018 ~~~ https://www.medicalnewstoday.com/articles/323755.php

I found this article as well: https://www.clinicaladvisor.com/home/meeting-coverage/aanp-2015-annual-meeting/magnesium-helps-prevent-manage-asthma-attacks/

I tend to choose more natural methods (food and supplements) wherever possible but there appears to be some medications available to treat eosinophllic asthma for people who prefer that route.

I will also add that Magnesium is a tricky mineral. Certain forms will cause digestive upset. Certain forms are acidic. It can really be a challenge to find the one that works for you. Magnesium rich foods might be a better option for some. Do your research on the symptoms of magnesium deficiency and see if you have any of them. Then research supplementation. If you decide to supplement, know that it might take a little trial and error before you find the right one, at least that was the case for me. It is recommended that you start slow with magnesium supplements and build up over time. Patience is required as it will take some time before the magnesium builds up in your system. And as for potassium, I recommend getting it from foods. Potassium supplements can be dangerous. Read about it and see if it resonates with you. As the above poster stated, that wasn't her issue.

As I said previously, the human body is very complex and no two of us will be alike. It appears SOB might be anxiety related for some of us. For some of us it may be related to diet. For some it might be an allergic response. Listen to your gut on this stuff. What works for one won't necessarily work for another. Keep researching and trying different things until you find what is right for you. Don't allow this to take your life.

Blessings

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@helpnywhereucan I have eosinophilic or e -asthma, and my doctor called it allergic asthma. Eosinophils are one of the types of white blood cells. Mast cells are blood cells that release histamine causing allergic reactions like for example an itchy bug bite. The article link below talks about those. My rescue inhalers do work, but I also do allergy shots and use HEPA filters at home. I've started wearing a mask when I'm out in public because I'll be triggered by stuff on other people like smoke or fragrances. There are times when exposure to my triggers is too much and nothing really works except getting back into filtered air. I do also have a preventative steroid inhaler and it works by suppressing the immune system. My functional medicine doctor (who does my allergy shots) has warned against long term effects from steroid inhalers, so I reserve that for when I really need it like before going to a show and being in public close to other people. If my other methods of shots, antihistamines, rescue inhaler, Mucinex, and cough drops (for the menthol) are not enough, I'll use the steroid inhaler which does work. One of the tests I had at Mayo for my asthma measured exhaled nitric oxide and from that they determine if you have airway inflammation. When I get to having too much phlegm that I can't clear, it causes my heart rate to go up, and I'll resort to using a topical antibiotic ointment in my nose that cures the infection that seems to be starting, and I'll clear all the phlegm. This was prescribed for me as a pre-surgery treatment for staph infections when I had spine surgery at Mayo, and I found it worked well when I had a sinus or chest infection, and my doctors have given me a prescription to use it when I need it. I've been able to reduce the frequency of this by being better about controlling my allergies through reducing exposure and being dillegent with allergy shot injections.

Here is a very techinical article about eosinophilic asthma.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990389/

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@jenniferhunter

@helpnywhereucan I have eosinophilic or e -asthma, and my doctor called it allergic asthma. Eosinophils are one of the types of white blood cells. Mast cells are blood cells that release histamine causing allergic reactions like for example an itchy bug bite. The article link below talks about those. My rescue inhalers do work, but I also do allergy shots and use HEPA filters at home. I've started wearing a mask when I'm out in public because I'll be triggered by stuff on other people like smoke or fragrances. There are times when exposure to my triggers is too much and nothing really works except getting back into filtered air. I do also have a preventative steroid inhaler and it works by suppressing the immune system. My functional medicine doctor (who does my allergy shots) has warned against long term effects from steroid inhalers, so I reserve that for when I really need it like before going to a show and being in public close to other people. If my other methods of shots, antihistamines, rescue inhaler, Mucinex, and cough drops (for the menthol) are not enough, I'll use the steroid inhaler which does work. One of the tests I had at Mayo for my asthma measured exhaled nitric oxide and from that they determine if you have airway inflammation. When I get to having too much phlegm that I can't clear, it causes my heart rate to go up, and I'll resort to using a topical antibiotic ointment in my nose that cures the infection that seems to be starting, and I'll clear all the phlegm. This was prescribed for me as a pre-surgery treatment for staph infections when I had spine surgery at Mayo, and I found it worked well when I had a sinus or chest infection, and my doctors have given me a prescription to use it when I need it. I've been able to reduce the frequency of this by being better about controlling my allergies through reducing exposure and being dillegent with allergy shot injections.

Here is a very techinical article about eosinophilic asthma.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990389/

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Thanks for your commentary. SOB could be related to asthma for some. I never considered that until I started researching and some (but not all) of the symptoms of intrinsic or eosinophilic asthma matched mine. I still have the nasal congestion at times and my SOB followed right on the heels of a cold. None of the doctors I saw said I had an issue with eosinophils so I'm going to rule e-asthma out for now, although I have tested on the high side of normal for eosinophils in the past and wondered what that meant. It appears optimizing vitamin D levels helps correct eosinophil levels so maybe it was related to vitamin D. I can be a hermit at times.

Here's are a few articles I found on the link between Vitamin D and asthma in case it resonates with someone.

https://www.ncbi.nlm.nih.gov/pubmed/28830802http://www.jbiomeds.com/biomedical-sciences/Correlation-between-Asthma-severity-and-serum-vitamin-d-levels-vitami-from-a-tertiary-care-centre-in-north-india.pdf
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I am wondering if anyone else has a slight tightness or pressure in their chest alongside the SOB. I have no cough or wheeze . I also feel a bit of pain in my back but it could be muscular (carrying a heavy -backpqck everyday on walking commute). Unfortunately my anxiety over this is so bad. My blood work came back normal except for a slightly low RBC. I am focusing on a nutrient dense diet but am getting depressed and anxious over this situation .

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@nycmom

I am wondering if anyone else has a slight tightness or pressure in their chest alongside the SOB. I have no cough or wheeze . I also feel a bit of pain in my back but it could be muscular (carrying a heavy -backpqck everyday on walking commute). Unfortunately my anxiety over this is so bad. My blood work came back normal except for a slightly low RBC. I am focusing on a nutrient dense diet but am getting depressed and anxious over this situation .

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@nycmom

I have shortness of breath, chest tightness in the middle of my chest, sometimes chest pain, but not always, upper back pain in the middle of my shoulder blades. All my bloodwork, heart, lung tests have been nornal... my rdw count was a bit low, ddimer elevated, and co2 just a tad high. I deal with this everyday... i am not hyperventilating like people do suggest.... no way...... my doctor is saying anxiety..... i have been doing the 4, 7, 8, breathing.. seems to help.... trying to stay hydrated.... i still feel back pain even if im not as sob. I have sleep apnea, and am 80 lbs overweight... i dont think its that though as i have been heavy a while now. Actually lost 30 lbs, quit smoking, no change really. You can private message me if u would like to chat. I also have facebook.

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@aea1205

@nycmom

I have shortness of breath, chest tightness in the middle of my chest, sometimes chest pain, but not always, upper back pain in the middle of my shoulder blades. All my bloodwork, heart, lung tests have been nornal... my rdw count was a bit low, ddimer elevated, and co2 just a tad high. I deal with this everyday... i am not hyperventilating like people do suggest.... no way...... my doctor is saying anxiety..... i have been doing the 4, 7, 8, breathing.. seems to help.... trying to stay hydrated.... i still feel back pain even if im not as sob. I have sleep apnea, and am 80 lbs overweight... i dont think its that though as i have been heavy a while now. Actually lost 30 lbs, quit smoking, no change really. You can private message me if u would like to chat. I also have facebook.

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@nycmom

I meant co2 low not high in my first post....

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