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?

Sorry. I must have missed it.

REPLY
@felicityr

Hi Abidaisi,
This is a good question and an important thing to try and nail down.
When I think of my "shortness of breath", it's defining feature is that (even though I am at rest) I take a normal breath in but it doesn't feel like I have had "enough". I then try for a bigger breath. Sometimes this will "click over" my breathing – give me the feeling that my need for air has been satisfied and i can breathe out, but, sometimes, even a bigger breath can't satisfy the feeling of having 'enough". The drive to breathe is the most basic conscious drive we have. It kicks in the moment we are born (and we are even practicing in the womb before we are born) so when our alarm system tells us we are not getting a big enough breath it is pretty distressing.
I believe this is the moment lots of people with this condition get panicked and then get labelled with a primary panic or anxiety disorder.(I am not arguing that anxiety plays no part in the abnormal breathing patterns of some people, rather that I believe it is NOT the answer for all of them).
For me, when I get to this point I just feel resigned ("here it goes again") and I resort to the other "tricks" I have to try and get a satisfying breathe: wriggling my jaw to start a yawn is my usual first trial. Then I try sitting quietly and letting the feeling of suffocation build while telling myself I have been here many times before and I always come through it. It's a faulty alarm and despite its noise I know my oxygen level is ok. Often this leads eventually to an almost unstoppable large gasp which "clicks over" my breathing again. Occasionally I will lie down if I am standing – but always on my side not my back (because I have this belief that the problem has something to do with low blood pressure within my lung blood vessels). Sometimes I will just jump on the spot to trigger a deeper breathe through exercise.
I'm sorry this is so long winded but for me, the term "shortness of breath" doesn't capture the specifics of what I experience.
But the thing is, instantaneously when my breath "clicks over" relief floods through me and I have NO shortness of breath -maybe for minutes, maybe for hours, until the signal to take a deeper breath becomes evident again and I again feel a building "shortness of breath".
All in all, I have (usually) days to weeks where my breathing goes "off", as I have described above, coupled with periods when I can go for months with no problems at all – I have months where my breathing is essentially normal. Maybe the odd unsatisfying breath that is fixed with a bigger "gasp".
I suppose the key feature for me is the complete relief of any sense of "shortness of breath" the instant I click my breathing over.
Hope this is of some help.
Please if you do have shortness of breath though, don't assume it is this until you have been checked out by your doctor. And if you still don't think it is this, and you feel unwell, seek another medical opinion.
Warm regards (it's getting cold on this side of the world!!)

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@felicityr That's a good description of what this condition is- we call it shortness of breath, which in reality, I think is more like if you're out of breath or get out of breath quickly. I think probably the most accurate term might be "air hunger" where there's a constant hunger for air that only gets satisfied every few breaths.

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@lidiaboglarka

Hi All, maybe it's a silly question and already discussed, but I'm wondering if our sighing dyspnea can be connected to any mineral or vitamin deficiency, such as magnesium.
I am jumping from one research to another, and keep arriving back to magnesium deficiency as a possible cause. I'm wondering if you've already experimented with taking it as a supplement, and whether it helped.
I started taking Mg citrate today, I feel better, but one day is not representative. It could be easily just the fact that it's finally a sunny Satruday, and my mood is higher 🙂

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@lidiaboglarka When my dyspnea first started back in 2012, I did research on mineral/vitamin deficiencies as well. So I started taking vitamin B12, which strangely had an immediate effect of clearing the problem very quickly. I could breathe normal again. That went on for probably just a few weeks, maybe a couple of weeks, and then the dyspnea returned and so I started taking an iron supplement. Once again, that helped clear the problem for days, and then it returned. So I don't know why that happened, but any supplements I take now, including magnesium, don't help the problem.

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@merpreb

Sorry. I must have missed it.

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Do not know where to fit this in but here goes, Cannot get the answer to: For a person who has never taken prednisone will taking 150 mg of prednisone and then 10 hours later taking another 150 mg of prednisone be dangerous or even deadly for an 83 year old woman with many health problems? I will explane more if someone needs to know for an answer.

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@merpreb

@lidiaboglarka– I'm not so sure that Tourette's syndrome is the name to put on your descriptions as a young child. Sometimes we mimic other's expressions, just to try a few times and we get carried away. I also did something with my upper lip, curling it up toward my nose. Must have looked very pretty! Have you spoken to a doctor about this?

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That's reassuring, also good to know I wasn't the only child having wierd movements 😉
No, I completely forgot about that until I saw that post, and haven't talked to a doc since. I observed myself, and I don't think it's a tic. I do need that breath. That has always been my normal breathing pattern, light or shallow breathing with occasional sighs to keep the balance. It didn't change – only my ability to fulfill it.

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@merpreb

@lidiaboglarka– This is a great question. Among the most serious symptoms of magnesium deficiency is a heart arrhythmia, or irregular heartbeat However, in some people, it may cause heart palpitations, which are pauses between heartbeats. Other possible symptoms of arrhythmia include lightheadedness, shortness of breath, chest pain, or fainting. Do you have any of these? Has you magnesium level been tested? I take 400 mg with my calcium

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Three years ago I didn't have arithmia, but my BP and pulse is usually very low. Nowadays it feels even worse.
I definitely have lightheadedness, muscle cramps and inflammation, lately headache, acidic stomach (for some days I've been taking PPI, that calmed down my stomach), chest pain (most probably because of a strained pectoralis muscle and my possible reflux). Cramps in my calf is quite common, and nowadays vibrating sensation around my mouth. And of course, SOB. Regardless of what I'm doing, resting or exercising. I also can easily get stressed. I have coeliac, and even though I'm keeping the diet for 8 years now, I easily can have nutrition deficiency.
I didn't have serum mg checked, but my urine test came back with normal amount of Ca, b12 and iron. The last two I'm taking as a supplement.

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@gabrielm

@lidiaboglarka When my dyspnea first started back in 2012, I did research on mineral/vitamin deficiencies as well. So I started taking vitamin B12, which strangely had an immediate effect of clearing the problem very quickly. I could breathe normal again. That went on for probably just a few weeks, maybe a couple of weeks, and then the dyspnea returned and so I started taking an iron supplement. Once again, that helped clear the problem for days, and then it returned. So I don't know why that happened, but any supplements I take now, including magnesium, don't help the problem.

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Thank you, and it's sad none of them gave permanent solution. Now I remember you've included these to your orginal post, it seems that my memory is as short as my breath 🙂

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@peach414144

Do not know where to fit this in but here goes, Cannot get the answer to: For a person who has never taken prednisone will taking 150 mg of prednisone and then 10 hours later taking another 150 mg of prednisone be dangerous or even deadly for an 83 year old woman with many health problems? I will explane more if someone needs to know for an answer.

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I think ER can give you a very prompt answer if you call them. Also they can help in case of an overdose.

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@lidiaboglarka

Three years ago I didn't have arithmia, but my BP and pulse is usually very low. Nowadays it feels even worse.
I definitely have lightheadedness, muscle cramps and inflammation, lately headache, acidic stomach (for some days I've been taking PPI, that calmed down my stomach), chest pain (most probably because of a strained pectoralis muscle and my possible reflux). Cramps in my calf is quite common, and nowadays vibrating sensation around my mouth. And of course, SOB. Regardless of what I'm doing, resting or exercising. I also can easily get stressed. I have coeliac, and even though I'm keeping the diet for 8 years now, I easily can have nutrition deficiency.
I didn't have serum mg checked, but my urine test came back with normal amount of Ca, b12 and iron. The last two I'm taking as a supplement.

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Ask your doctor about magnesium. I just switched to MagOx and It made a huge difference. You have to find the dose and brand of magnesium that works for you. For anyone desperate and not getting help from their doctors, focus on acidity. It's a common theme for all of us. I changed diet, used supplements etc. I'm very careful not to ingest anything that creates acidity in the body and use alkaline supplements…greens powders, alkaline water etc and it's made a huge difference. When all else fails, try deep breathing. If I feel a little heartburn ( which is a SOB trigger for some) I can deep breathe for just a few minutes and eradicate it.

Might not work for everyone but just wanted to share how I beat it.

Good luck everyone!

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@peach414144

Do not know where to fit this in but here goes, Cannot get the answer to: For a person who has never taken prednisone will taking 150 mg of prednisone and then 10 hours later taking another 150 mg of prednisone be dangerous or even deadly for an 83 year old woman with many health problems? I will explane more if someone needs to know for an answer.

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Hi @peach414144, I agree with @lidiaboglarka. If you are concerned about having double-dosed on prednisone, please call ER or a pharmacist. They will be able to answer your question knowledgeably and specific to you. Mayo Clinic Connect is not a substitute for medical advice or in case of emergency. Please call ER or a pharmacy.

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@colleenyoung

Hi @felicityr, you mention that you are a doctor and medical specialist. Are you a PhD or MD? What field of medicine?

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Hi Colleen, I have a medical specialist degree (an FRACP) and am a practicing doctor. I love medicine and all things medical fascinate me but I come to this group because I have experienced over many years the mysterious breathing anomaly being repeatedly described here. Despite being medical (or maybe because of it) I am acutely aware of the difficulties doctors have in dealing with symptoms with no clear answer.
My own sense is that this 'condition' causes more morbidity than medicine recognises but that because it has now been labelled "panic" and "anxiety" no one is bothering to consider it more closely.
I really don't want to be here giving anyone medical advice, but I understand that on a site like this there is always a risk that anything i say will be taken as "medical advice". It is always difficult being medical regarding declaring that you are. If you don't then it can be hard to explain why you know what you know, but if you do you risk all that goes along with that.
Please if you want to speak with me more (eg about my medical field, which is one of the big medical specialities), use my provided email to contact me as I prefer not to put too much out publicly which could identify me specifically.

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@felicityr

Hi Colleen, I have a medical specialist degree (an FRACP) and am a practicing doctor. I love medicine and all things medical fascinate me but I come to this group because I have experienced over many years the mysterious breathing anomaly being repeatedly described here. Despite being medical (or maybe because of it) I am acutely aware of the difficulties doctors have in dealing with symptoms with no clear answer.
My own sense is that this 'condition' causes more morbidity than medicine recognises but that because it has now been labelled "panic" and "anxiety" no one is bothering to consider it more closely.
I really don't want to be here giving anyone medical advice, but I understand that on a site like this there is always a risk that anything i say will be taken as "medical advice". It is always difficult being medical regarding declaring that you are. If you don't then it can be hard to explain why you know what you know, but if you do you risk all that goes along with that.
Please if you want to speak with me more (eg about my medical field, which is one of the big medical specialities), use my provided email to contact me as I prefer not to put too much out publicly which could identify me specifically.

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Morbidity?? That is so not what I want to hear as someone who has this and panic disorder. Now I am ultra freaked out.

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@gabrielm

@lidiaboglarka When my dyspnea first started back in 2012, I did research on mineral/vitamin deficiencies as well. So I started taking vitamin B12, which strangely had an immediate effect of clearing the problem very quickly. I could breathe normal again. That went on for probably just a few weeks, maybe a couple of weeks, and then the dyspnea returned and so I started taking an iron supplement. Once again, that helped clear the problem for days, and then it returned. So I don't know why that happened, but any supplements I take now, including magnesium, don't help the problem.

Jump to this post

Have you tried any psych meds? I keep seeing that SSRI's can reverse this.

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@qbug

Morbidity?? That is so not what I want to hear as someone who has this and panic disorder. Now I am ultra freaked out.

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Hi Q bug,
I'm so sorry I freaked you out. That was not my intention but I can see how it happened.
There are two terms used all the time in medicine. They "go together" and are "morbidity" and "mortality".
(In medicine they are used as neutral terms.)
We use them when we are talking about the effects of any medical illness or condition.
Mortality refers to the chance of a person with a condition dying from that condition, so, for instance, a high speed car crash without a seatbelt on would be considered to have a "high mortality".
Most medical conditions people have don't kill them, but they can cause varying degrees of suffering – pain, limitations of movement, difficulty exercising etc etc. These things are, collectively, referred to as the "morbidity" of a condition. So something that has a high morbidity has a lot of negative effects for the person who has it, and something that has a low morbidity has not too many negative effects.
Chronic shortness of breath, and, in particular the sensation of "air hunger", which many people on this site are struggling with, are often played down by the medical community. My point regarding "morbidity" is that doctors often don't understand the degree of suffering (ie the morbidity) that these conditions cause people to endure and so they don't take them that seriously.
For many people with panic disorder, breathing difficulties are an intrinsic part of their disorder and this is well recognised. So if the doctor says you have panic disorder and gives you treatment for it and it all makes sense and you feel better then that is good, and appropriate.
My comment about "panic" is that for some people, it is not the primary disorder causing their breathing problem, but if they get labelled with that, and the label is incorrect, it becomes almost impossible to get the doctor to help them look for alternative, better fitting, diagnoses, and, unless they do, it may be less likely that the person will be able to get help to get better. For people in this situation, the wrong label can be devastating.
I hope this helps to reassure you.
Kind regards

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@felicityr

Hi Q bug,
I'm so sorry I freaked you out. That was not my intention but I can see how it happened.
There are two terms used all the time in medicine. They "go together" and are "morbidity" and "mortality".
(In medicine they are used as neutral terms.)
We use them when we are talking about the effects of any medical illness or condition.
Mortality refers to the chance of a person with a condition dying from that condition, so, for instance, a high speed car crash without a seatbelt on would be considered to have a "high mortality".
Most medical conditions people have don't kill them, but they can cause varying degrees of suffering – pain, limitations of movement, difficulty exercising etc etc. These things are, collectively, referred to as the "morbidity" of a condition. So something that has a high morbidity has a lot of negative effects for the person who has it, and something that has a low morbidity has not too many negative effects.
Chronic shortness of breath, and, in particular the sensation of "air hunger", which many people on this site are struggling with, are often played down by the medical community. My point regarding "morbidity" is that doctors often don't understand the degree of suffering (ie the morbidity) that these conditions cause people to endure and so they don't take them that seriously.
For many people with panic disorder, breathing difficulties are an intrinsic part of their disorder and this is well recognised. So if the doctor says you have panic disorder and gives you treatment for it and it all makes sense and you feel better then that is good, and appropriate.
My comment about "panic" is that for some people, it is not the primary disorder causing their breathing problem, but if they get labelled with that, and the label is incorrect, it becomes almost impossible to get the doctor to help them look for alternative, better fitting, diagnoses, and, unless they do, it may be less likely that the person will be able to get help to get better. For people in this situation, the wrong label can be devastating.
I hope this helps to reassure you.
Kind regards

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Thank you for clarifying!!! I am not a medical terminology savant haha!

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