Out of breath with exercise, asthma, something else?

[PeterPan]

Ok, walk me through this because I'm clearly not very self-aware with my body and don't know what's going on here. I have asthma, yes. I'm overweight, yes, about 35 pounds probably. I lift and have been working out for 2-3 years now (I've lost track), though I had a break. I got out of breath before, when I was first starting, it improved slightly, but cardio has been my nemesis. I'm having someone make my plans now, and they're appropriate for my strength level. 

So I pant after I lift and I pant when I run. And people are like oh I breathe heavily too. No I'm like they hear me coming down the hall and they know it's me. I sprint laps, like sprint a lap, walk a lap, where 18 laps are one mile (meaning we're talking around a basketball gym, 30 seconds) and I'm out of breath. I *run* at a placid pace, not sprinting, and I'm out of breath. I lift and I'm out of breath.

It *doesn't* feel like the asthma. My asthma has been under control pretty much since last June. I have had no bronchitis or pneumonia for one calendar year now, and I've only needed my inhaler maybe twice since last June. I had *one* day this spring (maybe a week ago) where I was like dude I think my lungs are a little tight. I stopped running, came home, took turmeric and zyrtec and was fine to run later in the week.

Is it (and remember I have no clue what I'm talking about here)

1) scar tissue from having pneumonia and bronchitis so many times over the course of two years? I had a lot of stress, everything flared up, and it was probably 5-7 times total in two years. I literally lost track.

2) the asthma and I don't realize it? My lungs don't feel tight, but maybe I'm not getting enough oxygen even so to power my oh so awesome, muscle-laden body? Hahaha. 

3) weak inspiratory muscles? I was just reading a study about this https://www.colorado.edu/today/2019/02/25/novel-workout-improves-health  and I ordered the lower tech version of the product they used https://www.powerbreathe.com/plus  to see if it would help. So the idea is to increase the strength of the muscles supporting the rib cage, etc so you don't fatigue so easily.

4) weak cardio overall?

5) something else I'm not thinking of?

So my options seemed to be:

1) try an inhaler anyway, just to see what happens. I don't really like this option, because like I said I'm lifting 4 days a week. Using a muscle relaxer that gives you the shakes right before you lift seems sorta inverse. And honest they're not tight like an asthma attack.

2) get smart and take my pulse oximeter and peak flow meter and make data while I run. I don't feel light-headed, fwiw. I've had that happen if I don't stop and breathe, so I know it CAN happen. I'm just panting like I worked really hard. Everything I do makes me look like I'm working really hard.

3) shut up and suck up.

4) go to my very nice gp I actually have now, pay $80, get no answers, and get referred to someone, I don't know who.

5) find a pulmonologist who specializes in sports medicine (is there such a thing?) and have them hook me up to contraptions and tell me precisely what's going on. If it's just I'm fat, I'm gonna feel really stupid, and I'll have blown a lot of money. If something needs to be done, it might give me good data. If I can get the same data by using my stupid pulse oximeter somehow, I should do that. And if it would be like $1k for the testing, that would be really rough. I actually have to pay for this, so that factors in. 

I've thought for 3 years it's just that I was overweight and out of shape, but I don't think I'm THAT out of shape. I lift weights for 60-90 minutes (with breaks) and I can run 2 miles with the breaks (run 2 laps, walk 1). It's just I pant a lot. If I DON'T stop and breathe, like if I superset without slowing down, I get lightheaded. I had that happen, because the plan said superset. I'm *strong* enough to superset, but I was lightheaded in the locker room. 

I also think that my breathing is related to my fatigue amount the next day. I'm not really concrete on that. I just think if I could breathe better, I'd fatigue less, because when I don't breathe well one day (for whatever reason) I'm definitely more fatigued the next. I think it's at the point where I need to do something sensible, and I'm not sure what it is. I had a pulmonologist, but he wasn't doing anything preventative. And really, I seem to need an astonishing level of air to feel good. Like we've talked about this on other asthma threads, but my peak flow is usually 520-540 when I'm feeling well. It's so unusually high relative to my age/height that I almost wondered if that means something is WRONG with me? Like maybe weak inspiratory muscles are leave my lungs floppy so I take in more or need more??? I know, that doesn't make sense, lol.

So there. I think I'd be a powerful wonder woman if I could get my breathing better and get this stupid panting to stop. I think it's disproportional to the amount I work out and where my fitness should be. But I haven't a clue what to do next. Any ideas? Is there a particular type of doctor who specializes in this?

[Terabith]

I don't see a downside to trying number 2.  If that doesn't work, I would try number one next.  I mean, I wouldn't like that as a default thing, but as a "try it and see if it makes a difference," it seems like a useful data point to have, right?  I agree with you that I don't love either number 4 or 5, since I suspect the gp is likely to shrug and the specialist is likely to be very expensive and still maybe shrug.  So I'd try 2, followed by 1, and see what happens?  Make the next plan after you have more data?

[PeterPan]

1 minute ago, Terabith said:

I suspect the gp is likely to shrug and the specialist is likely to be very expensive and still maybe shrug. 

Oh dear, that's what I was afraid of. 

I'm trying to google to figure out what kind of data I'd be making. 

3 minutes ago, HeighHo said:

Did you mention before that you had methylation issues?   

I think you need a Dr. that is into functional medicine.

Well that's something I hadn't thought of. Yes, brilliant memory there. I have some defects that leave me on the high side (COMT, etc.) and also the MTHFR. I totally had not thought about that. I've been wanting to get my b12 and homocysteine tested, because my good cholesterol runs low. I've been out of the B vitamin I was taking and am waiting for a new bottle. Would that help my breathing?? Or you're saying methylation itself is part of breathing?

I don't know, you're blowing my mind here. I totally had not thought of that. Now I've got to google.

[PeterPan]

6 minutes ago, HeighHo said:

I think you need a Dr. that is into functional medicine.

I was just watching some video about doctors in Cleveland who do this. They seemed to vary, even within the video. How would I know if I had a good one?

[Terabith]

That's a thought....vitamin B can effect energy, can't it?  I wouldn't THINK it would alter breathing, but maybe energy?  I think it is possible you have scarring in your lungs, too.  But I don't KNOW that.

[Carol in Cal.]

Yes, focus on the methylation a bit, but also, what about iron?  Do you tend toward anemia?  If you are low in iron, your blood cells don't move oxygen around nearly as effectively, and I could imagine that causing you to huff and puff somewhat, particularly after exertion.

 

[PeterPan]

Ok, could I say that I'm now ANNOYED that my doctor wouldn't run my homocysteine levels? Apparently I could keel over from a blood clot! https://www.stoptheclot.org/homocysteine-and-mthfr-mutation/

[PeterPan]

2 minutes ago, Carol in Cal. said:

Yes, focus on the methylation a bit, but also, what about iron?  Do you tend toward anemia?  If you are low in iron, your blood cells don't move oxygen around nearly as effectively, and I could imagine that causing you to huff and puff somewhat, particularly after exertion.

 

Interesting point. My iron has always been really good when I've been tested. I had labs this fall and it was good. Even when pregnant my iron was good. But that's a really, really good point that minerals are involved in all that, hmm.

[Carol in Cal.]

3 minutes ago, PeterPan said:

Interesting point. My iron has always been really good when I've been tested. I had labs this fall and it was good. Even when pregnant my iron was good. But that's a really, really good point that minerals are involved in all that, hmm.

So if you want to start gentle/inexpensive on this, you could:

Start your good B's again

Mentally audit your recent eating for iron, and maybe increase iron-rich foods just a tad

Take an epsom salt bath and go outside in the sun twice a week just in case it's a D lack or Mg lack, gentle ways to address these and not overkill on the other side

[PeterPan]

This article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735467/  lists three common issues that *mimic* EIB=exercise-induced bronchiospasm. 

-vocal cord dysfunction

-cardiac disorders

-gastro... reflux

I don't think I have the reflux, and I hope I don't have a cardiac disorder. I'm looking at charts on the VCD. How common is this? How probable is this as an explanation?

https://www.checkupnewsroom.com/its-not-asthma-its-vocal-cord-dysfunction/

https://www.nationaljewish.org/health-insights/health-infographics/understanding-vocal-cord-dysfunction

What I'm seeing is that VCD is difficulty getting air IN and asthma is difficulty getting it OUT. That seems overly simplistic to me and probably not valid diagnostically? Or is it?

[sangtarah]

10 minutes ago, PeterPan said:

This article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735467/  lists three common issues that *mimic* EIB=exercise-induced bronchiospasm. 

-vocal cord dysfunction

-cardiac disorders

-gastro... reflux

I don't think I have the reflux, and I hope I don't have a cardiac disorder. I'm looking at charts on the VCD. How common is this? How probable is this as an explanation?

https://www.checkupnewsroom.com/its-not-asthma-its-vocal-cord-dysfunction/

https://www.nationaljewish.org/health-insights/health-infographics/understanding-vocal-cord-dysfunction

What I'm seeing is that VCD is difficulty getting air IN and asthma is difficulty getting it OUT. That seems overly simplistic to me and probably not valid diagnostically? Or is it?

 Dd9 has VCD and asthma, and that’s exactly how she describes VCD - hard to get air in. For her, it’s also related to anxiety, but it can act up with environmental triggers. For what it’s worth, her pulmonary dr advised us to use an inhaler if we can’t tell the difference; if the coughing stops and breathing improves, it was asthma. The only effective technique for VCD, they said, was a breathing pattern to relax the vocal cords. 

I would vote to try the O2 monitor and peak flow meter and see what you get.  Then try the “rescue” inhaler. I don’t think it would hurt to try those before moving on to the other options. I definitely think scar tissue can play a part, btw, but I’m sure a doc would know more about that. 

[PeterPan]

18 minutes ago, HeighHo said:

Yes, the B12 is part of breathing/fatigue.  Many other causes too though. Is it just recently that you aren't able to run wihout alternating walking/running?  

What happens if you lose the weight? What happens if you run a little slower?

I don't know how to find a good doctor other than asking for referrals from other doctors or patients.

So you're specifically saying b12? Wowsers, so did not know that.

The person making the plans has me doing the alternating. The most I had ever done in the last few years was 4 laps at a time, and that took me a while to work up to. That was with working out 4+ days a week, and those workouts were pretty vigorous, like crossfit type classes just at the Y.  So no, this isn't recent but a long-standing issue. And I sort of ignored it at first because I figured I was fat and out of shape. Now I'm still heavy, but I've been working out enough that this is absurd. 

You're right, it's a valid question whether it's the weight. A girl I was walking with (during the breaks between run laps) is about the same fitness level and weight and level of overweight and SHE thought I was unusually out of breath.

[PeterPan]

40 minutes ago, Carol in Cal. said:

So if you want to start gentle/inexpensive on this, you could:

Start your good B's again

Mentally audit your recent eating for iron, and maybe increase iron-rich foods just a tad

Take an epsom salt bath and go outside in the sun twice a week just in case it's a D lack or Mg lack, gentle ways to address these and not overkill on the other side

I'm on magnesium and D and have done blood labs to keep my D at the top of the normal range. It definitely makes a difference on energy but doesn't seem to impact my breathing. 

It's a really interesting question what effect the Bs have. I really don't know.

[PeterPan]

8 minutes ago, sangtarah said:

 Dd9 has VCD and asthma, and that’s exactly how she describes VCD - hard to get air in. For her, it’s also related to anxiety, but it can act up with environmental triggers. For what it’s worth, her pulmonary dr advised us to use an inhaler if we can’t tell the difference; if the coughing stops and breathing improves, it was asthma. The only effective technique for VCD, they said, was a breathing pattern to relax the vocal cords. 

I would vote to try the O2 monitor and peak flow meter and see what you get.  Then try the “rescue” inhaler. I don’t think it would hurt to try those before moving on to the other options. I definitely think scar tissue can play a part, btw, but I’m sure a doc would know more about that. 

I was hoping you'd pop in!! I remembered your comment about VCD in your dd. So on the O2, seems to me it would go lower with both, yes? I'm trying to imagine doing the peak flow meter. I guess I should just try it and see what happens. In those moments I'm trying so hard to get a deep breath, but I can try. 

So if the inhaler helps, it was the asthma. I hadn't thought of it that way, lol. So the albuterol does *not* help VCD? Interesting. 

What are the breathing patterns for the VCD? I'll have to google it and try. If I'm breathing anyway, I might as well breathe a different way and see what happens. 

If it's scar tissue, that's gonna suck. But then maybe that means the ISTM therapy can help by compensating or making another aspect stronger? I mean, I'd be happy to give up cardio too, haha. Not like I'm a great lover of the cardio, lol. I have such small aspirations, just one mile, that's all. And I thought I had it before I had the pause (for sickness, ds' therapies, etc.). But that was when people were noticing how red, dead, and tired I was. That seemed to improve after I got the asthma under control. I must be going in circles. 

It might be a combo of things, duh. Like get my Bs up and and and.

Off to google VCD breathing. Certainly can't hurt.

[sangtarah]

18 minutes ago, PeterPan said:

I was hoping you'd pop in!! I remembered your comment about VCD in your dd. So on the O2, seems to me it would go lower with both, yes? I'm trying to imagine doing the peak flow meter. I guess I should just try it and see what happens. In those moments I'm trying so hard to get a deep breath, but I can try. 

So if the inhaler helps, it was the asthma. I hadn't thought of it that way, lol. So the albuterol does *not* help VCD? Interesting. 

What are the breathing patterns for the VCD? I'll have to google it and try. If I'm breathing anyway, I might as well breathe a different way and see what happens. 

If it's scar tissue, that's gonna suck. But then maybe that means the ISTM therapy can help by compensating or making another aspect stronger? I mean, I'd be happy to give up cardio too, haha. Not like I'm a great lover of the cardio, lol. I have such small aspirations, just one mile, that's all. And I thought I had it before I had the pause (for sickness, ds' therapies, etc.). But that was when people were noticing how red, dead, and tired I was. That seemed to improve after I got the asthma under control. I must be going in circles. 

It might be a combo of things, duh. Like get my Bs up and and and.

Off to google VCD breathing. Certainly can't hurt.

Her O2 doesn’t seem low with VCD, only the asthma. Albuterol doesn’t touch the VCD, just helps the lungs. 

The hospital SLP* taught it to us - breathe in for 3 counts, then puff small breaths out in a count of 1, 2, 3. It’s probably easier to watch, lol! 

Edited April 17, 2019 by sangtarah
To add correct profession - I think I need to sleep 😴🤣

[PeterPan]

22 minutes ago, sangtarah said:

a breathing pattern to relax the vocal cords.

Ok, I'm trying some of the things I'm finding, and they seem good! Is there a kind she particularly prefers?

https://azsneeze.com/vocal-cord-dysfunction-breathing-exercises/

-with tongue sticking out

-with tongue tip behind upper teeth at palate

http://img.medscape.com/pi/emed/ckb/allergy_immunology/134823-1337455-137782-1696689.pdf

-straw breathing

**This article says to do the exercises to pre-treat. That seems really smart to me.

https://www.runnersworld.com/advanced/a20819013/exercises-for-those-suffering-vocal-cord-dysfunction/  

This is a pretty extensive article, so I need to read it. It's talking about the SCM and some things I think I would need to stop and really pay attention to to know if they're happening. They're good questions though. 

So I like this, because now I have some things to try. They may or may not be it, lol, but at least I can try them and notice these muscles and areas and see what is happening. 

[PeterPan]

3 minutes ago, sangtarah said:

Her O2 doesn’t seem low with VCD, only the asthma. Albuterol doesn’t touch the VCD, just helps the lungs. 

The hospital PT taught it to us - breathe in for 3 counts, then puff small breaths out in a count of 1, 2, 3. It’s probably easier to watch, lol! 

Thank you!!! That's very helpful. I'll play with it and see what happens.

[PeterPan]

And don't worry, I'm not dropping the B thing. I think I need to gather that data on the breathing AND make a move on the Bs. I just don't know how I want them tested and how extensive that testing needs to be. I sorta let myself circle to inaction on that one. Ok, it's just the price. 

Anyways, I'm listening and pursuing BOTH the breathing and the Bs, not only the one, never fear.

[sangtarah]

Oh, and the Belly Breathing technique is what we were taught to use. We were supposed to practice every day, but you know how things have been going lately. 😝 Hopefully I can coach her when she needs it. 

[PeterPan]

So I'm reading the article on Runner's World (as apparently this is common?)  https://www.runnersworld.com/advanced/a20819013/exercises-for-those-suffering-vocal-cord-dysfunction/   and https://www.runnersworld.com/advanced/a20818998/vocally-distressed/ It's saying there's a book Running on Air so it sounds like I should get that. I don't think I was paying very much attention to my breathing while doing this running, so who knows what I was actually doing. I could be holding my breath for all I know, mercy. 

[gardenmom5]

early on, I found if I was exercising too hard for my physical condition - my ability to breath became more difficult.  then it became difficult even if I wasn't exercising...

so, I learned to listen to my body.  now - I have to get back into things after injuring my knee, twice.  and having adrenal problems that have really set me back.

[PeterPan]

7 hours ago, gardenmom5 said:

I found if I was exercising too hard for my physical condition - my ability to breath became more difficult.  then it became difficult even if I wasn't exercising...

so, I learned to listen to my body.

It's a valid question. Definitely with you on the interoception questions and needing to notice my body. I've worked on it, but clearly not ENOUGH since I can't answer the questions in the thread, lol. At least now I've got a good list of what I'm supposed to be noticing:

-is it breathing OUT that is difficult or breathing IN?

-am I breathing while I run, breathing while I sprint?

-is there tightness in my lungs or larynx or neither?

So I would think with my meters plus trying to notice those things, I should be able to sort this out. 

I think, given the level of my overall fitness, strength, and stamina (ability to lift long sets without muscle fatigue, etc.) that it's not my level of fitness. People who give me looks at the Y aren't looking at me like it's my level of fitness or working too hard but something else. When I look at others with a much greater level of obesity, they aren't out of breath like this. It seems like an unusual level. 

And we'll see. My new B vits should come soon, maybe today. Another wild card is the thyroid issue. I'm on 3/4 gr naturethroid and the doc didn't want to go up because my TSH. With the additional (significant, ridiculous amount) kelp I take, I have energy and can work out again. I ran out of one of my kelp things and used two 1/2 gr a day till the new came, and my exercising was stronger. I think, and this is just my theory, that processing the iodine and minerals to make energy from the kelp is fatiguing my system. I had decreased my kelp supplements by 1/3 when I started doing labs for the thyroid, but now I find myself wishing I had decreased them more. I don't have anything really definite on that, and I don't know how long I would have to let those levels drop (by decreasing the kelp and hence my energy) to get my TSH down enough that he would bump my meds. Like if it takes the TSH 2 weeks to respond to new levels, then I'd have to feel like crap for 2 weeks. Might be worth it. I just haven't found data on how quickly the TSH changes to make a plan there. But it's another thing on the table, sure. I don't know whether that is affecting my breathing. My TSH is below 2 and my energy and stamina are otherwise fine. It's the breathing.

[Laura Corin]

What's your resting heart rate?

Edited April 17, 2019 by Laura Corin

[ktgrok]

Check peak flow. Could be you are getting enough oxygen for regular stuff, but not exercise. Or, exercise is triggering inflammation and your peak flow is lower when exercising. Exercise induced asthma is a thing. 

Or, you are anemic, which can cause panting, etc because you are not getting enough oxygen to the body even though you are breathing fine. 

Or, you are pushing yourself harder than you should be. 

[ktgrok]

Also, remember that lifting weights is about muscle, but what you are describing is cardiovascular fitness. There are PLENTY of super strong guys who look like a Marvel superhero and can lift a small car for hours but get winded walking up a set of steps. Cardiovascular fitness is a totally different thing. 

[PeterPan]

21 minutes ago, Laura Corin said:

What's your resting heart rate?

Well huzzah, another question I hadn't thought to ask! You're right, that tells you a lot. Let me get my little fandangled thing and find out.

Ok, I'll retake in a few minutes. It went up to 81 when I walked to the bedroom to get the meter and it quickly dropped back down. It's now at 66/67. I'll take it again in a few and see what happens. It seems to be staying put there. I don't know if that's good, bad. I'll have to google.

21 minutes ago, Ktgrok said:

Check peak flow. Could be you are getting enough oxygen for regular stuff, but not exercise. Or, exercise is triggering inflammation and your peak flow is lower when exercising. Exercise induced asthma is a thing. 

Or, you are anemic, which can cause panting, etc because you are not getting enough oxygen to the body even though you are breathing fine. 

Or, you are pushing yourself harder than you should be. 

Yup, that's my next thing is to take my peak flow meter. I went through my labs again last night and my iron was good, right in the middle of the normal range. It has always been good. It's a valid question on pushing too hard. It feels *good* what I'm doing and I recover. 

22 minutes ago, Ktgrok said:

Also, remember that lifting weights is about muscle, but what you are describing is cardiovascular fitness. There are PLENTY of super strong guys who look like a Marvel superhero and can lift a small car for hours but get winded walking up a set of steps. Cardiovascular fitness is a totally different thing. 

Yup, I was reading about VO2 last night. I'm not sure what all the ways are to measure cardiovascular fitness. They were talking about an exhaustion test, and I don't think that's a good idea for me. And the thing is, I've been working out enough over the last few years that it seems disproportionate. But is there a safe, reasonable way to measure cardiovascular fitness and see if that's the issue? Maybe it's as simple as resting heart rate? I really don't know. 

I thought all this time I just was out of shape, that I didn't do enough cardio. Now I don't know. I'll go google it. I really don't know how they measure that. 

[PeterPan]

Ok, so there are two tests of cardio fitness I think I could do safely. https://www.sharecare.com/health/evaluating-measuring-fitness-levels/measure-my-cardiovascular-fitness  

-step test=3 minutes with 18" step at 24 steps per minute, record pulse after 1 minute. Then do some math and it generates a score for recovery and hence efficiency.

-treadmill test=walk one mile as fast as can control, take heart rate, do math for score

I'm realizing the Y has you do the step test as part of their fitness testing, so I actually have somewhere my baseline score from a few years ago when I first started... It was in an email, so I don't know where that is. Maybe they would have it? I could even get them to do that portion of the test for me.

Here is the scoring calculation for the step test pasted from that link above.

Duration of exercise (sec) X 100 divided by Recovery pulse X 5.6 = cardiovascular efficiency. Then locate the # in one of following categories:28-38  poor, 39-48  fair, 49-59 average, 60-70 good, 71-100 very good  

Edited April 17, 2019 by PeterPan

[PeterPan]

Now I'm off to measure and see if I have a step that is 18" hahaha. 

[PeterPan]

I'm back. This is the step test I did at the Y. https://www.topendsports.com/testing/tests/step-ymca.htm  They use a 12" step for this. Another link they have https://www.topendsports.com/testing/tests/step.htm is saying that a step test *is* a good measure of VO2 and cardiovascular fitness, but that a very high step (like the 18" at the other links) may underestimate fitness in short people, imagine that. I mean 18" for me is like a hurdle, lol. That's measuring whether I can even get up that high, which I'm not sure I can. I know I've seen very fit people leap like that, but that's not me. I can do that with chairs but 18" is just really high. 

I think I'm going to look through the step tests on the Y site and find one that is easy to administer that would give me good data.

 

[gardenmom5]

1 hour ago, PeterPan said:

It's a valid question. Definitely with you on the interoception questions and needing to notice my body. I've worked on it, but clearly not ENOUGH since I can't answer the questions in the thread, lol. At least now I've got a good list of what I'm supposed to be noticing:

-is it breathing OUT that is difficult or breathing IN?

-am I breathing while I run, breathing while I sprint?

-is there tightness in my lungs or larynx or neither?

So I would think with my meters plus trying to notice those things, I should be able to sort this out. 

I think, given the level of my overall fitness, strength, and stamina (ability to lift long sets without muscle fatigue, etc.) that it's not my level of fitness. People who give me looks at the Y aren't looking at me like it's my level of fitness or working too hard but something else. When I look at others with a much greater level of obesity, they aren't out of breath like this. It seems like an unusual level. 

And we'll see. My new B vits should come soon, maybe today. Another wild card is the thyroid issue. I'm on 3/4 gr naturethroid and the doc didn't want to go up because my TSH. With the additional (significant, ridiculous amount) kelp I take, I have energy and can work out again. I ran out of one of my kelp things and used two 1/2 gr a day till the new came, and my exercising was stronger. I think, and this is just my theory, that processing the iodine and minerals to make energy from the kelp is fatiguing my system. I had decreased my kelp supplements by 1/3 when I started doing labs for the thyroid, but now I find myself wishing I had decreased them more. I don't have anything really definite on that, and I don't know how long I would have to let those levels drop (by decreasing the kelp and hence my energy) to get my TSH down enough that he would bump my meds. Like if it takes the TSH 2 weeks to respond to new levels, then I'd have to feel like crap for 2 weeks. Might be worth it. I just haven't found data on how quickly the TSH changes to make a plan there. But it's another thing on the table, sure. I don't know whether that is affecting my breathing. My TSH is below 2 and my energy and stamina are otherwise fine. It's the breathing.

I found yoga very useful for teaching me how to listen to my body.

with your thyroid - do you have adrenal issues?  (they often go hand in hand).  to know for sure, requires the 24 hour spit test.  the blood test is not reliable.  I have to support the adrenals - as well as take extra iron and a complete mineral complex.

[PeterPan]

6 minutes ago, gardenmom5 said:

I found yoga very useful for teaching me how to listen to my body.

with your thyroid - do you have adrenal issues?  (they often go hand in hand).  to know for sure, requires the 24 hour spit test.  the blood test is not reliable.  I have to support the adrenals - as well as take extra iron and a complete mineral complex.

Used to have CFS/MCS, so yeah been down that path. 

Well I fell down a rabbit hole with this testing. Step testing at 18" seems nuts for me, and turns out the step norms were based on treadmill testing. So I'm going in circles here instead of getting it done, lol.

 

[BeachGal]

Serrapeptase is very good for breaking down scar tissue. In your case if you were to take it, you probably would not want to take it during cold and flu seasons because it has caused pneumonia in some rare cases. It can also cause spider veins. And don’t do mega doses. Maybe 20,000 IU for 4-5 days and then none for 2-3 days. Any weird symptoms, then you stop.

https://selfhacked.com/blog/health-benefits-serrapeptase/#Side_Effects_of_Serrapeptase

Ray Sahelian’s site might also be worth reading.

 

Edited April 17, 2019 by BeachGal

[PeterPan]

15 minutes ago, BeachGal said:

Serrapeptase is very good for breaking down scar tissue. In your case if you were to take it, you probably would not want to take it during cold and flu seasons because it has caused pneumonia in some rare cases. It can also cause spider veins. And don’t do mega doses. Maybe 20,000 IU for 4-5 days and then none for 2-3 days. Any weird symptoms, then you stop.

https://selfhacked.com/blog/health-benefits-serrapeptase/#Side_Effects_of_Serrapeptase

Ray Sahelian’s site might also be worth reading.

 

Thank you, I'll look into it! I had no clue I could do anything about the scar tissue, and it seems to me I must have some. I've just been so fragile with my lungs since then. Definitely going to look into it.

[Katy]

I've had a lot of the same health issues as you and once in my 20's being more out of breath than normal was my only symptom of pneumonia for a couple of weeks. A couple of decades later and I would be more concerned about heart issues.  Still, I'd go to the doctor immediately before trying all the alternative stuff.  It's worth the $80 or whatever.

[PeterPan]

Ok, I'm back with data. It happened during the test, the not being able to get my breath, and it got really scary. It actually left me shaking and SCARED. I'm still shaking a little. 

peak flow before=525

peak flow after = 570 

O2 before =98%

O2 after =99%

I used the Queens test here https://www.topendsports.com/testing/tests/step-queens.htm  and the women's norms because I had a toy bench that was exactly 16.25" to fit the test. I did it with a metronome at 88bpm to get the required 22 steps per minute. The extreme symptoms began at 2 minutes in. Until then I was able to regulate my breathing. I became unable to use calming strategies and regulate my breathing and keep pace, so it got scary. Normally, if I'm at the gym, I will look out the window, take a break, use strategies to get it calmed down. I could not and finish the test, and it left me visibly shaking, anxious, scared. 

My heart rate, per the way it's gathered, was 33 beats in the 15 seconds, which becomes 132 bpm,which put into the VO2 max equation using the version for women yields a score of 41.43. If we ask what the score would be if I were slightly off on my counting, like maybe that should have been 34 beats, then the number is 40.69.

https://www.topendsports.com/testing/norms/vo2max.htm  Using the norming charts provided for that test and looking at the column for my age (42), that means my VO2 max is now in the good range, with only "excellent" being higher. That's better than 5 other categories for my gender and age. I'm turning 43 next month, and in two years that same score will be considered EXCELLENT.

So we see that I was able to elicit the symptoms with 2 minutes of exertion, that they are creating distress, and that my peak flow goes UP during this and that my O2 is retained or improved. My cardiovascular fitness also could be eliminated as the cause. I don't think it's reasonable to say that someone scoring almost in the top category for VO2 max likely has that as the explanation.

So where does that leave us? 

[BeachGal]

Do you have any good running stores? Maybe you could go in and talk to someone and ask if they know any MDs in your area who will help you get a more definitive answer.

[PeterPan]

22 minutes ago, Katy said:

I've had a lot of the same health issues as you and once in my 20's being more out of breath than normal was my only symptom of pneumonia for a couple of weeks. A couple of decades later and I would be more concerned about heart issues.  Still, I'd go to the doctor immediately before trying all the alternative stuff.  It's worth the $80 or whatever.

Ok, but then what doctor? I posted my data right after you, hehe. I really don't know what I'm even looking for here. I mean I saw online about a scope they put down your throat to train you to do VCD relaxation during exertion. I'm not even sure that's it. I'm not having hoarseness, the coughing, or other symptoms. 

Is the basic heart listening they do at the GP enough to eliminate that as an explanation? Is VCD the remaining logical explanation? Is there something else? If it's scar tissue from the repeated pneumonia and bronchitis, wouldn't my O2 and peak flow levels be affected? Like seriously, I'm flabbergasted that they went UP. I never ever ever would have expected that.

It kind of makes you question that it's ever been asthma. No, I definitely have asthma too. Like when I'm at 340, 380, it's really scary bad. I know how that feels. I must have big lungs and need a lot of air, lol. 

So I'm stumped. I have no clue what's causing this, and yet here I am able to provoke it with just two minutes of a step test. It was almost like to panic attack, very significant. So when I'm stopping on the track and going out to get my breath back and relax and look out the windows, I'm doing the right thing. But what in the world???

[PeterPan]

Just now, BeachGal said:

Do you have any good running stores? Maybe you could go in and talk to someone and ask if they know any MDs in your area who will help you get a more definitive answer.

Oh thou art BRILLIANT!!! You're right, we have a really great running store in town where I get my shoes. I kinda don't belong there because they're all skinny and I'm, well I'm me, lol. But yeah, who knows they might be able to say something. 

[PeterPan]

27 minutes ago, Katy said:

being more out of breath than normal was my only symptom of pneumonia for a couple of weeks.

I'm not sure if this is more than normal. It has been this way for years. The last couple years has been hard on me and coming back from my break (where I didn't lift or work out for maybe 6 months) has been hard. I feel older somehow. I'm 42, almost 43, and I was 39 when I started working out. I think it was that last round of antibiotics. It was a different one, and I've just never felt the same since.

I did look up functional medicine docs like HH said. I found this swanky dude in the big city who has been on tv, has a slick website. He wants $3000 in tests after the $350 intake appointment and he takes over your life and nutrition. I've already done that. I think we're really targeted at this point, whatever it is. My overall setup with supplements, etc. is pretty good. I know I had a lot of antibiotic exposure with those illnesses and I know I'm feeling a bit older and that I need those Bs, which I'm waiting for, waiting for.

If it's this VCD idea, then it would explain why the taking breaks and relaxing helps. However during the step test I TRIED to do it and got overwhelmed. If you don't stop, it actually gets overwhelming. And I don't think that's adrenal fatigue either. Btdt, where I had to take a nap after walking 5 minutes. That's not what is happening.

[PeterPan]

I'm flabbergasted by my VO2 scores and that the peak flow went UP. That's blowing my mind. That's actually a lot of progress!! Like I've worked really hard here, so that's cool to see. I was SAYING I was getting more fit, but people hear 188 and they're like no way, lol. I'm sorta built like a Clydesdale horse. 

[PeterPan]

Would hormones have any effect on this? I don't know, you hit early 40s and it just seems like the thing to ask...

[PeterPan]

37 minutes ago, Katy said:

I would be more concerned about heart issues

I'm looking at this. https://www.mayoclinic.org/symptoms/shortness-of-breath/basics/causes/sym-20050890  It lists some things like heart attack and cardiac tamponade (excess fluid around the heart). Wouldn't the doc have caught this during that regular annual GP visit? I went to one and he listened to me. That was this fall, maybe 6 months ago.

Edited April 17, 2019 by PeterPan

[PeterPan]

I think I need to see somebody who does sports, somebody who's thinking through all the systems as a whole (heart, lungs, etc.) rather than a guy who does only one thing. Otherwise I don't know how you sort this out.

[PeterPan]

Ok, so according to this study, it's logical to assume it's VCD. Comorbidity with asthma is super high. https://www.ncbi.nlm.nih.gov/pubmed/19962874

Still trying to figure out what doc I'd see. The university has a sports medicine branch, but I'm not sure they're doing VCD. They list asthma and injuries. 

[Katy]

Maybe google VCD and see what branch of medicine has published about it the most?  With anything rare it's not going to be easy to diagnose.

[QumaCote]

I haven't carefully read every single reply (sorry!), but please go get your heart checked out.  My dh had absolutely NO markers for heart disease and appeared to be super healthy.  However, he had a heart attack about 6 months ago.  He had 100% blockage in his dominant artery.  He was complaining that he was out-of-shape and got super winded whenever he exerted himself which made no sense to me because he was always active.  However, it was his heart.  Fortunately, because he was always active, his heart had created other robust circulatory pathways which prevented him from having major heart damage.

I pray it is NOT your heart.  However, I never would have believed my dh was having heart issues, so I do not want you to ignore that.  I trust you are able to find help soon and that it is something easy to correct.

[PeterPan]

2 hours ago, QumaCote said:

I haven't carefully read every single reply (sorry!), but please go get your heart checked out.  My dh had absolutely NO markers for heart disease and appeared to be super healthy.  However, he had a heart attack about 6 months ago.  He had 100% blockage in his dominant artery.  He was complaining that he was out-of-shape and got super winded whenever he exerted himself which made no sense to me because he was always active.  However, it was his heart.  Fortunately, because he was always active, his heart had created other robust circulatory pathways which prevented him from having major heart damage.

I pray it is NOT your heart.  However, I never would have believed my dh was having heart issues, so I do not want you to ignore that.  I trust you are able to find help soon and that it is something easy to correct.

Yes, I want someone who can check both the heart and VCD angles. I agree it's not safe to *assume* it's VCD.

2 minutes ago, HeighHo said:

I'd start with the GP.  blood work and check out heart.  For sure you shouldn't be panting. 

For me it was genetics; heart was ruled out due to other genetic problems, D was brought up to correct level, some gastro and thyroid possibilities were ruled out and we arrived at scope or try B12.  The right form of B12 brought me to life, I can run now, never could before without being exhausted after a 1/4 mile jog around flat track.  I no longer have to sleep 9 hrs a night. 

Ok, so the doc listened to my heard 6 months ago and ran normal blood work. The levels were all brilliant, awesome, fabulous. Yes, tested D at my request (because had genetics had shown it was an issue) and the level I'm supplementing it at is keeping it at top end of normal range. Did thyroid and tidied that. So b12 got you the rest of the way? Basically I just need to run labs and see what the vampires say. 

Is there a trick to the b12 to get the levels right? Like with D, it's top end of the normal range. It doesn't seem like getting things into "normal" gets you to feeling good. So how did you know you had the dose right? And on the forms, are you going with something like the Yasko chart? I *think* the preferred form for me was adenosyl (sp). I'd need to go back and check. I have the contradictory genes, so doing methylated is a super no-no and doing regular doesn't feel good either. I was looking at the bottle that's coming and even the levels in it are pretty low. I'm thinking they aren't going to be enough to get my levels up to happy, but I don't know what happy will be, lol.

And how often would you retest B12 when tweaking? Is that every 4 weeks? 6? Or you can pretty much tell when they're right?

[PeterPan]

I'm working on getting the scrip for the b12 and homocysteine labs. 

[PeterPan]

Just now, HeighHo said:

 

I retest B12 every six months.  For me, i started out at 200 ng/DL That is considered normal in the US, but its the low side, where it will keep you alive, but not allow you to thrive.  Wrong form of B12 took me to 900.  I felt marginally better.  After a year, switched to right form of B12. Night and day difference in fatigue and ability to run, slept less,  test number stayed same for a few years and then went to 1100 -- at that point the doc said lay off, and I was getting some anxiety so I did.   I was taking 1000 mc/day, no just 1000 mc/week...I arrived at that by how my memory was doing.  

I am not using anything like Yasko.  I tried a B complex suggested for my genetic variations but didn't seem to do much.   I am so thankful that my lifelong fatigue is fixed that I really don't want to mess with it any further.  

Fabulously helpful. I can't believe I let this go so long. I'm googling it and you're right, straight down the line, b12 can cause this. It's definitely the easiest place to start. I think I can get the scrip this evening and get it run tomorrow, which gives me results pretty quickly. 

So what's the product you're using? Am I allowed to ask? 

[PeterPan]

It was my GP who blew me off btw. He's like your this and that are fine so your b12 will be fine. Hoops, jumping, sigh. But the guy making my plans is a chiro, so he can write the scrip, done. It's the least invasive, least expensive explanation. Then you're at heart problems and VCD, so let's hope it's the B12, lol.