When you can't catch your breath but the tests are normal

"I can't get a full breath in. It feels stuffy, so I keep taking big breaths."

Some people describe it this way. When they go to the hospital and get tested, the lungs and the heart are both clean. Oxygen saturation is 98%, 99%. Nothing is wrong. So they come back having been told it's "nervous."

I tell these people a slightly different story.

What you're lacking is not oxygen. On the contrary, you have plenty of oxygen. What you're lacking is carbon dioxide.

Most people are surprised. After all, they've been taught that carbon dioxide is waste the body needs to get rid of.

Carbon dioxide is not a waste product

We learn that carbon dioxide is something to be thrown away. That's only half true.

Carbon dioxide is the regulator that sets the acidity (pH) in the body. It plays the role of keeping the blood from tipping too far toward alkaline.

What happens if you breathe more often and more deeply than you need to? Carbon dioxide leaves more than necessary. Then the blood tips toward alkaline.

From here, strange things start happening in the body.

What alkaline-tipped blood does

  You breathe often and deeply
              ↓
  Carbon dioxide leaves the body
              ↓
  The blood tips toward alkaline
              ↓
  ┌────────────┬────────────┬────────────┬────────────┐
  ↓            ↓            ↓            ↓
Calcium      Brain        Nerves       Heart
gets bound   vessels      get          speeds
             narrow       sensitive    up
  ↓            ↓            ↓            ↓
Numb hands   Dizziness    Anxiety,     Palpitations
and feet     Foggy head   tension      Tight chest
Tingling                  Muscle
around                   cramps
the mouth

Let me say a bit more about calcium in particular.

Calcium in the blood exists in two forms. The kind bound to protein, and the kind floating freely. What the nerves and muscles actually use is the freely floating calcium.

When the blood tips toward alkaline, more of this free calcium gets bound onto the protein. The total amount of calcium in the body stays the same, but only the usable calcium decreases. On a test, the calcium comes out normal.

So your hands and feet go numb, the area around your mouth tingles, and in severe cases your hands cramp up. This is why taking calcium supplements often doesn't help. It's not that you're short of it — it's that it's tied up.

Here a nasty loop forms

This is the most heartbreaking part.

When you feel short of breath → you breathe bigger → more carbon dioxide leaves → you feel dizzy, numb, and your heart races → you get more anxious → you breathe more.

The very action taken to get rid of the symptom makes the symptom worse. And in the meantime, the body genuinely suffers. When the sympathetic nervous system stays switched on, oxidative stress builds up in the body, the blood vessels get sensitive, and blood pressure rises and falls. As time goes on, recovery slows down.

So what should you do

First, let me tell you a method you can use when it's urgent.

Don't take big breaths in. Do the opposite.

• Breathe in short through the nose
• Purse your lips and breathe out long (about twice as long as the inhale)
• After exhaling, pause briefly
• Repeat this for a few minutes

The trick is to reduce the inhale and lengthen the exhale. You're giving carbon dioxide time to stay in the body.

There used to be advice to breathe into a paper bag. I don't recommend it. If you actually have a heart or lung problem, it can be dangerous. Don't do it when the diagnosis isn't certain.

But why do you keep breathing that way

This is the place I actually see in the clinic. Breathing techniques only calm the symptom; the cause is often somewhere else.

First, sometimes it's the body, not the mind, that comes first.
If your belly is always bloated and full of gas, the diaphragm has no room to descend. Then you can't take a deep breath and end up breathing shallow and fast. The breath has become shallow because the belly is full. For these people, when digestion becomes comfortable, the breath becomes comfortable too.

In fact, some people feel their chest tighten and their heart race when their belly is full. The heart tests are always normal. The stomach and intestines swell and push the diaphragm up, and that pressure stimulates the heart and the autonomic nervous system.

Second, sometimes the nerves are already sensitized.
When tension continues for a long time, the very brain circuit that directs breathing becomes sensitive. Even when there's no danger, it keeps breathing in a state of alert.

Third, sometimes the neck and shoulders are stiff.
People who breathe using only the upper chest muscles always have knotted necks and shoulders. This is both a result and, at the same time, a cause.

What I do

So I don't just say "breathe well." I look at which axis collapsed first.

• If the problem is abdominal pressure, I first lower the tension and bloating of the gut. This makes room for the diaphragm to descend
• If the problem is the sensitivity of the nerves, I help in the direction of calming the overexcited circuit
• If the problem is a stiff neck and shoulders, I release them so that the nature of that tissue changes

I use herbal medicine in the same direction. There is no medicine that breathes for you. But it is possible to create an environment where the body can breathe comfortably again. When the belly becomes comfortable, the nerves are less startled, and the stiff places loosen, the breath deepens on its own.

What must be checked first

Even if you read this and think "this is my story," you must get tested first.

Shortness of breath appears the same way in heart and lung disease. In the following cases, go to a hospital, not an oriental medicine clinic.

• You're short of breath even at rest, and it gets worse when you lie down
• Your chest hurts as if being squeezed, or the pain radiates to the jaw or arm
• You suddenly become short of breath while one leg swells and hurts
• Your lips or fingernails are bluish
• You have a fever along with cough and phlegm

If none of these signs are present, and your tests are clean but breathing still feels stuffy — that's where I can help.

To be honest

That hyperventilation creates this chain is a well-known fact. Low carbon dioxide and alkalosis, calcium getting tied up, and the narrowing of brain vessels are all established physiology.

But at which point in this circuit herbal medicine works, and how much, has not yet been sufficiently confirmed in humans. Most of it is what has been shown in the lab and in animals. I see it help in clinical practice, but I won't present that as an established fact.

Also, not everyone whose breathing feels stuffy is hyperventilating. If it's not, saying so, and guiding you to where you need to go is half of my job.

---

Finally, please remember just one thing.

When you can't catch your breath, don't take a bigger breath in. Breathe out slowly and long.

What the body wants is often not more air, but a brief moment of room to pause the breath.