Fibromyalgia and shortness of breath

People with fibromyalgia don’t breathe properly

Research has shown that shortness of breath (dyspnea) is common in people living with Fibromyalgia.

While I was working in direct care, gong to people’s houses to assist them, I was asked many times – why are you “out of breath”?  I was not even aware I was short of breath and breathing hard.  I still struggle with this issue though I exercise, maintain a healthy weight and practice deep breathing taught at my weekly yoga class.

Some research has shown 50% of FMS patients feel short of breath, they experience disordered breathing patterns, taking small, rapid breaths and using only the small muscles of the chest. 

Like me, many people do not realize this and do not take steps to practice slow, deep breathing, using the large muscles of the abdomen, a more desirable method of breathing.

What causes shortness of breath with Fibromyalgia?

There are many causes of shortness of breath but we will concentrate on the main ones that often accompany Fibromyalgia.

Inadequate Sleep:  Many of the FM symptoms are also the classic symptoms of sleep deprivation.   That’s not to say fibromyalgia is simply a sleep disorder; there’s much more to it than that. But it’s clear that non-refreshing sleep does make the symptoms worse, especially tiredness, which can lead to shortness of breath.

Gastroparesis:  Gatroparesis,  or “slow stomach” is marked by nausea, bloating and abdominal pain.  A study was done at Temple University that revealed that fatigue is another top symptom of gastroparesis, which can result in shortness of  breath.  Nutritional deficiencies can also contribute to energy depletion, resulting in shortness of breath.

Depression and Anxiety:  Depression, anxiety, irritability, mood swings, personality changes and panic attacks are all symptoms that may accompany fibromyalgia, and all very exhausting to live with.  But, according to Dr. Robert Bennett, a renowned FM expert and researcher, the number of fibromyalgia patients who experience depression is no greater than for any other chronic illness. Speak to your doctor if you are experiencing symptoms of depression and anxiety.

Hyperventilating:  Feeling very anxious or having a panic attack may cause you to hyperventilate or overbreath, a state of  breathing faster or deeper than normal (hyperpnoea) causing excessive expulsion of circulating  carbon dioxide.

Before I received a diagnosis of Chronic Fatigue Syndrome and later, Fibromyalgia, I had several panic attacks caused by high anxiety.  I would hyperventilate and I literally felt like I was dying, that I could not breathe.  It is very frightening!

During one episode, I had gone to the emergency room and a doctor, who listened and treated me with respect (unlike as a hypochondriac) told me that the heart may influence having a panic attack.  At the time, I didn’t understand.

In fact, Hyperventilation and panic attacks appear to occur in a small segment of the population that have mitral valve prolapse.  Researchers aren’t sure exactly why those with FM seem to have more MVP than the general population. Perhaps there is a genetic factor involved, or a dynamic change that results from the dysfunctional autonomic nerves. More research is needed in this area.

Chest pain:  FMS patients frequently suffer from the pain of Costochondritis, making it difficult to breathe without pain.   Costochondritis is inflammation of the costal cartlage, which connects each rib to the sternum at the sternocostal joint, and is a common cause of chest pain.The lungs do not expand completely, allowing you that deep breath, due to the fact that when the lungs expand they press up against the painful joints where the ribs meet the breastbone.  A person becomes a shallow-breather not wanting to hurt with each breath.  Although it was described first by German surgeon Alexander Tietze in 1921, doctors’ still know very little about the syndrome eighty-eight years later.

Low Blood Pressure:   Dr. Peter Rowe at Johns Hopkins University School of Medicine first discovered the connection between low blood pressure and CFIDS. His paper titled, The Relationship Between Neurally Mediated Hypotension and the Chronic Fatigue Syndrome was published in the September 1995 issue of JAMA.  I can usually sense when my blood pressure is running low, I feel short of breath, light headed and the need to sit.  It usually is in the morning, as I tend to be like a computer, needing to “boot up”.  My doctor also advised me to increase my salt and water intake to increase blood volume.  I was mistakenly omitting salt from my diet, thinking it would be healthier.

Hypothyroidism:  Even though fibromyalgia is a different condition than either hypothyroidism or hyperthyroidism, there are numerous similarities between these conditions. Some people that are diagnosed with hypothyroidism also have Fibromyalgia.

B12 Deficiency/Pernicious Anemia:  Vitamin B12 is needed to produce an adequate amount of healthy red blood cells in the bone marrow. Vitamin B12 is available only in animal foods (meat and dairy products) or yeast extracts (such as brewer’s yeast). Vitamin B12 deficiency is defined by low levels of stored B12 in the body that can result in anemia, a lower-than-normal number of red blood cells.

Iron Deficient Anemia: Iron deficiency anemia is a decrease in the number of red blood cells in the blood due to a lack of iron.  I tend to be borderline.  It is best to have the iron levels checked, as anemia symptoms can mimic symptoms of FMS and CFS.

A study implicated a possible association between FM and a decreased ferritin level. “We suggest that iron as a cofactor in serotonin and dopamine production may have a role in the etiology of FMS.”  (Eur J Clin Nutr. 2010 Mar;64(3):308-12. doi: 10.1038/ejcn.2009.149. Epub 2010 Jan 20.)

 

What to do for Shortness of Breath?

If you experience shortness of breath, be sure to take note of when it occurs, how often it occurs and other related symptomatic information and take this information to your doctor.  It will help them  in reviewing your case.

Ask your doctor to determine if you may be suffering from hypothyroidism, low blood pressure, low B12 levels or iron deficient anemia, and tell them if you are experiencing any anxiety or depression.

 A blood test will be needed to determine if you are anemic.  They may suggest ways to build up your blood count, such as choosing iron-rich foods.  I found cooking in cast iron pots and pans was another way to increase my iron levels.  Your doctor may also suggest an iron supplement or prescription.

The Harvard School of Public Health states meat, poultry, fish, shellfish, eggs and dairy products foods are the main sources of dietary vitamin B12.  Most people naturally obtain plenty of vitamin B12 via their normal diets, but if you need more vitamin B12, concentrate on adding more of these foods into your meals and snacks.  There are alternatives for people like me that do not drink cow’s milk such as coconut, almond or soy milks.

The afa blue-green algae is also an easy way to supplement your diet with vitamin B12.

Discuss a vitamin B12 supplement with your physician. Some people require vitamin B12 pills or injections to obtain the amount of B12 their bodies need, says MayoClinic.com.  However, this should be approved by your doctor for optimal safety. If injections are needed, they are given by a health-care professional.

If it is painful to catch your breath or you have pain on the breastbone and surrounding cartilage, your doctor will be able to advise you on how to relieve the pain, such as rest, heat and/or Ice on the affected area, anti-inflammatory medication to reduce inflammation, OTC (over-the-counter) pain medications, physical therapy and ultrasound treatment, or small cortisone injections to reduce inflammation in the costals (only in severe cases).

Try soaking in a warm Epsom salts bath to help to relieve pain.  Science is slowly catching up to the old tried-and-true methods.  A new study on rats to be printed in The Journal of Physiology confirms clinical experience that magnesium decreases nerve pain.  Magnesium is a main component in the AFA Blue-Green Algae, which I am wild about!  In fact, it is grown wild!

Learning to Breath Properly

As we know, certain actions and emotions can encourage rapid, shallow breathing that limits the amount of air entering and exiting your lungs. Incorrect breathing, such as hyperventilating, can cause dizziness, muscle spasms, chest pain and confusion.

The key to good technique is learning how to breathe with your diaphragm,  the muscle beneath your rib cage, the same one you use for singing or laughing.   “If you’re breathing properly, you can feel your diaphragm pushing down into your belly; utilizing the diaphragm is the key to letting go of stress. It sends a message to the nervous system that you’re relaxed. 

Even practicing for a minute every hour will have noticeable benefits. It will completely change your mental and emotional state.  Good breathing has physical benefits for the whole body, as it helps reduce acidity and makes the body more alkaline.  If you have chronic acidity in your body tissue, you’ll have a greater tendency to develop chronic disease.”