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Breathe - Hyperventilation increases your pH

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Hyperventilation, a common faulty breathing pattern, has vast consequences on every bodily system. Learn how to recognize and correct this problem.

One of the most amazing things we do all the time is breathe. From the first breath we take as a baby through to the last breath we take when we die, the cycle of breath continues whether or not we notice. Our breath is essential to our survival - we can only last about 4 to 6 minutes without it. Free breathing massages all our organs including the heart, decompresses our spine, oxygenates each and every cell in our body, and relaxes the mind.

Take a moment or two to notice how you breathe. Place one hand on your chest, and the other on the side of your lower ribcage. Do not take in more air than you normally would do, but rather, quietly observe your breath and notice which hand is doing most of the moving. Is it the rib hand? Good. Notice how your belly is expanding with each breath too. Place both your hands on your lower ribcage now. Relax your abdomen, and as you inhale a normal amount of air, feel your ribcage expand all around. Allow the air to come out all by itself. Notice how your spine moves. If you are lying on your back or stomach, notice how your pelvis moves. Are your legs moving too? Your breath is breathing you and in so doing, is moving you.

Why all this fuss about breathing? Why should we care about how we breathe? Because poor breathing strategies have real health consequences on a physical and a psychological level, and we tend to breathe rather often. It is not like we can decide to stop breathing for a while, so changing to a more optimal breathing pattern can have a huge impact on the ease with which we live in our bodies.

Over breathing, or chronic hyperventilating is a very common breathing pattern that can have many significant consequences. Hyperventilation causes a loss of carbon dioxide from our body which makes the blood more alkaline. In this alkaline environment our hemoglobin, which are the buses that carry the oxygen that we breathe, now has a harder time releasing the oxygen to the cells. As a result, the cells get less oxygen, and through feedback loops, the body signals a need for more air, so the person breathes more frequently, which usually leads to more loss of CO2. The alkaline environment also causes more calcium to enter the muscles and nerve tissue, making them more excitable than they should be, and causes the arteries of the brain, heart and body to constrict, which means reduced blood flow to these tissues. Symptoms of hyperventilation include headaches, chronic muscle tension, chest tightness, cold hands and feet, digestive issues, dizziness, lack of ability to concentrate, irritability, shortness of breath, anxiety, fatigue and even low back or pelvic pain, as when the breath isn't right, the other deep core stabilizer muscles have difficulty controlling the movement of the vertebrae and pelvis. (Some medical conditions such as diabetes or kidney disease may result in an acid environment, so hyperventilation may be the body's way of trying to rebalance the blood pH).

Some hints that you may be hyperventilating include chest breathing, (place one hand on the chest and one on the side of the ribs - does the chest hand move more than the rib hand?), breathing more than 15 times per minute, breathing frequently through the mouth, using your abdominal muscles to force the air out of the lungs so that another breath can be taken quickly, not pausing after the inhale or the exhale, very shallow breathing that is more like the flutter of a butterfly wingthan the slow rhythmical strokes of an eagle.

To begin correcting this breathing pattern, place the hands around the lower ribcage and direct a normal size breath of air deep into the pelvis, relaxing the abdominals and feeling the lower ribs expand all around slightly, and then allow the air to slowly come out all by itself. Notice if you are breathing quickly and actively slow it down by getting the air lower into the lungs. Try to slow down your life - stop rushing about, and slow down your thinking, planning, worrying, mental rehearsing. Physical, mental and emotional hurrying are linked to hurrying the breath.

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Farhi, Donna; The Breathing Book Henry Holt and Company Inc., New York, 1996.

Sherwood, Lauralee; Human Physiology, From Cells to Systems West Publishing Company, St. Paul MN, 2003.

Online at The Certified Capnobreath Trainer

Chaitow, L. Breathing pattern disorders, motor control and low back pain Journal of Osteopathic Medicine Volume 7, Issue 1, April 2004, Pages 33-40.

DeGuire, S. et al. Breathing retraining: a three-year follow-up study of treatment for hyperventilation syndrome and associated functional cardiac symptoms Biofeedback Self Regul Jun;21(2):191-8, 1996.

Gardner, WN The pathophysiology of hyperventilation disorders Chest 109; 516-534, 1996.

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Comments (27)

Submitted by Breathless (not verified) on Sun, 07/23/2006 - 5:51am.

You say: "Hyperventilation
causes a loss of carbon dioxide from our body which makes the blood more alkaline."

How much more alkaline, and can you quantify this? What pH would suggest that someone is hyperventilating? I thought that pH was difficult to disrupt in the absence of various metabolic and other disorders or serious respiratory disorders - particularly as we have renal compensation mechanisms etc. that tend to return pH towards normal. So, I would appreciate your guidance on this. Similarly, what is "the normal size breath of air" to which you refer? Is there a guideline on this, because it is presumably not the normal amount for someone who is hyperventilating?

When you refer to an alkaline environment, I'm not sure when you are referring to respiratory alkalosis, metabolic alkalosis, serological alkalosis or intra- or extra- cellular alkalosis. When you are talking about diabetes and kidney disease and the possible role of hyperventilation as the body's countermeasure to correct pH, are you referring to acute crises or something that is a lower-level chronic metabolic acidosis?

Again, with your comments about calcium, I am not clear whether you are describing acute or chronic conditions. I also don't know which alkalosis you are referring to, although I would guess it is serological?

Diaphragmatic breathing does seem to be helpful where it is practical. Do you have any guidance for people who are obese or who have levels of intra-abdominal fat that produces splinting or difficulty in using the diaphragm?

Best - Breathless

Submitted by Dr. Rob Lamberts on Mon, 07/24/2006 - 5:17am.

By definition, hyperventilation is a lowering of the blood Carbon Dioxide level.  At least, that is what they taught us in physiology class.  It will result in a respiratory alkylosis which will temporarily change the blood pH.  The problem is that this is immediately compensated for by several physiologic counter measures.  The first is that the kidneys no longer hold on to bicarbonate and so lower the pH close to 7.4 (creating a combined respiratory alkylosis and metabolic acidosis).  This is the eventual outcome of rapid breathing.  The second thing that happens is a depression of the respiratory centers of the brain that tell you how much to breathe.  If you hyperventilate, your body will try to slow down your respirations. 

I know that people will hyperventilate from time to time due to emotional stress, but I have not heard of chronic hyperventilation.  It would seem to me that the body's overwhelming drive to have a normal pH and pCO2 would overcome any psychologic factors.

Augusta, GA

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Submitted by Anonymous (not verified) on Wed, 07/26/2006 - 8:41pm.

What exactly does it mean when you have both alkalosis and acidosis?  If there are opposing forces causing either acidemia or alkalemia then you are correct, however this is the case at all times as our bodies constantly have a + and - flux...  But, in the general terminology, you don't have "combined" alkalosis and acidosis.

Submitted by Dr. Rob Lamberts on Thu, 07/27/2006 - 3:51am.

The key here is the terminology for acidosis vs. acidemiaAcidosis and alkylosis refer to the contributions of the kidney and lungs to the overall pH in the body.  This is how it is referred to in physiology.  Acidemia (and Alkylemia) is the overall state - the final pH.  You can't have a combined acidemia and alkalemia, since they refer to a measurable number (the final pH of the blood, 7.4 being normal). 

The respiratory acidosis/alkylosis is caused by the lungs' ability to regulate the CO2 level in the blood through "ventilation."  Ventilation is a term in physiology refering to the way your breathing causes CO2 to go up or down, hence "hyperventilation" is defined by the partial pressure of CO2 in the blood stream being less than 40.  ("Respiration" whole different thing from "ventilation," but I won't go into that now).  Metabolic acidosis/alkylosis is the kidney's management of the dissolved CO2 in the form of bicarbonate (which is the complimentary base for Carbonic acid (H2CO3) caused by the dissolution of CO2 in the blood).  This is measured by the bicarbonate level in the blood.  So when you hyperventilate (cause a respiratory alkylosis) you will temporarily cause an alkylemia, but then the kidneys take over and get rid of the bicarbonate (causing a metabolic acidosis), which brings the pH back to 7.4 (which is the ideal pH in the blood). 

The body does not want to get away from normality, so there are mutiple ways to get back normality.  This terminology (combined acidosis and alkylosis) is confusing, but it refers to the various contributing factors to the overall pH in the bloodstream.  It really refers to the primary phenomenon (someone getting rid of the CO2 through their lungs and causing an alkylosis) and the secondary compensation of the body to improve that (getting rid of HCO3 in the kidneys).  You can even have a chronic respiratory acidosis combined with an acute respiratory acidosis and a metabolic acidosis - it gets very confusing.  This is what drives 1st year medical students and interns crazy at times.  The attendings are constantly asking to make sure you understand the various components of the overall pH in the body.

At least this is what I was taught.

Rob

Augusta, GA

New Websites:

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Submitted by Vreni Gurd on Sat, 07/29/2006 - 9:13pm.

Using a capnograph is the easiest way to measure hyperventilation.  I am no expert on this but I believe that anything below PaCO2 of 30mmHg is considered hyperventilating, although possibly depending on symptoms even 32mmHg could be considered hyperventilating.  I don't think there is any magic number.

When I was talking about a "normal" sized breath, I meant not to take in more air than usual.  In my experience, when you ask someone to take in a breath of air, they usually exaggerate the breath, often expanding more into the chest than they normally would.  "Normal" in this case is the patient's normal.  I am in no way talking about norms. 

Hyperventilation in this context is a chronic thing - people develop a neural pattern that is incorrect, whatever the cause (psychological, physical etc.), and they over-breathe all the time. 

For the most part, I was talking about blood alkylosis.  My understanding is that renal compensation is not adequate to overcome chronic hyperventilation.  Look at my last reference for further info on that.

As for diaphramatic breathing, I think this is vital to health, and that even people that are obese can learn how to do this.  If they are splinting their abdomen, they have a dysfunctional deep core, and they need to be referred to someone trained in helping them find their transversus abdominis and pelvic floor, so that they can replace their splinting stabilization strategy with the correct one, and once they stop using their obliques to grip their ribcage which stops it from moving, they will be able to learn to breathe properly.  This is a motor control issue that probably has led to the poor breathing pattern.  As far as I am concerned, the only segment of the population that has a real excuse for not being physically able to diaphramatically breathe, would be women in their third trimester, where the baby is now big enough to be able to prevent the lungs from descending.

I think you will find my last reference listed very helpful to you and may answer your questions much better than I possibly can. 

I hope you find this helpful, and sorry for the delay in my response.

Vreni Gurd

Health and Vitality Coach
CHEK 3, NLC 2
www.wellnesstips.ca

Submitted by Breathless (not verified) on Sun, 07/30/2006 - 6:47am.

A capnograph will just tell me about ETCO2 levels - the assessment of whether this is hyperventilation will depend on the person's medical history and other factors.

You wrote "My understanding is that renal compensation is not adequate to overcome chronic hyperventilation.  Look at my last reference for further info on that."

Most physiology text-books claim that renal compensation is sufficient to push the blood pH back 'towards normal' in the case of respiratory alkalosis. I am familiar with Gardner. He gives a very mixed picture of acid-base adaptation and it is not always clear when he is discussing acute or chronic hyperventilation.

I was asking you about the disturbance in pH that you implied in the title of your piece, not the ETCO2 levels. You refer to blood alkalosis - again, what level would that be if you say that renal compensation is inadequate to overcome chronic hyperventilation? You said, "Hyperventilation increase your pH" - I think it is entirely reasonable to ask you to quantify that change and indicate the pH level you are talking about.

I think that we will disagree about whether the presence of high levels of intra-abdominal fat can actually prevent full-mobilisation of the diaphragm. It is not practical for everyone to find a suitably qualified physical therapist to work with them to correct this matter. And, I have met people who weigh between 300-700 lbs, they have significant issues in finding a trainer who is experienced with/or a gym-health studio with appropriate equipment that can accept/ people that size.

What is your evidence for people overbreathing "all the time"? Gardner doesn't say that - in fact he comments that some people's ETCO2 goes up during sleep and drops during wakefulness. If you have a study that says otherwise, then I would be interested.

Best - Breathless

Submitted by Vreni (not verified) on Mon, 07/31/2006 - 12:22am.

I have not found the pH number you are asking me about yet.  I will ask the practitioner that I know that does the capnograph work whether she knows what the exact pH levels are and get back to you when she gets back to me.  

You are certainly correct that it is difficult to find trainers that a) know how to retrain the motor control systems properly to correct core function and breathing, and b) feel comfortable working with people of that size, and I acknowledge that that is a very significant stumbling block.  And finding physiotherapists that have access to Real Time Ultrasound to assist in core retraining and a capnograph to train the breathing pattern is no picnic either.  Access is a big problem.  That said, I do think that if they did have access, and they were motivated, they would be able to make the changes necessary over time.  (Always hopeful!) The motor-control exercises I am talking about do not need any equipment, and therefore do not need to be done in a gym, but can be done in the comfort of their own home.  

My thinking is that if someone's normal breathing pattern is to breathe very rapidly - so rapidly that they have to force the breath out by contracting their abdominals in order to take in the next breath as soon as they would like, and when I bring them out for testing on the capnograph to find that they are below 30mmHg, I would suggest that that is possibly a rather chronic hyperventilation pattern.  Their neural pattern is currently set to breathe in this fashion.  In my experience, changing a breathing pattern is not easy, so it is unlikely that this is an occasional thing, unless they just finished exercising or are overly stressed for some reason, which would accellerate their breathing and possibly create temporary hyperventilation.

Perhaps I need to be more careful with my wording - "all the time" is probably pretty extreme.  I'm more looking at overall patterns - not necessarily a 24/7 thing.  But if someone is commonly an apical breather, I think it is worth trying to change the pattern if they are having any kind of symptoms.  I just feel that breathing abnormalities are very common, and can be a contributing issue, if not the cause of many other problems, and my sense is that it is rarely considered.  My goal for the article was more to bring awareness to the issue, and to encourage physicians, physical therapists, and other health practitioners to check breathing patterns rather than overlook it, if they have someone presenting with symptoms.  I am sorry if I offended you in any way.

Vreni :)

Submitted by Anonymous (not verified) on Fri, 08/04/2006 - 5:05pm.

SOMETIMES WHEN I GO TO SLEEP I HAVE PROBLEMS BREATHING I CANT BREATH I BREATH REALLY FAST THEN WHEN THAT HAPPENDS I GET A CHEST PAIN AND MY HEART STARTS 2 HURT IT ONLY HAPPENDS WHEN I GET MAD OR WHEN I GO TO SLEEP @ NIGHTS

Submitted by Vreni Gurd on Sat, 08/05/2006 - 3:38pm.

Hello, Breathless,

I haven't had a lot of time to look into this, but here are two studies that  I've found so far. 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1902283&dopt=Abstract   Chronic respiratory alkalosis.  The effect of sustained hyperventilation on
renal regulation of acid-base equilibrium

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=1405350&query_hl=6&itool=pubmed_docsum
Chronic respiratory alkalosis induces renal PTH-resistance, hyperphosphatemia and hypocalcemia in humans

I hope you find this helpful.  I also want to thank you for pushing me - I am not trying to be a doctor, but am very interested in how the body works, so your questions force me to look in more detail, which is a good thing. 

My goal is to challenge people to back up and look at possible foundational causes of problems from a holistic perspective, rather than immediately trying to treat minute symptoms.   In my opinion, breathing is foundational, and incorrect breathing patterns can cause a whole host of problems in the body, and it makes more sense to address the breathing pattern than treat each symptom separately.

 

Vreni Gurd

Health and Vitality Coach
CHEK 3, NLC 2
www.wellnesstips.ca

Submitted by Daniel (not verified) on Tue, 08/15/2006 - 1:05am.

Recently, mainly while exercising or after intense short-term exertion(ie:sprinting ect..)  I'll feel a shortness of breath, as if I'm not getting enough oxygen from my breathing.  I have to stand still and try to slow my breathing, and avoid the temptation to run for help, feeling like I need immediate access to an oxygen mask!  The longest it has ever taken me to recover is about 5 minutes.  How can I be sure what is happening to me?  Am I not breathing enough during the intense exertion, or breathing too much?  (Male, 43 Years old and in fairly good shape.)

Dan

Submitted by Vreni Gurd on Tue, 08/15/2006 - 8:51am.

Don't worry about feeling short of breath after an intense bout of exercise.  This is not considered hyperventilation - your blood actually becomes acidic with exercise rather than alkaline.  If the exercise is very intense, you are using anaerobic metabolism, which means you are exercising without oxygen, and this causes the accumulation of lactic acid.  You are breathing hard because you are in oxygen debt from the previous bout of exercise, and you need your aerobic system to help your body return to a resting state.  This happens to everyone that exercises anaerobically.  If you watch Olympic athletes that are doing short term activities - figure skaters after their program for example, you will notice that they are out of breath too.

 

Vreni Gurd

Health and Vitality Coach
CHEK 3, NLC 2
www.wellnesstips.ca

Submitted by Dan (not verified) on Wed, 08/16/2006 - 10:34pm.

Thanks for your response!  but I just want to make sure I made my problem clear before...When I've had these episodes, at first I'd start to breath rapidly and deep, but that immediately felt as if it was making the situation worse...so that's when the struggle to control my breathing/panic mode comes in to play. 

Dan

Submitted by Breathless (not verified) on Tue, 08/22/2006 - 1:46pm.

I do appreciate you getting back to me.

My understanding is that 7.44 pH is still within the normal physiological range (upper part of the range is 7.45 pH) - being a logarithmic scale, it would take a lot to shift it further above that. So - other things being equal, it seems as if hyperventilation wouldn't necessarily disturb the pH out of the normal physiological range.

The 1st reference involves normal human subjects in whom acidosis had been induced with ammonium chloride and altitude-induced hypobaric hypoxia to bring about respiratory alkalosis: it is not really the sort of 'naturally occuring' chronic hyperventilation and respiratory alkalosis that you discuss. I accept that the researchers report the blood hydrogen ion concentration decreased by about 0.4 nmol per liter for every decrease of 1 mm Hg (0.13 kPa) in PaCO2 but this still gives me no feeling for an alteration in the pH.

The 2nd reference is about changes to mineral levels etc. but not about pH and it is about hypobaric-hypoxia-induced hyperventilation. Unless I don't understand what PTH has to do with pH?

I haven't been able to find references about normobaric chronic hyperventilation and pH - aren't there any?

I agree about the importance of the breathing pattern rather than the symptoms. I wonder if it is just over-stating the matter to claim that hyperventilation under normobaric conditions has any impact on pH that disturbs it other than within the normal physiological range?

Breathless

Submitted by Anonymous (not verified) on Fri, 04/11/2008 - 7:49pm.

hello,

I've just started physio for hyperventilation, a couple of weeks after doing my homework of lying down and doing my breathing exercises, i have my pelvic floor muscles contracting on exhaling. can you please tell me if this is normal?. or am i doing something wrong?. my bladder is sometimes irrated by this if i dont empty it before hand.thank you.

Submitted by Vreni Gurd on Sat, 04/12/2008 - 10:08am.

Hi there,

I teach a slight pelvic floor contraction on the exhale, with the emphasis being on "slight", so don't squeeze it to death. Try gently squeezing the anus rather than trying to stop urination - maybe this will reduce the irritation. Your bladder should not be bothered by this, as the pelvic floor is meant to be slightly contracted all the time in order to stabilize your pelvis and low back. If this problem continues after more correctional sessions with your physio, he/she may refer you to someone who can check why your bladder is being irritated. Good luck!

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Elizabeth (not verified) on Wed, 04/23/2008 - 11:41pm.

Hi there,

I was just wondering if there was an approximate time you had to be breathing heavily for this ph change to take place?

I've only recently suffered from two attacks of what was most probably hyperventilation in the last three weeks. The first time it happened I woke up with a virus of some sort and after taking a shower felt dizzy. I went to sit down and was probably breathing a little deeper than usual because this is what I would naturally do to calm down and help the dizzy feeling. But within about 30 seconds I had a tingly feeling in my hands followed almost immediately by them clenching up and not being able to move. My heart was beating like crazy and after I couldn't move that's when I probably went into paniced breathing. The same thing happened again when I was travelling in a car and started feeling slightly car sick except this time there were really sharp pains in my muscles whilst I couldn't move. My legs were still hurting from it for the next two days. This time someone was with me and called an ambulance. The doctor told me I was anxious about life, which was an interesting assessment considering how I have nothing to be anxious about.

Both times I might have been breathing a little deeper from normal, but not in an panicky way. I had no reason to be in a panic about anything at the time. I've also noticed that my normal resting heart rate has been increased from its usual 70 beats per minute to 90 beats per minute and this has been the same these last three weeks (I'm 17yrs old, exercise regularly, normal body weight).

I just thought I'd put this up here too in case anyone has any ideas, though don't worry about it if this was the wrong place to ask, my ain question is the first one I asked. My parents arn't booking me in for a doctors apointment for six weeks till me doctor comes back from holidays see.

Thankyou,

From Elizabeth

 

Submitted by Anonymous (not verified) on Tue, 03/15/2011 - 11:23pm.

HI, Am longtime smoker w/COPD(emphysema) When I begin to hyperventilatre I get an uncontrolable URGE to urinate. How exactly is this relasted to hyperventilatioon. Any suggestions?

Submitted by Anonymous (not verified) on Tue, 03/15/2011 - 11:23pm.

HI, Am longtime smoker w/COPD(emphysema) When I begin to hyperventilatre I get an uncontrolable URGE to urinate. How exactly is this relasted to hyperventilatioon. Any suggestions?

Submitted by Anonymous (not verified) on Tue, 03/15/2011 - 11:23pm.

HI, Am longtime smoker w/COPD(emphysema) When I begin to hyperventilatre I get an uncontrolable URGE to urinate. How exactly is this relasted to hyperventilatioon. Any suggestions?

Submitted by Anonymous (not verified) on Tue, 03/15/2011 - 11:23pm.

HI, Am longtime smoker w/COPD(emphysema) When I begin to hyperventilatre I get an uncontrolable URGE to urinate. How exactly is this relasted to hyperventilatioon. Any suggestions?

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