Air Hunger and Chronic Illness

When You Can’t Catch Your Breath: Understanding Air Hunger in Chronic Illness

Have you ever felt like you just can’t get a full breath in—like you’re starving for air no matter how deeply you try to breathe? That uncomfortable sensation is called air hunger.

It’s more than just feeling a little winded. Air hunger can come with a terrifying sense that your body isn’t getting enough oxygen. You may also feel weak, lightheaded, dizzy, or like you might faint. Some describe it as feeling like they’re suffocating, even when sitting still. But here’s the tricky part: when you go to your doctor, your lungs may sound clear. Your oxygen saturation may look normal. Your heart and lungs might be completely fine and yet, you’re still gasping for air.

So what’s going on?

Air Hunger in Functional Medicine: Root Causes to Consider

In functional medicine, we look beyond the surface to understand what your body is really trying to tell you. Air hunger is a signal, an alarm, often tied to deeper dysfunction in your immune, cardiovascular, and nervous systems.

Here are the most common root causes we see:

1. Iron-Deficiency Anemia and Other Anemias

Oxygen travels through the body on red blood cells. If your body doesn’t have enough red blood cells, or they aren’t functioning properly, you may feel out of breath even at rest.

Iron-deficiency anemia can cause:

• Air hunger or shortness of breath

• Pale skin

• Cold hands and feet

• Dizziness

• Fatigue and weakness

• Heart palpitations

But it’s not just about iron. Other causes of anemia, like B12 or folate deficiency, or chronic inflammation that blocks red blood cell production, can lead to the same symptoms.

2. POTS (Postural Orthostatic Tachycardia Syndrome)

POTS is a form of dysautonomia, meaning your autonomic nervous system doesn’t regulate blood flow the way it should. When you stand up, blood pools in your legs, and your heart races to compensate. Your brain and muscles may not get the oxygen they need, hence the feeling of air hunger.

Other signs of POTS include:

• Rapid heart rate with standing

• Dizziness or fainting

• Brain fog

• Chronic fatigue

• Nausea or GI upset

Many people with POTS describe “air hunger” as one of their most distressing symptoms.

3. MCAS (Mast Cell Activation Syndrome)

Mast cells are immune cells that release histamine and other inflammatory chemicals. In MCAS, these cells become overly reactive and unstable, triggering inflammation, allergies, and even respiratory symptoms like air hunger.

Histamine can affect the lungs and blood vessels, leading to:

• Shortness of breath or tight chest

• Nasal congestion and post-nasal drip

• Flushing, rashes, or itching

• Fatigue and brain fog

• Air hunger, especially during flares or after eating high-histamine foods

In some cases, the sensation is not from actual bronchospasm (like in asthma), but from histamine-induced inflammation and vasodilation, which can reduce effective oxygen delivery.

4. Mold Exposure and Chronic Inflammatory Response Syndrome (CIRS)

Mold toxicity can impair the brain’s ability to regulate breathing. People with CIRS may feel breathless, anxious, or like they’re suffocating, even when blood oxygen is normal.

Symptoms associated with mold exposure include:

• Air hunger and shortness of breath

• Memory and concentration issues

• Sensitivity to light, sound, or smells

• Body aches and chronic fatigue

• Static shocks or “electric” skin sensations

The inflammatory response to biotoxins can impact oxygen usage, mitochondrial energy production, and nervous system signaling.

5. Lyme Disease and Co-Infections

Air hunger is also reported by many people with Lyme disease, especially those with Bartonella, Babesia, or other co-infections. Some researchers and physicians believe spirochetes (the spiral-shaped bacteria responsible for Lyme) can affect the pulmonary system directly or trigger immune and autonomic dysfunction that impacts breathing.

With Babesia (a malaria-like parasite), people may experience:

• Shortness of breath

• Night sweats

• Chest tightness

• Headaches

• Drenching fatigue

• Air hunger, especially at rest or lying down

These infections often go undiagnosed for years and can mimic autoimmune conditions, anxiety, or even asthma.

Other Potential Causes to Consider:

• Hyperventilation syndrome (often triggered by anxiety or chronic stress)

• Low CO2 levels from over-breathing (which paradoxically creates the urge to breathe more)

• Thyroid imbalances, especially hypothyroidism-related anemia or dysregulation

• Mitochondrial dysfunction, impacting how your cells use oxygen

• Hormonal imbalances (estrogen and cortisol shifts can affect respiratory sensitivity)

What Can You Do?

The first step is always to rule out life-threatening conditions like pulmonary embolism, heart disease, or asthma. But once those are off the table, it’s time to dig deeper.

Functional Testing Options:

• Complete blood count (CBC) with ferritin, iron, B12, and folate

• Mast cell markers (histamine, tryptase, DAO)

• Mold illness testing (including mycotoxins and inflammatory markers like TGF-beta and MMP-9)

• Autonomic nervous system testing (tilt table, HRV)

• Lyme and co-infection panels (Babesia, Bartonella, Ehrlichia)

• OAT (organic acids test) to assess mitochondrial and metabolic function

Supportive Therapies:

• Iron and B12 replenishment if deficient (always test first!)

• Mast cell stabilizers like quercetin, DAO, and low-histamine diets

• Electrolyte and fluid support for POTS

• Mitochondrial support with CoQ10, B vitamins, magnesium

• Detox and binders for mold and environmental toxins

• Antimicrobial herbs or medications for Lyme and co-infections

• Nervous system regulation through breathwork, vagus nerve support, and limbic retraining

Final Thoughts

Air hunger is real—and it’s not just in your head. If you’re struggling to breathe and no one can tell you why, know that you’re not alone and that answers are possible. Functional medicine gives us a roadmap to uncover hidden root causes and help your body come back into balance.

You don’t have to live your life gasping for air. Let’s figure this out together.