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Low Blood O2, Any Ideas?

Pretzel Logic

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I was recently hospitalized because of trouble breathing, and low blood oxygen saturation(walking around in low 80s on room air). I have asthma, and sleep apnea and I use a cpap without supplemental oxygen. I normally have o2 blood sat in mid 90s and only occasional difficulty breathing, which my albuterol inhaler clears up. I was taking 400mg Test E and 70mg Trest A per week. Blood labs were done several times and were normal besides high creatinine/bun/gfr which is a chronic stable condition for me. Several chest xrays and CT w/contrast were done. No PE, very small area that could have been infection, but no fever, chills, white blood cell abnormalities, etc. Slight atelectasis, and pleural effusion that resolved. Lungs sounded clear throughout, no weezing or signs of asthma. Almost no cough and very slight amount of sputum, almost none. This along with respiratory swab and blood cultures came back negative. Echocardiogram was normal. Spirometry was normal and lung capacity and strength are strong inhaling and exhaling. A “sniff test” showed one side of my diaphragm contracting slightly less or unevenly with the other side. Nothing major was found. I was treated with iv antibiotics for the perceived infection and lasix for the effusion. The whole time my o2 sat was mid 80s on room air, low 90s on 3L of oxygen and I had intermittent difficulty breathing. I was discharged with supplemental oxygen and given referrals to a pulmonologist, neurologist, and rheumatologist for existing reactive arthritis, and polymyalgia rheumattica. The idea being that perhaps it’s a mechanical/muscle/neurological problem with my breathing and not my lungs, per se. Right now I’m at home and still have intermittent difficulty breathing, a blood o2 sat in the mid 80s on room air, and low 90s on 3L of oxygen. Sorry for the long post and thank you for reading it.

Does anyone have any similar experiences or ideas what may be causing the low blood o2 levels? I’m not looking for an internet diagnosis, but some possible experience or idea, especially in the context of bodybuilding. Thank you in advance for any helpful input.
 

[email protected]

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Well, in my case it was due to heart insufficiency and low EF. This lead to water in lungs and therefore O2 exchange was compromised.
But that should have been seen in your ECHO.
How high is your RBC?
 

maldorf

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Sounds like you've had good medical care. My ejection fraction now is below 20% but my oxygen sat is up in the high 90s if I remember right. It's never caused me breathing problems or water retention thank God.

I sure hope they figure our soon what's wrong with you.
 

Pretzel Logic

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Ejection fraction was good. The only thing seen on the echo was slight thickening of the left ventricle. Red blood cells, hemoglobin, and hematocrit were a little bit high, but not much. Sorry that I don’t have the numbers handy.
 

maldorf

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Ejection fraction was good. The only thing seen on the echo was slight thickening of the left ventricle. Red blood cells, hemoglobin, and hematocrit were a little bit high, but not much. Sorry that I don’t have the numbers handy.
And you had no signs of pneumonia or any kind of infection? Maybe the pulmonologist will find something. For some reason you arent getting enough oxygen diffusing through the alveoli. Did they find if your lungs are perfectly normal? Sometimes you can get things like fibrosis of the lungs. The drug Amiodarone can cause that, and its why I wont touch it.
 

Pretzel Logic

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And you had no signs of pneumonia or any kind of infection? Maybe the pulmonologist will find something. For some reason you arent getting enough oxygen diffusing through the alveoli. Did they find if your lungs are perfectly normal? Sometimes you can get things like fibrosis of the lungs. The drug Amiodarone can cause that, and its why I wont touch it.
There was a very slight spotty darkish area seen on the CT, but it’s questionable if it’s even infiltrate. The pulmonologist personally didn’t think I had an infection, even though some doctor or PA called it pneumonia, initially. It, along with the atelectasis and effusion, weren’t seen on the final imaging, so they cleared up. I don’t know if they’re perfectly normal, but with the tests they could perform in the hospital, nothing suggesting the kind of desaturation I’m experiencing was found. Specialists can order more tests in an outpatient setting, but they couldn’t do some tests while I was in the hospital because of insurance rules or conflicts.
 

maldorf

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There was a very slight spotty darkish area seen on the CT, but it’s questionable if it’s even infiltrate. The pulmonologist personally didn’t think I had an infection, even though some doctor or PA called it pneumonia, initially. It, along with the atelectasis and effusion, weren’t seen on the final imaging, so they cleared up. I don’t know if they’re perfectly normal, but with the tests they could perform in the hospital, nothing suggesting the kind of desaturation I’m experiencing was found. Specialists can order more tests in an outpatient setting, but they couldn’t do some tests while I was in the hospital because of insurance rules or conflicts.
Crazy that your O2 is still low after the results of the last imaging. I guess the doctors are stumped? So you continue to require supplemental oxygen to get your levels up to normal?

Glad I've not had that happen. I have asthma and heart failure.
 

Pretzel Logic

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Crazy that your O2 is still low after the results of the last imaging. I guess the doctors are stumped? So you continue to require supplemental oxygen to get your levels up to normal?

Glad I've not had that happen. I have asthma and heart failure.
Yes, exactly. The doctors are stumped and I require oxygen. That’s why they’re looking at autoimmune(which I have, but not in that area) and neurological problems/causes.
 

maldorf

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Yes, exactly. The doctors are stumped and I require oxygen. That’s why they’re looking at autoimmune(which I have, but not in that area) and neurological problems/causes.
Not sure how it shows on imaging, but I'm sure they looked for fibrosis? Can autoimmune issues cause fibrosis of the lungs? Hopefully whatever it is, it's not permanent.
 

nothuman

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Did they check your ferritin? If it's low, it can lower oxygen levels.

Also, sleep apnea lowers oxygen.

Last thing, make sure you breathe in and out through your nose and not your mouth
 

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