Hyperventilation and Its Ramifications

Hyperventilation or over-breathing can cause various health problems.

Sasha Yakovleva, the founder of the Buteyko Breathing Center, Interviews Ira Packman, MD

Dr. Packman: First, I want to say that Dr Buteyko‘s Breathing Normalization concepts regarding the origins and causes of many diseases, especially asthma, is radically different from what medical schools teach.

According to all medical schools (whether allopathic, osteopathic or homeopathic), hyperventilation is the result of certain diseases, not the cause. That’s why doctors say, “You have a chronic anxiety disorder, and therefore you hyperventilate.” Or, “You have chronic pain,” or “depression,” or “asthma,” etc., and “therefore you hyperventilate.”

Dr. Buteyko stated: No, hyperventilation is not the result of various diseases; it is the cause! His concept is revolutionary and maybe too simple for many academicians to accept.

Sasha: How does over-breathing, or hyperventilation, cause asthma and many other diseases?

Dr. Packman: Since the lungs are a part of the respiratory system, the effect of hyperventilation within the lungs is the easiest to explain and understand. The effects of hyperventilation on the whole body (systems and organs not related to breathing) are more complex.

The systemic ramifications of chronic hyperventilation are numerous. All of them are caused by a low level of CO2 in the lungs, which causes a decrease in the level of CO2 in the blood. In the case of asthma, the low level of CO2 in the lungs causes spasms of the airways. This spasm, which is the cause of wheezing, is the body’s attempt to retain the CO2 in the lungs, to correct the problem. Long-term, this shortage of CO2 in the lungs causes a compensatory response throughout the whole body. Every place where the body produces or excretes CO2 will attempt to increase the CO2 level in the body, to correct the deficiency caused by chronic hyperventilation.

These reactions throughout the body are the result of the body’s ongoing efforts to maintain homeostasis, the condition of balance, which is its most comfortable state.

Sasha: In other words, the body is always trying to stay as healthy as possible, right? Would you please elaborate on how homeostasis works?

Dr. Packman: All the main functions of the body are controlled by feedback mechanisms. For example, if your blood sugar is too high, the body will respond by creating more insulin to bring the level of sugar down. This is how the body maintains its balance. No matter what the circumstances are, homeostatic mechanisms are in play to bring us back into a physiologic balance. Some of the physiologic parameters controlled in this way include body temperature, glucose levels, hormone levels, mineral balance, and others but, most importantly, acid/alkaline balance (pH). Since pH affects all functions of the body, its control mechanisms are very sensitive and responsive. If pH changes, the body will do anything it can to bring it back to normal.

Sasha: Does hyperventilation affect pH?

Dr. Packman: When people chronically hyperventilate, their pH changes and their pH control system gets activated.

Sasha: So, what happens to a person who is hyperventilating? Let’s say that someone is sitting in a chair and breathing really fast and heavily for a minute or so? What will be the result of it?

Dr. Packman: The lungs will blow off too much CO2, lowering the CO2 level inside the lungs, and therefore lowering the CO2 level in the blood. As a result, the blood pH will go higher than the norm, becoming more “basic,” or alkaline. (By the way, normal pH is 7.4; 7.3 is considered Acidotic; 7.5 is Basic or Alkaline.)

That is acute hyperventilation. “Acute” means “quickly.” In this case, the pH is changing so quickly that the body cannot adjust. As a result, a person will start feeling light-headed, might experience shortness of breath, his or her muscles will cramp, his heart will race, his chest will tighten, he can get tingling or numbness in his fingertips or toes, he might feel chest pressure or pains – ultimately a person can pass out.

Sasha: But what if a person is breathing just a bit faster and deeper than normal, but does it for several years. It is not noticeable for him or the people around him, yet his lungs regularly process excessive volumes of air.

Dr. Packman: This person is also hyperventilating because he or she is constantly exchanging more air than needed. So, in this case, a person also blows off too much CO2, which changes his pH.

Since this person hyperventilates chronically, the physiologic state of the body is “pathologic” or diseased. In this situation, the body starts doing multiple things to correct the pH. Until the underlying cause of the pH abnormality is corrected (hyperventilation), the body cannot return to a healthy state. 

Sasha: When pH changes due to hyperventilation or any other reason, does the body try to correct this situation? Does it make an attempt to bring it closer to the norm?

Dr. Packman: Of course! The body always struggles to keep its acid/base balance correct. It expends a lot of energy on this because every metabolic and physiologic process in the body is pH-dependent. Whether absorbing nutrients from the bowel or making urine, all the reactions in the body are set up to occur at the pH of 7.4.

So, there are two ways the body can correct pH in the blood. First is a quick way through the lungs. And there is also a slow way, which is through the kidneys.

Sasha: Would you please explain how the body corrects pH in the blood through the lungs?

Dr. Packman: When the pH changes, the body quickly responds by changing the breathing. If the pH becomes more acid, the body starts breathing much faster in order to get rid of CO2 and bring pH back up to the norm.

If pH becomes more alkaline, the body starts breathing slower or starts to wheeze, in an attempt to accumulate CO2 and bring pH back down to the norm.

Sasha: And what is the second, the slow way to correct pH through the kidneys? How does this work?

Dr. Packman: If pH changes, and stays off the norm for a long period of time, then the kidneys have to correct this problem in order to prevent other organs and systems from failing.

If a person chronically hyperventilates, he drops the CO2 level in his blood, and his pH goes up, becoming more alkaline. In this case, the kidneys will excrete more bicarbonate (HCO3), which is a combination of CO2 and water (H20 + CO2 = HCO3). The kidneys change the pH by changing the amount of bicarbonate in the urine, which directly affects the bicarbonate and CO2 levels in the blood. 

Sasha: Is the excretion of this bicarbonate damaging for overall health?

Dr. Packman: Yes. You see, in order to get rid of bicarbonate, the kidneys also have to lose molecules of magnesium, phosphorus, calcium, potassium, and sodium. So, these vital minerals leave the body through the urine when normally the body should keep and use them. 

Sasha: Why would the body get rid of the minerals it needs?

Dr. Packman: Correcting the pH is its priority. To achieve this goal, the kidneys will sacrifice elements which are less important for the survival of the body in order to maintain a normal pH level.

Sasha: I assume, this makes a person chronically depleted of magnesium, phosphorus, calcium, potassium and sodium. This has to impact the body negatively.

Dr. Packman: It does. These minerals (particularly magnesium, phosphorus and calcium) are essential for many basic functions of the body – for example, the contraction of muscles and the propagation of nerve impulses. Their deficiency negatively affects how the nerves and muscles work, making a person feel dull and weak.

Sasha: I know that people who hyperventilate almost always feel weak and fatigued.

Dr. Packman: Hyperventilation affects our energy level. It happens due to the loss of phosphorus and magnesium from the kidneys. Phosphorus is needed to create ATP (Adenosine triphosphate) which is a molecule that stores energy. A lack of phosphorus and magnesium depletes our energy stores, and prevents the body from producing more energy. This affects every single action: anything that the body needs energy for is not going to work well. This includes the immune system, which will lack the energy to create antibodies to fight infections, the liver, the gastrointestinal tract, the kidneys, etc. Muscles and nerves are also affected. When you exercise, your muscles are using up energy. At the same time, energy is created inside the muscles by using ATP. If you don’t have much ATP stored, your muscles will fatigue quickly.

Sasha: This tells me that there is no single organ or system in the body which does not get affected by hyperventilation! Based on the information you have given, I can say that a person’s quality of life and functionality decreases severely!

Dr. Packman: There is another major factor, which makes this situation even worse. Chronic hyperventilation creates chronic oxygen deprivation. What are the results of this? It makes a person feel really lousy! His or her memory will become poor, emotions can be raw and uncontrollable, muscles get fatigued, the heart will not function efficiently, the liver will not be making proteins and glucose as it should, the bone marrow will not respond appropriately to the needs of the immune system… it goes on and on like this.

Sasha: How and why does hyperventilation create a state of oxygen starvation? It would be logical to assume that over-breathing provides us with more oxygen since we take in more air.

Dr. Packman: This is counter-intuitive. You see, our blood contains hemoglobin molecules, which load up on oxygen in the lungs and then carry it through the body, releasing it to the tissues and cells (whether it is the liver, the heart, the bowel, etc.). This process of releasing oxygen is pH-dependent. Christian Bohr was the Danish physiologist who discovered this relationship between pH on the one hand, and hemoglobin, with its propensity to keep or release oxygen, on the other.

Sasha: So hyperventilation makes blood pH more alkaline. How does it affect the release of oxygen to the tissues and cells?

Dr. Packman: If someone is chronically alkaline (let’s say his pH is 7.41 or 7.43 instead of 7.4), the hemoglobin molecules will hold onto the oxygen tighter, and will not release a sufficient volume to the rest of the body. As a result, the whole body will become oxygen-starved.

When doctors have a critically ill person in an intensive care unit, they always would rather keep him or her a little more acid than alkaline, because this increases oxygenation of the body. In a slightly acid environment (let’s say with pH 7.38 instead of 7.4), the hemoglobin molecule releases oxygen easier to all the organs of the body. This relationship between pH and the Hemoglobin molecule’s propensity to give up or hold onto oxygen is called the Bohr Effect.

So, chronic hyperventilation causes the pH in the blood to be chronically too high, or alkaline. This causes chronic oxygen deprivation and therefore everything in the body works less efficiently.

Sasha: So, hyperventilation starts a domino effect of reactions, which is positive in nature (the attempts of the body to maintain homeostasis), and yet they’re injurious for overall health. Is this right?

Dr. Packman: Yes. If a person chronically hyperventilates, the level of CO2 in his lungs drops, and this causes the pH in the blood to become abnormally high. To correct this situation, the kidney gets rid of bicarbonate. During this process, the body loses essential elements, which negatively affect everything in the body. On top of it, the body becomes less capable of storing and producing sufficient energy, and also it experiences oxygen starvation. So nothing works well!

Sasha: That’s why Doctor Buteyko stated that hyperventilation was not only a cause of asthma but about one-hundred-fifty of the most widespread diseases. He also called asthmatics “fortunate” because he believed that their bodies were capable of preventing this “train wreck” by correcting the situation in the very beginning. What would you say about this?

Dr. Packman: I agree with this statement. What I described with respect to the kidneys’ reaction to hyperventilation is the slow response to hyperventilation. It can take days or weeks for the kidneys to react. The lungs of an asthmatic react to hyperventilation in seconds.

When an asthmatic hyperventilates, his or her pH goes up, becoming more alkaline. This creates the necessity to acidify the blood quickly. How to achieve this?

The body says: “I know! I should spasm up the airways and hold on longer to the CO2-rich air that is about to be expelled! This will increase the CO2 concentration in the air sacs, increase the CO2 concentration in the blood and thus correct the pH.” This is exactly what the bodies of asthmatics do. In other words, wheezing is the body’s compensatory mechanism to the alkalosis caused by the state of chronic hyperventilation.

Sasha: So, the body of an asthmatic spasms airways, and as a result a person experiences difficulties breathing – wheezing, tightness of chest, coughing or suffocation.

Dr. Packman: Correct. The body chooses this discomfort over the more serious trouble hyperventilation can create.

Sasha: What happens if Buteyko Breathing Normalization Method is applied?

Dr. Packman: It is as if we say to the body: “Alright, you want more CO2? Slow down your breathing and you’ll have it, so you don’t need to spasm anymore.”

When an asthmatic starts breathing slowly and through the nose, he or she decreases the volume of air exchanging in the lungs, and stops losing a lot of CO2 through exhalation. This increases the level of CO2 inside his air sacs and in the blood – consequently, the pH goes down and becomes normal. The crisis is over! Airways don’t need to spasm anymore and constriction is released. As I’ve already mentioned, the lungs respond incredibly quickly!

By following the recommendations of the Breathing Normalization Method, asthmatics are able to increase the level of CO2 in their lungs and maintain it at a normal level. When this happens, there is no need for their airways to spasm anymore, and no more wheezing, coughing, and suffocation attacks.

Sasha: I remember that in one of your talks, you compared Konstantin Buteyko with Albert Einstein, stating that Dr. Buteyko’s work rewrites the book of medicine in the same way Einstein’s work changed physics.

Doctor Packman: By producing his Theory of Relativity, Einstein said to his fellow physicists: “You are all wrong! This is how it really works!” In response, his work was ignored and Einstein had to work in a mailroom sorting letters. Today, of course, his theory is one of the foundations of modern physics.

Currently, Dr. Buteyko’s theory that hyperventilation is the cause of many diseases seems far-fetched because it contradicts the generally accepted theories of the medical community. To accept this concept, it requires us, the physicians, to completely change the way we look at the cause of most diseases. Dr. Buteyko’s approach is radical. The problem we have is that it works. It is up to us to explain it.

That’s exactly what Albert Einstein faced. His Theory of Relativity was real, and therefore the scientific community had to explain why it worked. This is our challenge as physicians: we have to open our minds and accept the fact that the way we think about the causes of many diseases, including asthma, may not be accurate. This seems simple, and yet it is also extremely complicated because to start thinking differently is not easy.

Einstein’s Theory of Relativity changed the way the world looked at energy, mass, and movement. It made physicists think differently about concepts they took for granted. I believe that Dr. Buteyko’s theory of hyperventilation as the underlying cause of many disease processes, and the ramifications of that theory, will revolutionize the way modern medicine looks at the causes of most diseases.

I would also like to mention my recent realization of the very interesting connection between Dr. Buteyko’s work and the theory and practice of Homeopathic medicine. In a homeopathic sense, people who chronically hyperventilate have a deficiency of the essential element CO2. In the case of asthma, wheezing is the body’s healing response to correct that deficiency. The kidneys also try to achieve the same goal. The Buteyko Method is, therefore, a homeopathic treatment for hyperventilation. It gives the body back the CO2, the vital element in which it is deficient. 

Sasha: And when this happens, people who are severely ill often feel as though they were given their life back. It makes sense since CO2 is considered to be a building block of life. It is a scientific fact that without carbon dioxide life on this planet would be impossible. So we had better acknowledge its importance before it is too late.

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