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What causes shortness of breath, loss of appetite and weight after quitting smoking?

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Posted on Thu, 19 May 2016
Question: I'm a 21 year old male who was a daily marijuana for 2.5 years. After a heavy night of smoking I woke up about 3 weeks ago feeling short of breath and feeling like I cant fully exhale when I breath . Since then I quit smoking and noticed some improvement but not as much as I'd like. The shortness of has been off and on during these 3 weeks which also coincides with an occasional "clicking sensation" around my right upper rib after exhaling from a deep breath. Some other symptoms I've noticed is loss in appetite , but minor loss in weight during these 3 weeks , (151-147) and some weakness, mainly with my grip. I've had zero cough and no fever during this time.
With that being said although I haven't been breathing what I would call normally I don't get winded easily. This morning I ran over a mile at about a 7 minute pace with relative ease.

Some history on myself. I've had a severe case of ulcerative colitis since 2010, with iron deficiency. Last week however I got my blood count checked and I had a hemoglobin of 14, and a certain iron count of 30.I'm writing to you because I'm a student away at college so I want to XXXXXXX the seriousness of what this could be. If in your medical opinion you feel it's nothing too serious I'd rather wait a few weeks to get checked at home.
doctor
Answered by Dr. Matt Wachsman (38 minutes later)
Brief Answer:
Reactive airway disease

Detailed Answer:
Hi,

About 1 in 6 people get some airway reaction with marijuana. There can be other chemicals mixed in that increase this. Frankly, I would have to say I am seeing a much higher percentage than that this week regardless of marijuana useage simply because there's a viral infection going around that irritates the airways a bit. Nobody went to the ER with it. Everybody gets better with mild treatment such as MONTELEUKAST or any other asthma medication. Can't say in your particular case without listening to chest AND I can say in a whole lot of other cases there is a mild inflammation of the respiratory tract going around that is made a bit worse with any other irritant (cigarettes mainly, but air pollution, marijuana, cold weather exposure and many other irritants). This hasn't been serious lately unless someone has some other illness going on.

And, with asthma the lungs overexpand. This is felt mostly as not being able to breath out as easily. There may or may not be wheeze noticed. The overexpanded lungs always stress the rib joints and these get a bit irritated/sore and crack a bit more.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Matt Wachsman (1 hour later)
Thank you for your insight. That seems like a very logical explanation, I was fearing the worst that it was a tumor causing this. I just find it odd that I can run and excercise but can feel like I can't get a full breath sometimes just sitting around. Is this an issue that can possibly resolve itself overtime through excercise and not going back to smoking ?
doctor
Answered by Dr. Matt Wachsman (1 hour later)
Brief Answer:
cannot say

Detailed Answer:
Hi,

Generally bronchitis inflammation AVERAGES a MONTH to get pretty close to better. Versus about 15 seconds to a day or so with medication.
Tumor just isn't common at age < 40.. way the heck rare and comes on gradually.
Marijuana is not a big risk for any cancer.
and... asthma inhalers have stress hormones that open up breathing passages. exercise often has a similar effect for similar reasons (but can also trigger asthma especially exercising in the cold).
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Matt Wachsman (45 hours later)
Is it possible to have bronchitis inflammation in one lung and not the other? Just trying to figure out why I was getting that clicking sensation only near my right upper ribs while taking a deep breath , and not on both sides.
doctor
Answered by Dr. Matt Wachsman (16 minutes later)
Brief Answer:
Tricky

Detailed Answer:
localized problems in lungs are bad. implying pneumonia or a hole or other THING.

that is INSIDE the lung.
clicking is outside. can someone have one sore knuckle or one sore toe?
yeah. generally doesn't mean much. helped by Aleve. gets better in a few days
can't say whether it is INSIDE or outside without being there.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Matt Wachsman (5 hours later)
It's been odd to say the least. I certainly feel that I've been improving , and that clicking sensation near my right upper rib has been occurring less often, but nevertheless still occurs. Although I feel improvement that clicking sensation above limited only to my right side has me concerned about a possible serious underlying cause. Would you say that concern is valid?
doctor
Answered by Dr. Matt Wachsman (41 minutes later)
Brief Answer:
well... a few things...

Detailed Answer:
An external clicking sound is very unlikely to be the lungs. Slight abnormalities of the rib joints can click but aren't very much of anything.

More of a point is whether it can possibly be ignored by you. If not, then a chest x ray can rule out a serious problem and allow you to realize that needless concerns may pop up in your mind without your control and you don't have to pay much attention to them.

Hope this helps you.

Regards.
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Matt Wachsman (18 hours later)
Not sure if this helps clarify anything but it's a clicking sensation I feel on my right side when taking a deep breath, not a sound.
doctor
Answered by Dr. Matt Wachsman (9 minutes later)
Brief Answer:
yes, mainly inside or outside

Detailed Answer:
This can also be just a rough tendon scraping against bone but if on the outside unlikely to be serious, as mentioned above.

But there's another possibility that the Pleura(covering of the lung) is producing a friction rub while there's deep breath involves, to be sure it's better to go for a Chest X-ray (PA view) .

Regards



Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Matt Wachsman (1 hour later)
Thank you for your insight. I will definitely go for that X-ray when I get home for spring break. Fingers crossed it's nothing serious like a potential tumor or anything like that.
doctor
Answered by Dr. Matt Wachsman (8 minutes later)
Brief Answer:
tumors are quite unlikely

Detailed Answer:
Welcome back dear.

Given your age, it just isn't likely to be the usual tumor / lung cancer. And if the clicking is outside, the doctor just might not even order it, someone examining you is always going to have certain information which I do not.

In any case, you're certainly welcome and we can get direct questions directed specifically to a particular doctor if there are more questions in the future.

Take care
Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Matt Wachsman (2 days later)
After thinking about somethings and looking around the dreaded Internet I might have overlooked some symptoms in the past that could be attributed to a potential lung cancer and I wanted to run it by you. Approximately around November I developed a sebaceous cyst near a lymph node in my left armpit.Doctor ordered a sonogram which confirmed it was just a sebaceous cyst. However the cyst popped and left a weird flap of skin that still oozes pus. I link this to the lung cancer theory because of an article I read online saying how certain lung cancers can contribute to abnormal sebaceous tissue growth.

Ironically during this time in November I had another incident with smoking marijuana. I was smoking it out of a water pipe and took one long harsh rip, which was followed by something very strange. My mouth started pouring out saliva uncontrollably like a river which lasted for a few days to a week , accompanied by a hard time swallowing and a feeling of something stuck in the back of my throat. After a few days those symptoms left me and I really didn't think much of it other than maybe just smoking too much that night. But now I'm starting to question if it may be apart of a bigger picture.

December rolled around and I noticed going up a flight of stairs at my job left me a bit winded more than usual but I kind of chalked it up as me being out of shape and being a daily/heavy marijuana smoker for a few years.

February comes, and I tried vaping marijuana wax. Which 4 weeks ago from today developed the feeling that started all this of which I felt I couldn't take a full/satisfying breath. Pretty much since then I've felt weakened, and definitely noticed a significant appetite decrease but without much weight loss, lost about 4-6 and haven't lost any weight since.

I've noticed I have good/bad days. Some days I feel I'm able to take fuller breaths more than others and have more energy than other days. But nothing to which I'd call normal yet. The clicking sensation I mentioned previously more or less stopped but I did notice a tenderness to touch on both ribs, but more specifically my right rib. I also noticed my endurance when I run hasn't really been effected but I did notice after excercise , or just in general that I've had more of an urgency to spit phlegm out. The phlegm is completely clear but I noticed it's pretty thick. Not sure if I mentioned this as well but I also did notice a dull ache near my right upper back during the onset of this but has went away shortly after the initial onset of these symptoms.

Side note: is it at all possible to send pictures through here? I'd like to send a picture of my hands just to check for clubbing and I'm also having a hard time telling if my nails have a purplish hue to them.

I appreciate you and your insight. You've given me nothing but excellent feedback so far. Although I do have a doctors appointment scheduled for when I return home from school. I'm using this as more of a mental XXXXXXX on what to expect when I visit them. I was diagnosed with a very serious case of Ulcerative colitis just 5 years ago when I was 16, so I've tended to fear the worst since then.
doctor
Answered by Dr. Matt Wachsman (7 hours later)
Brief Answer:
several points.

Detailed Answer:
First, signs of cancer would be cough that is not all over the lung but localized. As such breathlessness wouldn't be a good indicator; wheeze all over, or overfilling of the lung and straining ribs wouldn't be good indicators. X ray would show it.

Ok, probably first is that lung cancer per se is extraordinarily RARE in young people.
http://www.cdc.gov/cancer/lung/statistics/age.htm

But cancer can be from other organs and spread to the lung. This occurs in inflammatory bowel disease if there is the development of colo-rectal cancer. Again this is not at all common but is more likely (sort of like it is more common to be struck by lightning on a clear day than being hit by a meteor). X rays OR the blood CEA test would show it if there were a colon cancer to the lung.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Matt Wachsman (5 hours later)
Could quitting smoking also contribute to some of these symptoms ? I've had a few edibles here and there just because I felt was going through some withdrawal symptoms but I would say this is hands down the longest stretch I've gone without smoking marijuana in close to 3 years.
doctor
Answered by Dr. Matt Wachsman (24 minutes later)
Brief Answer:
not exactly

Detailed Answer:
Lack of exposure causing a symptom ? I don't see how that can make sense? On the other hand, lack of marijuana is well known to precipitate mental changes including being hypervigilent, paranoid, and anxious.

So, to summarize, marijuana can cause lung irritation that can be like asthma. Thic can cause lung expansion and irritation of the joints of the chest. These are not like cancer symptoms which is quite rare in those under age 40.

Inflammatory bowel disease is a serious condition that should have follow up. It can lead to cancer of the bowel which can go to the lung. These are not common.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Matt Wachsman (1 hour later)
Through reading online I found that some long term heavy marijuana users had some difficulty breathing and tightness in chest after quitting marijuana. Perhaps maybe due to a cleansing process the lungs undergo after stopping long term use ?

Few other points. I noticed you're an addiction specialist , so I'm not sure if you may be familiar with the new marijuana form known as wax. It's exactly like it sounds it's essentially thc extracted in a wax form and when vaped you can actually notice a waxy particle build up towards the mouth piece. The last time I smoked/vaped was using marijuana wax which is something I hardly ever used. Is it possible a wax particle may be obstructing my breathing?

Ironically the doctor appointment I have scheduled with and have had a relationship for years is an oncologist. I have no history of cancer nor does my family but I'm under this doctors care for my iron defiency. Do you recommend any blood tests they can perform that can perhaps rule some things out ?

Lastly, is it possible to get prescribed an inhaler without going through an X-ray process and all that. I'm in college taking a high volume of credits so I'd like to try the inhaler to see if it helps, if not then of course I'd go for further testing. Not sure if this is something you're allowed to prescribe online ?
Any feedback is appreciated . Thank you for your time.
doctor
Answered by Dr. Matt Wachsman (9 minutes later)
Brief Answer:
good questions.

Detailed Answer:
"maybe due to a cleansing process the lungs undergo after stopping long term use "
no. Maybe because when they are no longer stoned out of their gourds they notice things like not being able to breathe.. house burning down... ? Just an alternative theory. But it is more plausible.

There isn't anything on wax and the lung in the medical literature. It shouldnt have as much residue as regular marijuana cigarettes. There is a higher psychoactive component and increased psychosis is associated with it.

As mentioned either an xray OR the CEA test can show a lung tumor. Each has diseases that it can detect that the other one cannot. Other lung problems like infections for the chest x ray, colon cancer NOT in the lung for the CEA.

Often there are sample inhalers lying around. It can be prescribed online BUT only if the person is in the same location that would fall under the prescribers license.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Matt Wachsman (2 days later)
Are headaches , fatigue , and lightheadedness coincided with asthma ? Or could this be due to marijuana withdraw ?
doctor
Answered by Dr. Matt Wachsman (10 hours later)
Brief Answer:
Timing is key

Detailed Answer:
They are frequently associated with either but the reason they are associated with them, changes the timing of the symptoms.

Marijuana causes fatigue and lightheadedness commonly because of the direct effects. The symptoms would be associated with when the person is high and the symptoms would rapidly dissappear when the person is no longer high.

THe secondary effects of marijuana smoking on asthma and psychology last far longer than the marijuana expousre itself. So, the sympotms would be present for hours to days or even longer after the high had worn off.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Matt Wachsman (10 hours later)
Would you say those symptoms I mentioned in my last post are most likely to be correalated with the breathlessness I'm feeling? Just because I haven't used marijuana in about 5 weeks( when the breathlessness occured)
doctor
Answered by Dr. Matt Wachsman (12 hours later)
Brief Answer:
Timing is key

Detailed Answer:
Secondary effects of marijuana smoking LIKE PRODUCING ASTHMA and psychology last far longer than the marijuana exposure itself. Inflammation from smoking can last for quite a while. So, the symptoms would be present for hours to days or even longer after the high had worn off.

Mild asthma effects are usually felt as tiredness and decreased ability to exercise. They can also be felt as dizziness tingling, lightheadedness, etc.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Matt Wachsman (42 hours later)
Went to my doctor earlier this week who's been an oncologist for 25 years, they weren't the slightest bit worried about my symptoms being anything serious. She suspects a lung infection that needs time to heal.

They listened to my chest and said I sound perfectly clear.
However, since then I noticed clubbing in my fingers. And I've been having to urinate more frequently without actually producing a lot of urine. No pain or anything during urination just noticed going slightly more frequently and producing less urine.

Can these symptoms occur with a lung infection or do they hint something more serious?
doctor
Answered by Dr. Matt Wachsman (10 minutes later)
Brief Answer:
I don't know what to tell you but 'yes' sums it up pretty good.

Detailed Answer:
First, I note that I said all of this. except they mean lung INFLAMMATION which takes time to heal and there isn't much to do about it (monteleukast m a y b e).
and not lung INFECTION for which reasonably they should treat with antibiotics.

The only people I've seen who have had a low sodium also had lung disease including temporary worsenings from infection causing INFLAMMATION. Presumably the sodium went out in urine and presumably they would pee more. This is in the textbooks as an odd link between the lung and kidney hormones. Doubt this is fully understood.

Third, your clubbing is MINOR or it would have been noted by the physicians. Then, you can examine your circulation in the tips of the fingers by pressing the blood out and seeing how fast it returns ("capillary refill").

This is now about a dozen replies. further should be by direct questions through the service.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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What causes shortness of breath, loss of appetite and weight after quitting smoking?

Brief Answer: Reactive airway disease Detailed Answer: Hi, About 1 in 6 people get some airway reaction with marijuana. There can be other chemicals mixed in that increase this. Frankly, I would have to say I am seeing a much higher percentage than that this week regardless of marijuana useage simply because there's a viral infection going around that irritates the airways a bit. Nobody went to the ER with it. Everybody gets better with mild treatment such as MONTELEUKAST or any other asthma medication. Can't say in your particular case without listening to chest AND I can say in a whole lot of other cases there is a mild inflammation of the respiratory tract going around that is made a bit worse with any other irritant (cigarettes mainly, but air pollution, marijuana, cold weather exposure and many other irritants). This hasn't been serious lately unless someone has some other illness going on. And, with asthma the lungs overexpand. This is felt mostly as not being able to breath out as easily. There may or may not be wheeze noticed. The overexpanded lungs always stress the rib joints and these get a bit irritated/sore and crack a bit more.