Low SPO2?

[Kevo]

Every time I've had my blood oxygen checked in my adult life it is pretty low- 90-94%. I live at 6,200 feet. It is even lower at higher altitudes.

At pretty much every annual physical the conversation goes something along the lines of-

Medical assistant taking vitals- "Huh, that doesn't look right."

Checks a different finger or cleans off the pulse oximeter - "Hmm, still looks low"

Then they chart the SPO2 and the doc never brings it up. If I ask the doc they never have an answer.

I bought a pulse oximeter to track my blood oxygen during the pandemic and it confirms the findings of the doctors visits- consistently below 95%.

Is this a thread that I should pull on? Is this even a point of concern?

[Harry]

Huge concern.

That’s what mine was in my 40s, in my 50s it started dropping into the 80s and it was 78-82 by the time I hit 60 and it blew up my heart. (Aortic Aneurism) I was living at 7500 feet in Big Sky. I had to relocate below 2000 feet to get it above 90. Currently live at 1000 feet and it’s 92-93.

Sucks. But deal with it before you cause permanent damage. Don’t do what I did, which was ignore it.


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[Kevo]

Huge concern.

That’s what mine was in my 40s, in my 50s it started dropping into the 80s and it was 78-82 by the time I hit 60 and it blew up my heart. (Aortic Aneurism) I was living at 7500 feet in Big Sky. I had to relocate below 2000 feet to get it above 90. Currently live at 1000 feet and it’s 92-93.

Sucks. But deal with it before you cause permanent damage. Don’t do what I did, which was ignore it.


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Whoa, damn. What course of action would you have taken in your 30s and 40s knowing what you know now?

What could have been done to prevent the aortic aneurysm? And is there a name for the condition that you had that ultimately led to the aneurysm?

[brutah]

I'm not a doctor but that seems concerning to me. Are you black or have darker skin?

https://ihpi.umich.edu/news/commenta...perience-pulse

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[summit]

Aortic aneurism is not going to be predicted by low SpO2 decades earlier, or at least I'm not aware of any such evidence.

78-82 at rest while awake at moderate altitude is "oh fuck."

90-94 at rest awake at high altitude (>8000) is normal even for acclimated people. We don't raise an eyebrow unless <90 or maybe <92 in people we are concerned about. But 90 at 6500 if acclimated is low, if consistent and well measured.

Remember for a more reliable measurement you want a WARM finger and about 60 seconds (and a good waveform or reliable pulse indicator) to get a reliable reading. Usually medical office staff don't wait long enough, much less users of less accurate uncalibrated home units.

[Kevo]

I'm not a doctor but that seems concerning to me. Are you black or have darker skin?

https://ihpi.umich.edu/news/commenta...perience-pulse

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My skin isn't dark enough to cause issues with the pulse oximeters.

Thinking about it, my dad's family has cardiac issues- AFIB, syncope, heart failure, heart attacks. All were athletes and healthy and then ran into issues. My dad is currently the oldest male member of the family as far back as anyone knows. He's 67. There hasn't been a single guy in the family to live past 70, ever. My dad is still skiing and biking and hiking after AFIB and heart failure. His younger brother was a professional marathon runner and is still pretty healthy despite AFIB. He works out probably 4-5 times a week at 65. He's had multiple heart surgeries.

My grandpa died from some kind of cardiac event in his 50s. He was healthy and active and not overweight up to that point.

No one had low SP02 though, so not sure if it is tied to family history.

[Kevo]

Aortic aneurism is not going to be predicted by low SpO2 decades earlier, or at least I'm not aware of any such evidence.

78-82 at rest while awake at moderate altitude is "oh fuck."

90-94 at rest awake at high altitude (>8000) is normal even for acclimated people. We don't raise an eyebrow unless <90 or maybe <92 in people we are concerned about. But 90 at 6500 if acclimated is low, if consistent and well measured.

Remember for a more reliable measurement you want a WARM finger and about 60 seconds (and a good waveform or reliable pulse indicator) to get a reliable reading. Usually medical office staff don't wait long enough, much less users of less accurate uncalibrated home units.

Thanks. I've recently been at 93-94% at rest while awake while acclimated at 6,200 feet.

[fastfred]

This is your future then you die get used to it its a bitch

[detrusor]

Low SpO2 won’t cause an aneurysm. However, vascular disease can cause poor perfusion to the digits resulting in a low reading.

I think it’s worth it to have pulmonary function tests. They are non invasive and can tell you about lung issues. A low hematocrit or low blood pressure can result in a low reading but you would barely be alive in those cases.

What a consistently low SpO2 can lead to is pulmonary hypertension which eventually leads to right heart failure….


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[Harry]

What a consistently low SpO2 can lead to is pulmonary hypertension which eventually leads to right heart failure….


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That’s what happened with me. I should have been more specific.



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[Flounder]

I hardly ever got my oxygen checked so I don’t have a solid baseline. A couple of years I developed afib and got an Apple Watch to monitor it. That’s when I was able to start tracking oxygen levels. I averaged about 93-95% but it would go up to 100% now and then. A year ago I read the book Breath, The New Science of a Lost Art by James Nestor and it’s, no joke, changed my life.

The past year I’ve spent retraining myself on how to breath. Being asthmatic my focus had been in getting more air in my lungs. By breathing slower and at less volume it’s made huge changes including oxygen levels consistently in the 98-100% range.

It’s taken a shit ton of work to change 50+ years of bad breathing habits and I’ve still got a bit further that I want to go. Wish I’d know about it sooner because over breathing certainly caused a lot of my persistent issues. It’s crazy the profound changes including breathing tests are now better than an average non-asthmatic person even with lowering my asthma medications.

I’d definitely recommend reading the book and seeing if anything hits close to home. A year ago I would have never believed how much it would change my life. I don’t think my doctors fully believe it but they also can’t explain the vast improvement in my health.

[Harry]

^^ I’m going to read that book. ^^


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[fastfred]

Are you light headed? Dizzy? See spots? Have trouble breathing? Sleep poorly? Easily winded? Fatigued?

The numbers can be off but you need other symptoms to say "it's a problem" if you have any of the above you got a problem

I'm on oxygen 10 to 12 hrs a day 2 liters sometimes I get crazy and bump it to 3l I can get to 96 or 97 w o2.

Four years ago I could blow a 97% every day all day then the congestive heart failure kicked in I run 92 to 93 these days on avg living at 9000 ft at night I'm in the 70s and when I'm not having a good day it's in the high 80s

I was angry for a long time and when they asked if the o2 was helping I said don't know three years of being on o2 I now know it helps it helps w focus recovery and feeling good

The dizzy shit is becoming more constant I'm suppose to move lower but I have have personal issues that makes me can't I learn to hold on and pretend I'm ok even though I'm gonna pass out

Been putting off the test where check one of my holes honestly sometimes who fucking cares

It doest define me or hold me back life is short today was awesome

[AdironRider]

Every time I've had my blood oxygen checked in my adult life it is pretty low- 90-94%. I live at 6,200 feet. It is even lower at higher altitudes.

At pretty much every annual physical the conversation goes something along the lines of-

Medical assistant taking vitals- "Huh, that doesn't look right."

Checks a different finger or cleans off the pulse oximeter - "Hmm, still looks low"

Then they chart the SPO2 and the doc never brings it up. If I ask the doc they never have an answer.

I bought a pulse oximeter to track my blood oxygen during the pandemic and it confirms the findings of the doctors visits- consistently below 95%.

Is this a thread that I should pull on? Is this even a point of concern?

My son had this same problem (he’s only 2 now so slightly different). Really struggled to break 90-92 percent. It was really affecting his growth (0 percentile on growth charts) and when he got sick it would result in a 2-3 day hospital stay as his o2s would drop to the 70s. No one could pinpoint why unfortunately. We spent some time in salt lake with specialists, checked everything. Nothing conclusive.

After a year of this and several hospital stints my wife and I decided to move to the East Coast and lower elevations. His o2 levels shot up to 100 percent immediately and he started packing on weight. His development across the board improved as well.

It pained us to leave Teton Valley but the results have been dramatic. I hope that isn’t the case for you because Teton Valley is a special place. In my case I think it’s genetic because my o2s were never stellar and I got HAPE the first time I went back to high elevation after moving back East. I also really started struggling to sleep in my 30s.

I know this doesn’t necessarily help the cause but you should really monitor this as it can have serious health effects. I know several people who died from heart attacks in their primes that lived in the Valley and you do not want to live with your heart under permanent stress. I hope you find a solution I was unable to.

[bennymac]

wow props to you guys for doing that. Must have felt like a gamble but what a relief for you to see the results.

[Diamond Joe]

Do you smoke? Smoking will *defininitely* cause your SPO2 to be several notches lower than if you didn't.

[irul&ublo]

I'm not a doctor but that seems concerning to me. Are you black or have darker skin?

https://ihpi.umich.edu/news/commenta...perience-pulse

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I wonder if that fat assed Orange skinned freak has bad tests?

Does this belong in polyass?

[Kevo]

My son had this same problem (he’s only 2 now so slightly different). Really struggled to break 90-92 percent. It was really affecting his growth (0 percentile on growth charts) and when he got sick it would result in a 2-3 day hospital stay as his o2s would drop to the 70s. No one could pinpoint why unfortunately. We spent some time in salt lake with specialists, checked everything. Nothing conclusive.

After a year of this and several hospital stints my wife and I decided to move to the East Coast and lower elevations. His o2 levels shot up to 100 percent immediately and he started packing on weight. His development across the board improved as well.

It pained us to leave Teton Valley but the results have been dramatic. I hope that isn’t the case for you because Teton Valley is a special place. In my case I think it’s genetic because my o2s were never stellar and I got HAPE the first time I went back to high elevation after moving back East. I also really started struggling to sleep in my 30s.

I know this doesn’t necessarily help the cause but you should really monitor this as it can have serious health effects. I know several people who died from heart attacks in their primes that lived in the Valley and you do not want to live with your heart under permanent stress. I hope you find a solution I was unable to.

Damn, sorry to hear about the SPO2 issues with your son. Glad to hear he is doing better.

My previous house in CO was at the exact same elevation. I've lived at altitude for almost 20 years. Not sure if that is a helpful data point or not.

I guess I'll check my oxygen levels next time I go to sea level and see how they look. My running times at sea level and lower elevations are much better than at 6,000+ feet. Even at 4,000 feet I notice a difference.

Do you smoke? Smoking will *defininitely* cause your SPO2 to be several notches lower than if you didn't.

Nope, I don't smoke.

I'll check out that breath book too.

[ötzi]

Yeah, do read the book. It's journalistic and quite readable but there's a lot in it. Breathe through your nose and more slowly and deeply than you do now is the long and short of it but there's a lot more there too.

[goldenboy]

I'm always 90-95, but I also live at 9500'. And I have asthma and my lung function tests aren't great by any means.

Flounder, I'll check out that book. I think I heard a podcast with the author. Curious- how were you able to change 50+ years of breathing habits?

FastFred, sorry to hear all of that, hope you're doing ok.

Related- anyone use mouth tape?

[ötzi]

I don't, but Nestor goes into the tape thing in some depth in the book.

[old goat]

I'm a retired vascular surgeon living at 6000 ft. I've had an ascending aortic aneurysm repaired, aortic valve replaced, 3 heart bypasses (all one operation). I had a crash with 14 rib fractures. My SaO2 just now, with chilly fingers, is 97%. A couple of things you can do to check--besides warmiing your hands by vigorously rubbing them together. Take a couple of very deep breaths and a couple of strong coughs before checing. Check an earlobe. Have the value rechecked after vigorous exercise--you don't want to see it drop. You could have an arterial blood gas done--they take blood from the radial artery (pulse) at the wrist. Can hurt some--I refused one in the hospital one time. If the value is confirmed I'd want a chest xray and probbly pullmonary function tests.

How long has this been going on? What is the most vigorous exercise you do.? Are you short of breath with exercise? Does your heart rate go up quickly with mild-moderate exercise? Have you been exposed for significant length of time to dust, smoke, noxious gases? Do you smoke, or did you. Use mj on more than a casual basis. Use a vape cartridge from a sketchy source? Have you had any serious illnesses? Blood clots, or taken any medicines that are known to cause blood clots. Broken legs? (I don't expect you to tell us, but those are things I'd want to know if I were your doc. What if anything happens next would depend on the answers to those questions and more.

Your value is certainly not dangerous and doesn't require immediate action or treatment, but I would want to know the cause, to know if this is something that could get worse in the futrure. I don't think you need to make an appointment for this but at least ask the doc about it the next time you see them. Don't assume they noticed it. Stuff like that is easy to miss if you're not expecting it and especially if the value was entered digitally into your electronic medical record.

There are people who are unusually senitive to altitude. (Boredom alert: the main compensation for low inspired O2 at altitude is to breath more. This lowers your CO2 and raises the pH. Some people's brains are sensitive to the low O2 saturation and ignore the low CO2 and high pH and keep hyperventilating to get more oxygen.. Some people--the ones who are sensitive to altitude--have brains that ignore the low 02 and are sensitive to the CO2 and pH--those people don't breath enough to compensate for the low inspired 02. The difference between the two groups is biggest during sleep. Some people in the sensitive group can get high altitude pulmonary edema--mountiain sickness--as low at 8000 ft. ) It's possible you are one of those people. There's not much you can do about it on a long term basis. As long as you feel ok there would be no need to move. I would be cautious about going much higher than you have in the past. And I wouldn't assume this is the reason without some further evaluation.

[Flounder]

Flounder, I'll check out that book. I think I heard a podcast with the author. Curious- how were you able to change 50+ years of breathing habits?

I try to consciously pay attention to how I breath all the time. The main technique I’ve been using is Buteyko Breathing since it’s an approved asthma treatment in some countries. The book talks about Dr. Buteyko quite a bit and how the exercises increased the CO2 in your blood. CO2 binds to oxygen so having the right CO2 levels in your blood allows higher oxygen levels.

Also I do use the mouth tape every night. Other breathing exercises I do are 5/7/8 and box breathing. Learning to breath only through my nose while biking was hard. Skiing wasn’t too bad. I spent last winter on the bike trainer working on breathing. At the start I also wore a belt around my diaphragm to restrict breathing while exercising and sleeping.

It’s been a lot of work and lots more to come but the results have been worth it. Much more flexible and relaxed which improved my skiing and biking. Haven’t woken up with a headache in a year, used to have that happen once a week. Recovery time after a hard ride is about half. I sleep better and I have more energy.

[Kevo]

I'm a retired vascular surgeon living at 6000 ft. I've had an ascending aortic aneurysm repaired, aortic valve replaced, 3 heart bypasses (all one operation). I had a crash with 14 rib fractures. My SaO2 just now, with chilly fingers, is 97%. A couple of things you can do to check--besides warmiing your hands by vigorously rubbing them together. Take a couple of very deep breaths and a couple of strong coughs before checing. Check an earlobe. Have the value rechecked after vigorous exercise--you don't want to see it drop. You could have an arterial blood gas done--they take blood from the radial artery (pulse) at the wrist. Can hurt some--I refused one in the hospital one time. If the value is confirmed I'd want a chest xray and probbly pullmonary function tests.

How long has this been going on? What is the most vigorous exercise you do.? Are you short of breath with exercise? Does your heart rate go up quickly with mild-moderate exercise? Have you been exposed for significant length of time to dust, smoke, noxious gases? Do you smoke, or did you. Use mj on more than a casual basis. Use a vape cartridge from a sketchy source? Have you had any serious illnesses? Blood clots, or taken any medicines that are known to cause blood clots. Broken legs? (I don't expect you to tell us, but those are things I'd want to know if I were your doc. What if anything happens next would depend on the answers to those questions and more.

Your value is certainly not dangerous and doesn't require immediate action or treatment, but I would want to know the cause, to know if this is something that could get worse in the futrure. I don't think you need to make an appointment for this but at least ask the doc about it the next time you see them. Don't assume they noticed it. Stuff like that is easy to miss if you're not expecting it and especially if the value was entered digitally into your electronic medical record.

There are people who are unusually senitive to altitude. (Boredom alert: the main compensation for low inspired O2 at altitude is to breath more. This lowers your CO2 and raises the pH. Some people's brains are sensitive to the low O2 saturation and ignore the low CO2 and high pH and keep hyperventilating to get more oxygen.. Some people--the ones who are sensitive to altitude--have brains that ignore the low 02 and are sensitive to the CO2 and pH--those people don't breath enough to compensate for the low inspired 02. The difference between the two groups is biggest during sleep. Some people in the sensitive group can get high altitude pulmonary edema--mountiain sickness--as low at 8000 ft. ) It's possible you are one of those people. There's not much you can do about it on a long term basis. As long as you feel ok there would be no need to move. I would be cautious about going much higher than you have in the past. And I wouldn't assume this is the reason without some further evaluation.

Thanks very much for all of your info.

To answer at least some of your questions -

This has been going on since at least my early 20s. I'm now in my mid 30s.

I do a lot of trail running and cycling. I regularly run 12-18 miles at a time during the summer and bike 20-70 miles at a time.

I've climbed above 6,000 meters without supplemental oxygen multiple times and I've climbed above 4,000 meters hundreds of times. It is now rare for me to go much above 3,000 meters since I moved to a lower mountain range.

In the winter I do a fair amount of ski touring and skate skiing.

I wouldn't say I'm ever short of breath while exercising.

I was a wildland firefighter for a short bit and inhaled a lot of smoke. I also worked in a factory with a ton of salt and grain particulates in the air without lung protection. No known clotting issues. Never tobacco. Casual MJ at times. I went 6+ years without MJ and still had the same SPO2 readings during that time.

[old goat]

Have you ever been frostbitten or near frotstbitten? Once your arteries have had cold injury, even without tissue loss, they are prone to spasm, which would lower the Szo2 measurement. Are your fingers fairly sensitive to the cold?

Next time you have the measurement done, try the earlobe--if the doc has a device that will work on it, and try the deep breaths and coughs, and then make sure you keep breathing deeply while the pulse ox picks up your pulse. Gve it a minute or two for the Sao2 to come up. There can be a lot of variation depending on what position you've been in (don't check right after you get out of bed) and a lot of other factors. The number that matters is the highest value you can get.

Obviously given your fitness level and altitude tolerance it is much less likely that there is significant lung disease. I doubt you have anything to worry about. Between the smoke and the factory it is possible there's some scarring in the lungs but since you don't do that any more and never get short of breath, you can probably skip any further workup. (I worked several summers in a steel mill with a lot of exposure to coal dust without protection and my lungs are fine.)