More out of breath on stairs? When should I see a doctor?

Breathing hard when you climb stairs is common, because the NHS counts walking up the stairs as vigorous activity. What matters is change. If you are more breathless than you used to be, breathless after only slight effort, or it comes with chest discomfort or pressure, swollen ankles or trouble breathing when you lie flat, see a doctor before anything else. Once you have been checked, build up everyday activity gradually.

Maybe the stairs to your flat or the footbridge over the road used to be easy, and now you stop at the landing to catch your breath. Many people notice this after a period of moving less, after putting on weight, or as the years go by. This article uses information from the UK's NHS and MedlinePlus from the US National Library of Medicine to explain what is usual, which signs mean you should see a doctor, and how to become more active step by step.

Is it normal to get out of breath on the stairs?

Stairs make anyone breathe hard

The NHS describes vigorous activity as activity that makes you breathe hard and fast, so that you cannot say more than a few words without pausing for breath. Walking up the stairs is on its list of vigorous activities, next to running and swimming. So being out of breath after a few flights is what you would expect.

Hard effort can leave you breathless

MedlinePlus explains that when you are short of breath, you may feel as if you are not getting enough air, and that you can sometimes have mild breathing problems because of intense exercise.

Everyday things that make it more noticeable

The NHS lists these among the common causes of shortness of breath:

• being overweight
• smoking

MedlinePlus also lists anxiety among the things that can make you feel short of breath.

When should breathlessness on the stairs make me see a doctor?

The key question is whether it has changed. MedlinePlus says that if you often have trouble breathing, it is important to find out the cause, and the NHS says not to try to work out the cause yourself and to see a GP. The NHS adds that you are not wasting anyone's time by getting it checked.

Signs to book a doctor's appointment

Signs to get advice on the same day

The NHS advises getting urgent advice if you have difficulty breathing and are more short of breath than usual, feel sick or are being sick, cough up blood, have pain or swelling in one leg, or have palpitations, which may feel like your heart is racing, going too slowly, skipping a beat or fluttering in your chest. Thailand has no NHS 111 line, so if you have any of these, go to a hospital the same day rather than waiting for a routine appointment.

Which signs mean I need emergency help?

Call for emergency help (1669 in Thailand) or go to the nearest emergency department straight away if you have any of the following.

The NHS lists these signs:

• severe difficulty breathing: you are gasping, choking or not able to get words out
• your chest feels tight or heavy
• pain that spreads to your arms, back, neck and jaw
• lips or skin turning very pale, blue or grey
• feeling suddenly confused

The NHS advises not driving yourself. Ask someone to drive you or call an ambulance, and bring any medicines you take with you.

What will the doctor want to know?

Breathlessness has many possible causes. MedlinePlus lists problems with the lungs, the airways and the heart, as well as anxiety and allergies, among the things that can make you short of breath, which is why a check-up comes first. Finding the cause is the doctor's job, and the right next step depends on what they find.

Notes to bring

A few notes make the visit easier:

• when you first noticed the change, and whether it came on slowly or suddenly
• how many floors or steps you can now manage compared with before
• whether it happens at rest, when lying down or at night
• any other changes, such as swollen ankles, a cough, chest discomfort or dizziness
• all the medicines you take, and whether you smoke

How can I look after my heart and blood vessels if stairs feel harder?

Start with a check-up. As MedlinePlus explains, breathlessness can come from the lungs, the airways, the heart or other things, so the first step is finding out why with a doctor. After that, the everyday steps below, from the NHS, are about moving every day, building up gradually and not smoking.

Start with your doctor's advice

The NHS advises speaking to a GP first if you have not exercised for some time or have health concerns, and making sure the activity and its intensity suit your fitness.

Move a little every day

The NHS advises adults to do some type of physical activity every day and to break up long periods of sitting. For older adults, the NHS says even light activity counts, such as moving around your home, walking at a slow pace, standing up or making the bed. From there, the NHS goal for adults is at least 150 minutes of moderate activity a week, built up step by step.

If you sit at work all day and barely exercise, see I sit at work all day and barely exercise. Where do I start?

Taking the stairs at your own pace

Once your doctor is happy for you to be more active, you can treat stairs as part of your activity. Climb slowly, pause at a landing when you need to, and use the lift for the rest of the way at first. Choose the cooler hours of the day in hot weather. If you get chest pain or tightness, severe difficulty breathing or feel faint, stop straight away and call 1669, as in the emergency section above. If you notice tiredness or breathlessness that is different from usual, tell your doctor.

Smoking

The NHS lists smoking and being overweight among the common causes of shortness of breath. If you smoke and want to stop, ask your doctor about support.