Beta Blocks & Med Chat - You're Welcome To Chime In!

[iheartcats]

I have some good news for once, my breathing tests came back 'normal' (had asthma as a kid, sometimes have exercise-induced incidents in adulthood, but not having exercised in a while with POTS haven't had any). So overall I am showing no asthmatic symptoms, I guess! Yeah!

This means I can start Mestinon (going to after X-mas, I hate starting something new before I have a big event to deal with). So I hope that helps something...trying to stay positive and will give it 'time' to work. I hear it can take an adjustment period (gastro issues, etc.) that can improve.

It also means I may have the option of doing a Beta Blocker. Now...what do Beta Blockers do exactly?

I am currently on: Midodrine (10mg or 5mg 3 times daily, as needed), Seasonique (BCP), Allegra 180 Daily (Allergy), Xanax .25mg (as needed, rarely take), & a multi-vitamin with iron. I take Nasacort for allergies in the Spring/Fall.

How would a Beta Blocker fit in the mix? Would it interfere with anything else? I'm not exactly sure what they DO, but I am quite tachy (heart rate 'average' was 100 today, yuck, because I had a lot to do - I wear a Polar Monitor and it's always over 100 standing). I would love to have a lower HR. It wears me out being so high.

Thanks for helping me out.

[MelissaCrystal]

A beta blocker is just designed to keep your heart rate stable--there are a couple different types of BB's, but most of them also lower your heart rate to keep it from going over 100 during times of rest. There are some undesired side-effects, like low BP, inability to enjoy sex, muscle fatigue, and shortness of breath associated with some of them, but for most people they feel a huge difference in energy not having bad tachycardia anymore.

[firewatcher]

From wikipedia:

Beta blockers block the action of endogenous catecholamines (epinephrine (adrenaline) and norepinephrine (noradrenaline) in particular), on β-adrenergic receptors, part of the sympathetic nervous system which mediates the fight or flight response.

I use mine for tachycardia and the tremor. A tiny dose will work wonders for me!

[jump]

Hi!

Here's how beta blockers work for me:

I take 25 g. of Toprolol XL (metoprolol) at night before I go to bed. It helps control my tachycardias, which are usually worse in the morning (which is why I take it at night, so it's working in the AM).

On the BB, my sitting HR is usually around 52-57. My standing hr is anywhere from 65-90. While 90 is technically speaking still POTSy (because it's a significant change from 50) it's a LOT better than how I am without BB's. Without them, I routinely go from abut 65 to 120-180 which is very uncomfortable. On the BB's, my "tachys" are lower and they are also less frequent.

The BB also helps a LOT with my irregular heart beats. I used to have daily episodes of many many "skipped" beats (like three or four a minute for over an hour) and I used to have a lot of "fluttering" and "gurgling" sensations in my heart. On the BB I virtually never get these any more which is nice because they would make me out of breathe and uncomfortable.

The BB also helps me with bradycardia, strangely enough. Without meds, my hr used to plummet occasionally in the afternoons, to around 48. I would get very cold (my hands and lips would turn purple) and I'd feel confused until I could get my hr up. Even though my hr is lower on the BB, I don't get the huge drops in rate and I don't get the cold sensation and the confusion. Now my hr never gets below 52 except when I'm sleeping.

Here's what the BB DOESN'T do. Even though I'm not as tachycardic when I'm standing, I still have difficulty standing. I might be in line and get hot-cold sensations all over my body, break out in a sweat, feel very weak and faint, have an uncomfortable sensation in my chest, yet my HR will be only 75 or something. For me, it seems the BB masks or blocks the tachycardia but doesn't really change the core cause of my symptoms, so other symptoms still persist. These symptoms aren't as frequent as they were when I wasn't on BB's (when I really couldn't stand for more than a few minutes at all) but they still occur on a regular basis if I have to stand up.

The BB's haven't affected my other ANS symptoms at all, like the thirst, insomnia, GI problems, fatigue.

Over all I've found them to be really helpful. On the small dose I'm on, they haven't lowered my BP nor do they make me feel sluggish or tired (two common side effects). For me they're the difference between being preoccupied by my symptoms 24/7 and being able to ignore them a little and go about my daily life a little more freely. I also take a medication for my thyroid disorder and I take magnesium and B-complex supplements.

The nice thing about most BB's is that they don't stay in your system very long and they don't take a long time to work. So you could easily try a small dose of one, and you'd know within a day or two if it was helping you or not; furthermore, if it was making you feel worse, you could stop it right away and it would be out of your system quickly.

Good luck! I hope you find some things that help you!

[iheartcats]

Sounds like it may be worth starting a small dose - at least giving it a try. I know I sometimes have side effects from medicine, but never have had 'all listed side effects' if you know what I mean. I may have a few and if they are tolerable, and the meds help, I continue taking them.

Well, after I see how Mestinon goes it's nice to know that there's something else to try...tachycardia does get exhausting, easily.

[MelissaCrystal]

Definitely start off small, just like we have to do with everything! It was a shock to my body for about 2 weeks and then I felt GREAT. After about a year my body didn't like it as much, but that's just me. Just remember not to judge it right away--wait for your BP and everything else to adjust. Definitely should start off small though.

[flop]

With your allergies and previous asthma your doctor may recommend a "cardio-selective" beta-blocker (these have more effect on the heart and blood vessels and less effect on the airways).

I was started on Bisoprolol 1.25mg - a tiny dose that is normally used for heart failure. Over the years the dose has been slowly increased and I now take 2.5mg twice a day (the normal full dose is 10mg once a day so I'm still only on half a dose really).

My symptoms have changed in severity and frequency over the years but certainly initially bisoprolol was a very helpful med for me - I had 18months with no fainting episodes, I still felt ill but I didn't actually collapse.

As you mentioned starting Mestinon after Christmas I would advise that you follow the old science lab rule of "only change one factor at once". If you have 2 new meds you won't know what effect each one has individually - I would choose one med to trial first and when settled on that (or off it again if not helpful!) then try the other med.

Good luck,

Flop