Beta Blocker?

[joyagh]

My Dr. wants to put me on beta blockers b/c of my constant PCV's. I've heard it can also help POTS but I've also heard it can make you tired. Any advice on if it's worth trying? btw - I've noticed my PCV's are less frequent since I started wearing the abdominal binder.

[dakota]

I don't have POTS (my daughter does), but I had PVC's and was put on a beta blocker for them. It helped tremendously and I was only on a small dose. While I wouldn't say they made me tired, they did help me sleep, as the PVC's were keeping me awake. My daughter is on a large dose of a beta blocker and it doesn't make her tired at all. I think it could be different for everyone, as one doctor suggested a beta blocker to help my daughter sleep. It does not help with that at all for her.

[Kellysavedbygrace]

I've been on two different beta blockers for several months each- Metropolol 1st then Nadolol. I stopped because of hair loss. When I stopped fatigue seemed to improve some. I have some irregular rhythms and suspect they will want to put me back on them. I agree w Dakota, it is most likely different for everyone.

[Libby]

Just to further emphasize how everyone's different, they actually reduced my fatigue. Or the right beta blocker did, I should say.

I tried 3 betas - propranolol first (hated it, I could barely lift my head), then metoprolol and finally (and currently) toprol xr. My fatigue improved on the last 2 beta blockers. Not a huge amount, but it was noticeable. My heart is finally able to fill completely before it contracts, which means more blood flowing through my system.

I actually went on them for PVCs (and tachycardia, but that was my doc's afterthought lol - definitely not mine). It helped SO much. I go days without having any PVCs now, when before if I went 15 minutes it was a miracle.

If one doesn't work for you, don't be afraid to ask to try another. Propranolol, like I said, was awful for me - but it's great for other people. Metoprolol and Toprol XR are the same med, metoprolol, but Toprol XR is just the extended release form. That made a big difference for me too.

[peregrine]

Atenolol made me tired, but propranolol hasn't - it does sound like it really depends on the person and their individual reaction to different meds. (no PVCs above the usual for me)

[McBlonde]

Does anybody know why beta blockers cause fatigue? Do they cause fatigue for all patients or is it only patients with orthostatic intolerance?

[HyperPOTS8]

Fatigue is a common side effect of beta blockers for all types of patients.

[McBlonde]

Fatigue is a common side effect of beta blockers for all types of patients.

Thanks! I have always wondered....

[NMPotsie]

I'm on low dose propranolol (10mg TID) and love it. It controls my hyper surges pretty well and the tachycardia. Like Libby, bbs actually lessened my fatigue because my heart isn't working so hard just standing up. I noticed fatigue for the couple of weeks and then stabilized and I don't notice it at all anymore. I also had a lot of crazy heart issues and it has really leveled these out. I don't feel like there's a bird living in my chest anymore. The only issue it has exacerbated is my bradycardia, but it's not a lot worse than it's always been. It's also caused some wheezing at night with allergy issues.

McBlonde I was told that they cause fatigue because they block ne from its receptors. NE causes your vessels to constrict, your heart to beat faster, and your bp to rise in response to demands on your body (ie when you stand up). Since these things aren't happening you're getting less oxygen to your brain and lungs and more pooling (your vessels aren't working as effectively to move blood up), so you are more tired and experience SOB. This is why you generally salt and fluid load while on them, to counteract the "looser" vessels. Don't quote me on that; I just asked my doc and this was what he said.

[joyagh]

thanks for your relies. seems like they are definitely worth a try.

[McBlonde]

I'm on low dose propranolol (10mg TID) and love it. It controls my hyper surges pretty well and the tachycardia. Like Libby, bbs actually lessened my fatigue because my heart isn't working so hard just standing up. I noticed fatigue for the couple of weeks and then stabilized and I don't notice it at all anymore. I also had a lot of crazy heart issues and it has really leveled these out. I don't feel like there's a bird living in my chest anymore. The only issue it has exacerbated is my bradycardia, but it's not a lot worse than it's always been. It's also caused some wheezing at night with allergy issues.

McBlonde I was told that they cause fatigue because they block ne from its receptors. NE causes your vessels to constrict, your heart to beat faster, and your bp to rise in response to demands on your body (ie when you stand up). Since these things aren't happening you're getting less oxygen to your brain and lungs and more pooling (your vessels aren't working as effectively to move blood up), so you are more tired and experience SOB. This is why you generally salt and fluid load while on them, to counteract the "looser" vessels. Don't quote me on that; I just asked my doc and this was what he said.

So maybe that's why it took 3-4 weeks of the Bystolic building up in my body before the fatigue/blues symptom hit? I've wondered about that, too.

[flyingsquirrel]

I found that I got used to the fatigue in a couple of weeks. If you don't, you might try switching to a long acting beta blocker like nadolol and taking it at night. That way, by the time you wake up, the worst of the fatigue will have passed.

[McBlonde]

That's the part I don't understand about my own reaction with the beta blockers that I've tried. I don't have the fatigue/blues right away... It's like a month into taking a beta blocker that it hits me (feels sorta like a build up to that point i.e. like how it takes an anti-depressant a month to work) although in my case after a month of beta blockers have built up in me, crushing fatigue hits and a bad depression like feeling settles over me. With those symptoms, could the beta blockers be suppressing too much of my NE leading to fatigue and the blues?

[NMPotsie]

I don't know about the blues, but it could definitely cause the fatigue you described. Have you adjusted the dose? I was on a higher dose and it just crushed me. I was crying randomly and spontaneously, and really exhausted. I take a lower dose and spread it out over the day, when I need it most, so that it's in my system but not at high strength. If my bp is low, I only take 1/2 the bb after dinner to prevent a food coma.

I had a similar reaction as you, McBlonde, to clonidine. No matter how low the dose, I felt like dirt and got rebound hypertension. It just wasn't the right med for me.

[McBlonde]

That was a tiny dose (2.5) of Bystolic that did that number on me after 2 weeks (like you said "I was crying randomly and spontaneously, and really exhausted" ) after 4 weeks. I stopped the Bystolic & those symptoms disappeared.

I still haven't taken any of my Clonidine yet. It's sitting waiting along with the Wellbutrin. I realize that what I'm afraid of is not what happens if I take either... What I am afraid of is what happens if I have bad side effects and stop taking it. A regular person takes a drug, has a side effect, stops taking it and everything goes back to how it was before they started the drug. I don't seem to be like that... New symptoms after I stop is what scares me....

[Guest Alex]

I've tried different beta-blockers - bisoprolol - horrible fatigue, lightheadedness, dizziness, hypotension - it practically turned me into a zombie - after about a month of 2.5 mg a bisoprolol a day I was unable to get out of bed without being helped and I still experienced frequent episodes of tachycardia. Then I got diagnosed with POTS.

Now I'm on 10 mg propranolol 2xday since January with what I consider to be almost no benefits ( for ex I take my 10 mg when my resting HR is in the upper 90's and 2 hrs later my HR is almost unchanged). Plus I "gained" a bunch of symptoms I did not have before: painful pins and needles all over my body (neuro dr said there is no neuropathy involved), insomnia, horrible dreams, muscle aches and joint pains, I'm short of breath frequently, I gained a bunch of weight, and I could go on. What makes me wonder even more is the fact that if I try exercising my HR reaches 160-170 very easily. Bottom line - for me beta blockers drop my BP a lot, but for some reason the 10 mg propranolol I'm taking doesn't seem to help my tachycardia. I tried taking more than 20 mg a day and I experienced the same lightheadedness I had while on bisoprolol.

Judging by the posts I've been reading, most people benefit from beta blockers, I might just be the odd one out?!

Best,

Alex

[brethor9]

Alex, I am actually the same as you when it comes to betas....no matter how small the dose they just make me feel 100 times worse I suspect this could be because of underlying mast cell issues either way I just don't tolerate them well

Bren

[Guest Alex]

Bren,

I'm not necessarily saying I'm worse on betas. I think I just have a lot of side effects from them. Also, in terms of mast cell issues - I've read a bunch of stuff about symptoms associated with that and to me that just doesn't fit. I will ask my dr's opinion on that.

Alex

[anovello]

Beta blockers have been a life savor for me.. they have given me somewhat of my life back.. They helped eliminate the "inappropriate sinus tachycardia" ( so the doctors were calling it) which was the diagnosis before I realized that the rapid heart racing I was experiencing was a symptom of POTS/ dysautonomia. For an entire year I ended up in the E.R. a total of 5x before getting the tachycardia under control! I was afraid of my own shadow not knowing what was happening in my body. Once I got on the beta blocker I stopped having issues with my heart racing.

[anovello]

alex74alex- I took propanolol 10 mg for about 2-3 years and still had breakthroughs of tachycardia too. My cardiologist at the time bumped it up to 10 mg 2x a day, which seemed to make a slight difference but not enough . This type of beta-blocker crosses the blood brain barrier, which can be a reason for your nightmares and the other symptoms you metnioned. I too had those similar side effects to the proponalol so I switched to atenolol 12.5mg, which I take once a day and have had better results. No issues with tachycardia at all! Yes I am lightheaded, dizzy, and disoriented ,but I'm pretty sure its symptomatic of POTS/ Dysautonomia. So who knows!! But you may want to consider trying a different beta-blocker just to see if you get better results.

[E Soskis]

I've been on beta blockers for years but, I have AAG and not POTS - some people seem to tolerate them better than others - I could not make it without them - I take propranolol 40 mg every 4 hours - around the clock - even in the middle of the night - if I miss a dose, I have terrible heart arrhythmias that can lead to nearly passing out - I have a pacemaker to pick up my heart rate if it slows down too much, either from the beta blockers or from the actual disease of AAG - I have known people that take low-dose beta blockers for "stage fright" - it helps calm them down and settle their nerves so they can perform more effectively. I also know people that take low-dose blockers for migraine headaches- a sort of preventative. So, I would say that they are quite effective for many things as long as you can tolerate them. Of course, if you ever take a medicine that makes you feel worse than you did before, it might not be the right medicine for you! - ask your doctor!

[Guest Alex]

Anovello,

thank you for your message.

Propranolol would be the 3rd beta I tried - I was on metoprolol, then switched to bisoprolol before ending up on propranolol. So far propranolol seems to be the one I tolerate best.

The other thing - I did not experience any typical POTS symptoms until i started betas, before that I only had several episodes of tachycardia, all of them at rest. Back then I remember several drs checking my vitals laying down and standing (poor man's TTT) and I know for a fact that I did not display any significant increase in HR or a change in BP. Needles to say I was labeled with anxiety and sent home with an ativan prescription.

I'm not blaming drs or pointing fingers at anyone, but deep down I feel that the meds they prescribed might be responsible for the mess I am in today.

In terms of changing the beta blocker - I wish my dr would be more open, i wish he would actually listen to my concerns rather than blame everything on POTS. (just like most drs label us with anxiety, my dr seems to think that all my symptoms are due to POTS). Unfortunately for the time being I am stuck ...on so many levels.

Thanks again, and I'm glad to hear you found something that works for you.

Alex

[louloutinks]

I have been feeling REALLY bad lately. When I take the dog for a walk I constantly have to stop and crouch down to stop myself feeling faint but as soon as I stand up I get the dizzies again. It is even stopping me from taking a shower and now I have to bath instead. My HR is going ridiculously high on standing and I feel just awful.

I am waiting for a TTT in London but I decided to go to my doctor today as I cannot bare it any longer and he has given me 10mg of propanolol to take 'as required'. I will be taking it every 10 mins then lol.

How do I judge when to take it, as if I took it every time I stand up when my heart races then that would be too much. What do I do and how should I take it....advice needed and thanks in advance.

[peregrine]

Tinks - I can't give you medical advice per se, but many folks here on the forum take propranolol either 2x or 3x per day (I take it morning and evening, and make sure to take it in the morning about half an hour before I leave so it takes effect). The main metabolite of propranolol has a half-life around 6 hours but does continue working for longer than that, so twice a day makes sense. My cardiac electrophysiologist said that I can also take it as needed, which I did once when I had a really bad adrenaline surge. Just watch out for lightheadedness, which all beta blockers can worsen because they do lower your blood pressure.

[TCP]

I'm fine on it...already have fatigue, so haven't noticed much more of an increase.