Do Beta Blockers Help You?

[Altruism]

Hello,

Do you all see the benefit of taking a bb? Have you been on different beta blockers and which one worked for you? Do beta blockers lower your:

a/ standing hr

b/ resting hr

c/both

I know some people do not take them for MCAD reasons or because they feel more tired, but it seems like the rule of thumb is that beta blockers dovhelp lower everyone's hr to some extent, but they do nothing for my hr

I'm taking metoprolol and it does not affect my hr at all. My resting hr gets a little lower (55-60 from 65-60), but my standing hr is still 140+. Is this normal? What subtype of POTS could this be? Thanks!

[MomtoGiuliana]

It should lower both and your bp too. Perhaps your dosage needs to be adjusted or you need to try a different type? Can you talk to your doctor? Your resting hr seems low and your dr may not want it to get much lower? Beta blockers are used by many POTS patients but not everyone finds them useful. It may be that a different med or combination of meds will be best for you.

[Guest Alex]

Hi Lucy,

I am currently on propranolol, but have tried bisoprolol and metoprolol before.

Honestly I'd have to say that betas help at times, but not always. Despite taking one beta-blocker or another since last July, I still feel that my HR is not under control. I rarely see on my monitor numbers under 80 bpm, even at rest. (i am also taking florinef and mestinon and these meds are all supposed to keep my HR within normal limits...truth is they don't)

Most of my current symptoms only started manifesting themselves after I initiated my current course of treatment, but given that I've started a bunch of different pills at the same time it's almost impossible to tell what pill might be responsible for what problem, as well as what is/might be a POTS issue.

One thing beta-blockers definitely do to me though is lower my blood pressure. I've never been dizzy or lightheaded before them.

Unfortunately, as with all other meds, you won't know how you react to them until you've tried them, and a lot of people go through several different beta blockers until they find the right one for them. I couldn't tolerate metoprolol at all, for ex. It barely touched my HR but it lowered my BP to the point I was unable to stand despite taking a very low dose of it- I believe I took 12.5 mg once a day.

Have your drs run any tests to determine your POTS subtype? I am not sure I can help you figuring that out...sorry.

Alex

[RubyLane]

My bp usually runs low so the idea of taking a bb kind of scares me. My doctor has suggested trying one so maybe when I have the courage...

[Traceyf]

I have been on Atenolol for 12 years at a very low dose 12.5 mgs at bedtime for Migraines. My doctor told me that its one of those meds that over time needs to be increased, that it works better on the heart rate than it does on the blood pressure. I am very med sensitive. He recently tried to increase it in order to control my BP better, but it lowered my HR really low...40 lying down. It did nothing for the BP. And I was very fatigued on it. I think I have hyper pots..and honestly even though my heart rate stays low on the beta blocker I question whether is it making me feel worse. I have 0 for energy and feel so short of breath all the time. I wonder about MCAS and the beta blocker. Some of the side effects are tingling and cold extremities, Its hard to know if it is exacerbating the POTs symptoms. , Its so hard to find a doctor to give me any answers that I feel like I am self diagnosing constantly.

[Altruism]

Thanks for your responses, I appreciate you took the time to answer my questions!

You're right, I'll ask for a different BB when I see my neuro tomorrow. After developing severe SVT issues last week, I definitely need one that actually works.

TraceyF, I also wonder about MCAS, flushing episodes and cold extremities and I too feel like I'm self-diagnosing constantly. Ugh! I'm lost.

Looks like I have postural tachycardia, resting bradycardia and panic-induced SVTs in any position. What the **** should be the treatment plan? BBs will lower my resting pulse too much, but SVTs are killing me, not to mention that I'm bedridden from the tachycardia. I'm not convinced I can survive all this.

[Angela]

nope, in my case I am against bb's, tried one, made me so sick. also, one of my friends with hyperpots who takes propranolol and florenisef which I know I mispelled also has fluctuating bp's (high and low) and constantly has to trying to switch figure out which med to take according to fluctuating bp. gets very complicated and not my cup of tea, when you are constantly trying to figure out which one to take due to your current vitals. My neuro wanted my on clonodine (sp again?) due to hypertension but I declined. H1's and H2's have helped some, as well as motherwort for the high bp. I am not so worried about the low bp, as it is usually when I am laying down and my heart is still beating at a normal rate. I also dont salt load, but I do drink tons of water. used to do the gatorade, but didn't notice any change when I switched to plain old water except I was saving money.

[jangle]

They help my heart rate, and do seem to make a slight impact on my symptoms, they do reduce my lightheadedness and anxiety symptoms. But really the difference between taking them and not taking them is not that great. It might just be placebo effect to be honest.

[Altruism]

Thanks for responding, guys. I'm definitely giving up the Metoprolol. After taking 2x 25mg, my heart is still 120+ upon standing. This is NOT normal, right? I'll look into trying a different one, maybe propranolol or labetalol (wrong spelling I guess).

Angela, a stupid question - What are H1s and H2s?

[imre]

I'm taking nadalol. It is long acting and regulates my heart rate pretty well.

[peregrine]

I loves me my beta blockers, though not as much as my clonidine. I started on atenolol (after diltiazem, a calcium channel blocker, gave me edema), and it was a big improvement. It did lower both my resting and standing/exercising HR - resting is between 50-60 and exercising is ~120 unless I am climbing a really big hill in the city and then it maxes out at 160. I got fatigue with atenolol the first time, but haven't gotten it since. I took propranolol (a "non-selective" beta blocker) for about six months, but it gave me shortness of breath; if you have a history of asthma you may be better off with a "selective" beta blocker like atenolol. My neurologist did note that most folks with dysautonomia take much lower doses of betas than those used to treat high blood pressure (something something "don't tell a cardiologist the dose you're taking, they will think it does nothing" something something!), which is a good thing to keep in mind but may not be true for everyone.

H1s and H2s are different histamine receptors; you might know histamine as the chemical involved in allergic reactions (which is why antihistamines like Benadryl can help treat hay fever). Some folks with mast cell issues respond to antihistamines that target one or both receptors.

[blinkofani]

atenolol has been a life saver for me! i take 25mg before bed. it has lowered my standing HR and BP (it still fluctuates but isn't as high). my HR was going up to 200 when i was standing before the atenolol. now that i'm on it my HR still goes up quite a bit to maybe 130 tops (not that high all the time though) but it is a DRASTIC improvement in my quality of life. i was afraid to take it at first because i get bradycardia sometimes and i was afraid it would make that worse but it hasn't.