Beta-Blockers?

[andybonse]

Hello,

If the heart rate increases by 30 when standing up, if I we're to take beta-blockers, how much would this be redcued? I never faint or feel like fainting either, would this make me feel like im going to faint as the heart rate would be lower when standing and POTS needs the higher rate?

As obviously the blood wouldnt be going to the brain as fast if we slow it down?

[bebe127]

Andybonse,

First, everyone is different and reacts differently to various medications. I am currently on a BB Metaprolol 25mg 3x/daily (75mg/daily total). I was under the impression that this would keep my blood pressure in check (I have a tendency to have high bp) and regulate my heart rate. It seems to do both most of the time. It doesn't reduce my hr tremendously, but keeps it in the 80's. Sometimes though, I still get bouts of tachycardia (hr 120+) but it happens rarely now, usually if I've been in the sun or standing for a prolonged period of time. There are many BB out there and I would think that each one might do something a little different. I never faint or feel like fainting either. While it does help with the bp and hr issues that I have, it does nothing for the myriad other symptoms I deal with daily. I do feel as though I am doing much better now than I was a few years ago. Don't know if it is the meds., my resolve and resignation to having this illness and just learning to deal with it or a combination.

Talk to your doctor about the effects of any medication. I know that a few months ago, my dr. wanted to increase my dosage to 100mg/daily but said it could lower my bp too much and I could feel faint or faint. My husband and I decided that it wasn't worth the risk and that I'll have to learn to continue with bouts of tachycardia/bradycardia.

Best of luck to you.

Bebe

[bebe127]

Also, (and I'm no dr.) the dosage would determine how much it is lowered. As stated above, everyone is different and reacts differently. When I first started out, I was on a lower dosage. Once we played around with it for a few months we settled on the 75mg daily. My dr. has told me that he has another patient (with POTS) that is on 300mg. daily so, it just depends on your body and your needs. Meds can be a tricky trial and error ride.

[andybonse]

Thanks for the reply,

My issue with POTS is only the heart rate, I dont have any other symptoms really, just the feeling of my heart going up by 30 beats when standing, I hate it, I feel like I have a problem with my heart but i've had all the tests under the sun nearly! I bought myself a portable hand held ECG monitor, keeps me happy that my heart is beating normally! lol.

My main issue is, I have been diagnosed with Asthma my whole life, It never effects me, never had a asthma attack really either and beta blockes cant be used in people with asthma, but there are some beta blockers called cardioselective and apparantly people with asthma can have them, hopefully my doctor can enlighten me. However,

If I'm correct, I should be able to stand up while taking beta blockers and instead of a 30 heart rate raise, it possibly be only a 15 heart rate raise while on them? Would this be acceptable say? Obviously your not a doctor but I guess this would "cure" my symptoms and also allow me to be a lot happier!

My problem is I suffer my anxiety / panic attacks, just recently in the past 3 weeks, Ive been off of work because of them and now I have seemed to made myself more aware of my POTS, I've had it undiagnosed for a few years not realy bothered me and thought the heart rate raise was normal!

Thanks.

[andybonse]

Also, my blood pressure ranges from *usually* 120/60 - 135/80 which is obviously within normal ranges, so hopefully a low dose would not have a HUGE impact. This POTS is rubbish, is there any extensive research been done to this, i.e would you look forward to some new findings and great treatments in 10 years time say?

[bebe127]

No, I am not a dr. (nor have I played one on TV) although with all the research and reading I've done over the years (as many of us have) I think there should definately be a way to be "grandfathered" in

I can only speak of my experiences. Like I said, I do feel as though the medicine has helped keep my bp and hr in check, although I still have occasions where I have tachycardia/bradycardia. Happens for no apparent reason at times, at other times it happens if I'm out in the hot sun or standing for a prolonged period. I have no experience with asthma, so I can't answer that question, sorry.

On the subject of anxiety...I have always been a stressed out kinda anxious person, it's just my personality. Since having my first episode back in 2009 which the EMT's stated was an anxiety attack, I've had issues with this, sometimes severe. After an ER visit and trips to an EP that dx me with "probably POTS" in 2009 I've experienced anxiety quite frequently. Currently my GP has me on Xanax .5mg 3x/daily and quite frankly, I don't think I'd be able to function without it. Before POTS, I didn't really have issues with it. I have to make sure to keep my stress levels down as much as I can, and the littlest of things can set me off now, whereas before it wouldn't bother me as much. Since POTS is a form of Dyautonomia, and Dyautonomia is basically whackiness (quite the technical term) of our Autonomic Nervous System, and since anxiety is controlled by our ANS, it would only make sense that we seem to be in a constant "fight or flight" state.

In answer to your question, and again, I'm no dr. I think yes, provided you are put on the correct BB with the correct dosage, you should see a difference in your standing heart rate.

Best of luck to you in finding what works for you.

Be well!

[bebe127]

I'm not sure how much research is being done currently (so I might have to kiss the "granfathered" in senario goodbye). Dr. Blair Grubb is one of the leading Dr.s of this disorder. Have you read the information on Dinet.org, they reference him quite a lot?There is also a youtube video featuring another Dr. named Svetlana something or other (her name eludes me presently) found the website:

. Also, if you look on my blog : http://sometimeshelplessneverhopeless.blogspot.com/p/helpful-sites.html I have some information in the form of websites, articles, and blogs that I have found to be quite helpful (this is not a plug for my blog, it's just easier than listing everything, plus if you go on the other blogs there is quite a lot of information there as well).

BTW, welcome to the forum, hope you are able to get some information, support and encouragement This site has been a lifesaver for me!

Best wishes,

Bebe

[andybonse]

Thanks for the info, sometimes I feel a little short of breath and my HR will be 110 when im standing, if the beta blockers brought this down, would it also reduce the shortness of breath? Not sure if its from the heart rate being high or not?

[bebe127]

Sorry Andy, I cannot answer that one. I have many symptoms that wax and wane, but shortness of breath is not one of them.

[andybonse]

I think some of the shortness of breath is in my head, everytime I stand etc, Im constantly thinking about it so I do think some of it is phycological!

Its funny how I was at the gym last year pumping iron haha, I got quite big and never thought anything of POTS even though I had it then, and a lot more walking I used to do. Its funny though I did sometimes get chest pain but went away fast.

I am starting to think, over the last 6 months, I have not even exercised, just drive to walk get home sit down, so it may be I am very out of shape which has made my POTS worse and my job is a deskjob, but i've been off 3 weeks from all of this.

Do you think its a good idea to get a home excersise bike blast an hour a day on that get fitter again and see if it helps?

Going to see a cardiologist on Tuesday who knows about POTS so hopefully he can help, just hate the idea of all sorts of medication at 21 .

I have read though some people that get it young can grow out of it, I've had it since 18 I think, I guess I was classed as a teenager and could possibly get better.

*****, just looking at people doing normal things makes me angry then upset, blah!

Thanks for listening to my rubbish posts though! appreciate it

[davecom]

Andy, exercise biking definitely seems to help some people with POTS. Let us know what comes of your appointment.

[bellgirl]

Andy....Beta Blockers are tricky to find the right one for you, but like you, I have asthma, so I'm on a cardioselective beta blocker that's relatively new, called Bystolic (nebivolol). There is no generic, as of yet, so it is more expensive, but because of a longer half life, 12 hours, it has worked very well for me. I take half in the morning, 2.5mg, and half at night, 2.5 mg.

It is very important to exercise, cardiovascularly, too, to prevent blood pooling in your legs.

Physiological Panic Attacks are normal with someone with POTS; tachycardia, and dizziness are very common as well. It does feel like you can't breathe, and it is very real!

Bebe gave you the best video on dysautonomia, in my opinion!!

Wishing you the best in your journey, and prayers for the right treatment for you.

[bebe127]

Andy,

There are many who were active prior to POTS. I was a bit active beforehand, used to ride my bike outside 9 miles, 5-6x/week, run, walk, Wii Fit, Yoga, Pilates (not all in the same day of course LOL!). After POTS dx. it all came to a halt, but have recently tried to start back with just some walking. It's not that I have exercise intolerance, mostly I just feel like poop and am lazy to boot. I've heard and read about many people getting great benefits from exercising. Most cardios, I would hazard to guess would give you the same advice.

Yes, I have read that if onset is while your a teen there is a greater chance of recovery within a few years. Sadly, I'm old, LOL so the chances of mine going away are slim to none.

I forgot to mention, but maybe you can ask your cardio when you see him/her about what type of pots you have. That can make a difference in treatment plans including the use of Beta Blockers. I've read that people with Hyper POTS shouldn't take BB's. I suspect I might have Hyper (because my bp goes up, not down and I don't faint, although I'm sure there is other criteria) but I'm on BB's. Go figure. Don't have dr.s around my area that treat POTS. My GP is treating me and a few other people with POTS as well, but I've never got the feeling like he is all that knowledgeable unfortunately. Still after four years I don't know what type I have.

Keep us posted on how your cardio visit goes. Best of luck to you

[andybonse]

Thanks

Well my doc gave me a 24 hour urine test for cachemolines testing for adrenal tumors, but my levels came back normal so doubt its the hyper pots but my blood pressure goes up not down on standing, after 5 mins it goes bck to normal though

[andybonse]

hmm, after reading symptoms about hyper andral pots, I do have a lot of them quite strangely.

As I read it says it can result of injury, when I was 16 I was on my bike and went up a ramp and came off hurt myself and broke my collarbone and had to have surgery to fix it, just wondering if its a possible cause hmm!

[Chaos]

hmm, after reading symptoms about hyper andral pots, I do have a lot of them quite strangely.

As I read it says it can result of injury, when I was 16 I was on my bike and went up a ramp and came off hurt myself and broke my collarbone and had to have surgery to fix it, just wondering if its a possible cause hmm!

Surgery was what triggered my POTS initially. According to my POTS doc that's not uncommon. He said surgery is a known trigger for neuropathy as well- which is a cause for POTS in some of us.

[andybonse]

Hmm,

I'm just wondering what the doctor will try me on since my blood pressure is always in normal ranges, its the HR out of sync!

[bebe127]

I don't know what to tell you Andy other than it's an encouragement that the cardio that you are going to see has at least some knowledge about POTS and hopefully will be able to lead you in the right direction.

Be well

[andybonse]

Thank you . Cant wait to get back to normal or near enough more active gets boring inside haha.

[imapumpkin]

andybonse-- has anyone discussed with you the link between anxiety/panic attacks and POTS? I know bebe mentioned the connection between anxiety and higher levels adrenaline and in a constant state of fight. Often POTS is misdiagnosed as anxiety and they are also interlinked between the physiological and the neurological so I wouldn't be so quick to assume your shortness of breath is "in your head". Shortness of breath, or "Air hunger" is a common symptom of POTS. However, shortness of breath is not always tied to tachycardia so beta blockers will not necessarily help with shortness of breath.

On the subject of beta blockers, I take metoprolol to control my HR and I have been having very good results for the past 4 months. My HR still increases upon standing, however it returns to a lower rate much more quickly on the beta blocker. Of course everyone is different as the other posters have said, but my experience has been good. That being said, I did not tolerate propranolol. Beta blockers may help some things but it's not a miracle pill it may only help some of your symptoms, particularly your tachycardia.

As for the exercise and being active...a lot of us were very active prior to POTS onset. I knew I had POTS for over two years during which it was essentially dormant in my system and didn't flare until last summer, before which I lead an extremely active lifestyle...now I can only take short 10 min walks. Its very frustrating and I get the whole being bored inside thing. But everyone is different. Some people can exercise normally, some people can exercise moderately and some are entirely exercise intolerant so you really need to figure out what works for your body and your POTS and not set unrealistic goals for yourself.