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Have Beta Blockers Helped You?


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Hello,

When my problems really started to interupt my life it was thought I had inappropiate sinus tachycardia and as a result I was given propanolol 10mg to start to take, however I was told not to take them before my ECHO so I actually ended up not taking them at all as thats when things then get a lot worse and I was in and out of hospital being investigated for POTS. Since my diagnosis, my cardiolgoist seemed reluctant to start me on a beta blocker unless I really wanted to as he said in many cases people feel worse because although they do lower the heart rate which can prevent some of the symptoms they often counteract the mechanism by which the body is attempting to make up for the POTS'ness. As a result I am in two minds about whehther it would be a good idea for me to consider just starting the propanolol to see if it makes any difference to me. What I do not want to find is that it actually causes me to feel worse! I am also in the process of getting an exercise plan started up, a bit like the levine protocol, and I know although he does not accept individuals onto his POTS registry who take medication at the same time, he does recommend specifically propanolol in his research articles, which is interesting. I am also aware that 10mg is a low starting dose, but that it may also help with my anxiety too as although I don't feel there is any need for my anxiety when it gets bad (usually post exercise) it is happening anyway, so anything to help that situation might help my overall outlook!

So my question to all of you that do take some sort of beta blocker, I would love to know your experiences. Do you think they have drastically helped your symptoms or have they made no difference or made you feel considerably worse?

Everything is much appreciated and I look forward to reading your replies.

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I take 12.5 mg of Metoprolol once a day and it keeps my tachycardia under control. It stops my heart from racing and causing excess fatigue from running a heart marathon all day. In general my body feels much better on the beta blocker although it does drag down my BP slightly.

It is worth noting that I tried propranolol a few months before the metoprolol and while i was feeling better on it, i started reacting badly to it, so I had to stop it. I was put on Metoprolol after my surgery and have had only good results. So just because one beta blocker might make you feel worse, another might help since they are different types of BBs.

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I take 12.5 mg of Metoprolol once a day and it keeps my tachycardia under control. It stops my heart from racing and causing excess fatigue from running a heart marathon all day. In general my body feels much better on the beta blocker although it does drag down my BP slightly.

It is worth noting that I tried propranolol a few months before the metoprolol and while i was feeling better on it, i started reacting badly to it, so I had to stop it. I was put on Metoprolol after my surgery and have had only good results. So just because one beta blocker might make you feel worse, another might help since they are different types of BBs.

Thanks for your reply imapumpkin. Its interesting to find that you said that it actually stopped excess fatigue rather than causing fatigue directly, as I know beta blockers can make people feel more tired. I am going to a CFS/ME clinic in the middle of October I guess to see if they think I have some sort of overlap with this, because at the moment although I have POTS I am physically exhausted 24/7 even if I have had a really good nights sleep, the sleepy feeling often makes me feel really ill if I push myself too far. So it would be interesting to see whether this was caused by my erratic and tachycardic pulse rather than a separate entity as I know fatigue is a big symptom of POTS.

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My beta blocker keeps my HR down so that part is better, but I still have other symptoms (mostly pressure in my throat and face and weird nerve sensations).

I started on atenolol which made me extremely tired. Doc switched me to acebutalol next and I had a weird decreased respirations episode with that. Next I tried betaxolol and seem to be ok on it. I've taken it now for about a year and a half.

When I started, he said there was a whole list of betas that I could try until I found one that 'worked'. I had high hopes of it fixing all of my symptoms, but it has not.

Oh, and if you decide to try it and it doesn't work out, you can easily just quit taking it. They don't stay in your system very long.

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My beta blocker keeps my HR down so that part is better, but I still have other symptoms (mostly pressure in my throat and face and weird nerve sensations).

I started on atenolol which made me extremely tired. Doc switched me to acebutalol next and I had a weird decreased respirations episode with that. Next I tried betaxolol and seem to be ok on it. I've taken it now for about a year and a half.

When I started, he said there was a whole list of betas that I could try until I found one that 'worked'. I had high hopes of it fixing all of my symptoms, but it has not.

Oh, and if you decide to try it and it doesn't work out, you can easily just quit taking it. They don't stay in your system very long.

Ah yes you definitely have a good point about trying and seeing since you have to take them multiple times per day they definitely don't last long! Thanks for reminding me. And again thank you for your reply too, it is much appreciated

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A cardiologist had prescribed 25mg Toprol for palpitations that I had constantly. I took 12.5mg once a day for about 2 months. The palpitations were gone and it did lower my HR by about 20 points (still over 100 but lower). I can't say I felt better (besides the relief of no palpitations - thankfully) though because it also lowered my BP to around 80/50. So I assume the fatigue at that point was from a low BP (normal for me is 110/70). The Electrophysiologist that took me off the meds did tell me to wean off of them even though it was such a low dose. I think for me it was so that the palpitations didn't come back, but I'm unsure.

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I still feel debilitating fatigue around the clock even after a full nights sleep...and obviously its hard to tell what's POTS and what might be being caused by the beta blocker lowering my BP...but no beta blocker i'm pretty much housebound. with the beta blocker I can do stuff like go for short wants and do 10 min on a recumbent bike. i am able to do short errands like going on a grocery store run whereas before the metoprolol i couldn't handle walking around a store.

it's also about balance. when i left the hospital after my surgery i was on 50 mg of metoprolol because my HR was really high. once my HR stabilized my blood pressure started to drop so my cardiologist cut my dose down to 25mg, then when my HR adjusted to that, my BP started dropping again so he cut my dosage down to 12.5mg. That seems to be a good balance because it keeps my HR under 100 all day, and my BP doesn't really get much below 100/60.

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I currently take 25mg of atenolol twice a day 12 hours apart. This helps tremendously with my symptoms. I really can't function much without it because my heart rate gets so high, I get short of breath and have chest pains even while sitting. I have both POTS and inappropriate sinus tach. It does lower my blood pressure so I drink at least a liter of Gatorade everyday to help raise it. I tried several other beta blockers at different doses and some did not work at all while others worked but caused too much fatigue and other side effects. You could always try the propranolol and taper off it if it doesn't work or causes bad side effects. You may need to give it some time though, try different dosages/number of times you take it per day, or try out different beta blockers to find what helps you the most.

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I currently take 25mg of atenolol twice a day 12 hours apart. This helps tremendously with my symptoms. I really can't function much without it because my heart rate gets so high, I get short of breath and have chest pains even while sitting. I have both POTS and inappropriate sinus tach. It does lower my blood pressure so I drink at least a liter of Gatorade everyday to help raise it. I tried several other beta blockers at different doses and some did not work at all while others worked but caused too much fatigue and other side effects. You could always try the propranolol and taper off it if it doesn't work or causes bad side effects. You may need to give it some time though, try different dosages/number of times you take it per day, or try out different beta blockers to find what helps you the most.

Thanks so much for your reply Krissy. Really good to hear that it has helped you function and deal somewhat with a lot of your symptoms. I do sometimes think I also have a bit of IST together with my pots just because of the variability of it from laying down or standing. It doesn't just seem to follow the general pattern of POTS although I have this diagnosis. Have you ever thought that some of your symptoms have been contributed to by noradrenaline and the anxious side of things? Although I'm not in an anxious situation or feel like I should be anxious I feel that's how some of my symptoms feel as though that's how I would feel if I was anxious (sorry if that doesn't make sense). I know beta blockers can be helpful for that too by blocking these neurotransmitters so I don't know if that would be helpful just from that perspective although I'm sure my exhaustion is a lot to do with my erratic heart beat. Will be trialing doses over the next few days. My original prescription for IST was twice a day but I know for PoTs that taking it 3-4 times per day is often more beneficial. But again thanks for your time writing your reply it is much appreciated.

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Yeah I understand what you're saying. My symptoms are worse if I am anxious. But also, like you said, I get them when I'm not in an anxious situation. For example, before taking a beta blocker, my heart rate would shoot up just from rolling over in bed. When I took propranolol I had to take it 3-4 times a day. It would wear off after about six hours. The atenolol lasts a little longer so I only need it every 12 hrs. I hope you find out what works for you and get some relief from the beta blocker.

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I take a very small dose of pindolol each AM. It takes the edge off of tachycardia for me, which is otherwise uncomfortable. I don't believe it has any affect on my energy level. I have a tendency towards slightly high bp (eg 135/80) on standing. I think people who have bp drops with standing (or low bp at all) are likely to have more difficulty tolerating beta blockers.

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Yeah I understand what you're saying. My symptoms are worse if I am anxious. But also, like you said, I get them when I'm not in an anxious situation. For example, before taking a beta blocker, my heart rate would shoot up just from rolling over in bed. When I took propranolol I had to take it 3-4 times a day. It would wear off after about six hours. The atenolol lasts a little longer so I only need it every 12 hrs. I hope you find out what works for you and get some relief from the beta blocker.

Gosh that sounds exactly like me, I wear the mio alpha heart rate watch during the day and take it off just before sleeping and literally I'll move an arm in bed or slightly turn over and my heart rate will jump a ridiculous amount of beats and so forth. Interesting to know that somebody else has that too. Really glad beta blockers have helped you, will be trialing them today to see if I see a difference and will post my experience

Hope you are having a lovely day

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I take Metoprolol. They started me on a really, really low dosage. It was like a miracle drug. I had constant tremor, severe nausea and headaches, severe orthostatic tachycardia (resting heart rate was 40, standing would go up to 180 and into the 200's), I couldn't stand up, was constantly blacking out. I now take 50 mg twice a day. They tried to reduce it to 75 mg per day but caused symptoms to exacerbate. My blood pressure went too low (90/50) so they added a small dose of Midodrine and it's helped. I still have bad days where I feel really lousy, but my functioning is pretty darn good now. I can now go for walks, bike rides, and have been able to start some light weight training.

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