Lack of strength in legs

[DoubleEm]

Well here I am again with another question - sorry.

Despite reducing to 1.25mg Bisoprolol since the weekend my husband is still experiencing a serious lack of strength in his legs. This is preventing him walking even short distances outside and is completely freaking him out. There is no shortness of breath just feeling like he is pushing his legs to extremes. HR is being maintained well (58-62) during these episodes with only slight rise in BP which I believe is brought on by fear of falling down. INR levels good at 2.4.

Just had a battery of blood tests (Thyroid/ B12/Ferrate/ Diabetes  etc) and pressure examination of legs, as GP wants to rule out "other causes". Echo due to be done tomorrow then hopefully get to see a Consultant for the first time since discharge. It seems too much like a coincidence that this weakness is caused by anything other than the beta-blocker.

So we're not talking about being too breathless / tired to walk any distance just feeling like your legs won't support your body. Has anyone else experienced this lack of leg strength whilst taking Bisoprolol? I'm really concerned too but trying not to fuss too much.

[jennydog]

Please can you post details of any outcome of your husband's investigations/treatments?

My walking is a problem. My legs do not pick up after about 20 minutes standing and walking. After a rest I am better. The arches of my feet feel as though they are held in a tight grip. The medics think it may be due to wear in my lower back but are not sure. I am hoping for some tests to be done on Friday. I do wonder if this is all caused by some of the drugs they have tried me on. Amiodarone? Flecainide?  My Cardiologist didn't think it was bisoprolol.

[DoubleEm in reply to jennydog]

Sorry you are having problems with your walking and I hope you get some answers soon.

I certainly will post outcome of latest round of tests etc. in due course. When the GP tested my husband's leg reflexes, pushing and flexibility he said everything was A1 and that he had good leg agility (he's 67)

I wish you a peaceful life.

[Buffafly in reply to jennydog]

I am also interested as I have had numbness in my lower legs, and feeling of pressure when standing and coldness while sitting. I blamed this on Diltiazem while I was taking it as I had leg swelling but since I stopped it has improved but not gone. I have not sought a diagnosis yet as I have other more pressing health problems. I have arthritis in my spine and hips so I suspect that may be the cause. I don't remember having this feeling on Propafenone.

[Finvola]

When I first started Bisoprolol I took 2.5mg daily and suffered from weak legs, breathlessness and tight chest.  Once my dose was halved, things improved but I still get the 'empty leg' feeling on some days.  I also take Flecainide now, so either (or neither) could be to blame.

Hopefully, your husband will be able to get some identifying cause, as it sounds miserable.

[PeterWh]

It takes bisoprol 2 to 4 weeks and up to 6 weeks to get out of the system / stabilised so it is far too soon to see yet. 

[DoubleEm in reply to PeterWh]

Hi Peter, He is into the 7th week now and getting worse not stabilising - he has been taking Bisop 2.5mg for 5 weeks and has recently reduced to 1.25mg. After 3 weeks he felt good enough to resume his usual daily walk, albeit at a slower pace, and built up to a mile a day as before AF diagnosed. No ill effects whatsoever.

Then out of the blue after 2 weeks of walking this weakness has set in and despite reducing dose he is now walking around the house like he is carefully balancing and is all but confined to the house as he feels his legs will not support him outside as there is nowhere to sit. This is not a lack of  muscle strength nor is it that the legs feel heavy it is purely feeling that his legs are going to give way any minute. Not breathless, not dizzy. BP and HR pretty well maintained.

Never had anything like this before AF and if this is the shape of things to come he doesn't know how people manage. Pretty depressing really.

[Tolkien in reply to DoubleEm]

Hi there. I have EXACTLY the same problem 4 years in from having 1 bout of AF and being put on Bisoprolol. I too feel like I have to work my legs really hard and they feel week and trembly too. I agree it is very depressing. I am better on a bike though, but constantly wanting to sit down at 56 is not good!

[Peony4575 in reply to Tolkien]

Have you asked why you have to take bisoprolol continuously if you have only had one bout of AF ? If there isn’t another underlying need for beta blockers why are you taking it all the time . They may argue it is stopping you getting another episode . I had my first and so far only bout of AF 6 months ago they put me on bisoprolol in the hospital. Saw another consultant who said I didn’t need to be on it and I had two failed withdrawal attempts due to symptoms changed to atenolol and now a month off that but still have withdrawal symptoms. Just a thought

[Tolkien in reply to Peony4575]

Thanks for your reply Peony. I had a failed ablation for SVT and I was disappointed when the consultant said you must stay on Bisoprolol because you've had AF. If I try to stop taking it now I get loads of tachycardia so I'm stuck on it. I will try taking it at night as some have suggested and see if that helps. Just want to let DoubleEm know reading their post made me feel less alone with this.

[Peony4575 in reply to Tolkien]

You do get terrible tachycardia when you come off biso even if you do it slowly but if it’s rebound it’s temporary if you have tachycardia for other reasons that’s different . The side effects and withdrawal symptoms from biso can be terrible though some lucky ducks have no trouble at all . Stay safe !

[Tolkien in reply to Peony4575]

You too. Thanks.

[Hidden in reply to PeterWh]

Peter two people commented earlier that you hadn't been posting and concerned about you

[Peddling]

I have paroxysmal af and when I have an attack my first symptom is tired shakes legs.  Just climbing the stairs is a tremendous effort.  I also get an ache across my shoulder blades.  I thought it was bisoprolol but am now convinced it is just a symptom of af.  BTW I changed from bisoprolol to nebivolol which suits me much better.

[Peddling]

Should say shakey legs!

[Mike11]

Are the legs swollen ?   If so that could be blocking flow and hence causing the 'heavy feeling' many of us get sometimes.  Raise the bottom of the bed mattress so that any fluids can run back down during the night and it often fixes it, otherwise you may need the occasional dieuretic

[DoubleEm in reply to Mike11]

No, the legs are not swollen at all just feel like can't hold his weight (he is 6'1" and 13st)

[tony85 in reply to Mike11]

I take a diuretic when my leg swells up and it gets better

[lingooz]

Had same on bisop, had to come off, quality of my life was so poor,  changed to metoprolol as pill in pocket, also taking beta blockers could be helped by taking at night so worse of effects not noticed,  hope helps

[teach2learn]

Oh yes! Very tired legs. I force myself to do exercises at the gym using legs and, in between, climbing hills around home. They feel like jelly afterwards, but they are stronger now. I wondered why the change!

[pirnough6]

I was on 5mg bisoprolol and had it reduced twice and I am now on 1.25 which is so much better but it took about 5 days before I felt the benefit of a lower dose. I just kept doing my gardening and housework and literally working through it evev though I felt awful

[PeterWh in reply to pirnough6]

Often it can take a month to six weeks for a dose adjustment (up or down) to fully stabilise).

[countrygirl1]

Yes "empty legs" is a good description of me on Bisoprolol. I started on 2.5mgs and legs were weak but I think my body got used to it a bit and when dosage went up to 3.75mgs it was no worse. I do take mine at night so maybe that helps too.

[DoubleEm in reply to countrygirl1]

Have you always taken Bisop at night or did you change by taking it later and later every day?

[countrygirl1 in reply to DoubleEm]

I gradually and gently took it later each day until now it's around 8pm, I feel this has helped me to cope with the side effects.

[DoubleEm in reply to countrygirl1]

Thanks for the helpful reply

[tony85]

I have exactly same problem with my legs, but I don't take b isoprolol. I don't think it is the medicine.  peripheral neuropathy? ? Spinal stenosis?

[PeterWh]

If someone is in persistent AF and if they have problems with varicose veins and / or valves in the leg that have been incompetent then blood circulation suffers and it becomes harder to exercise and they get heavy because of the lack of oxygen.

Suggest that you check your SpO2 levels as well.

[Sammysideways]

Just 4 days into taking bisoprolol. When I walk up the 2 flights of stairs to the top room, my legs feel like they've just done a marathon. I'll consult my doctor about changing medication as I also take pramipexole for RLS.

[Slinkydog98 in reply to Sammysideways]

Hi, it's awful feeling, just zapped, had to stop bisoprolol altogether , could not even hang washing as arms felt like lead ,even though on lowest dose

[Sammysideways in reply to Slinkydog98]

What did you try after that and was it any better?

[DoubleEm in reply to Sammysideways]

My husband is managing without beta-blockers at the moment and is only taking Warfarin. It took approx. 3 months after stopping for him to regain his normal strength.

[sulli6van in reply to DoubleEm]

I have been having similar trouble to your husband in that my legs can suddenly go weak and feel that they are going to collapse. This most frequently happens when standing such as doing the vegetables for dinner or the ironing, or ambling around a supermarket. I can go for a proper walk though and legs are reasonably OK. I am taking warfarin and bisoprolol 1.25 after a mitral valve repair and maze procedure. When they gave me Ramipril as well it was tons worse - I didn’t need my blood pressure lowering and they took me off that. However my average blood pressure is still 105/59 HR 60-65. I believe that is too low for me and unless my heart rate is up a bit the blood does not flow back up my legs properly. The medics want to go down the neurological trapped nerve route but I do not believe it is anything like that. I wondered how things eventually panned out for your husband. Your last post is two years ago so hope you can pick up this post. Many thanks

[DoubleEm]

Hi, sorry to hear of your difficulty with your legs. My husband was eventually taken off Bisoprolol and he recovered his leg strength over approx. 3months so for him it appears that Bisoprolol was the culprit.

It was agreed that he would not take anything else except daily warfarin and he was fine until May 2018 when he had another AF episode and was hospitalised for 2 weeks. Finally discharged on Amiodorone and Candesartan pending cardioversion (Oct 18) thankfully still in normal rhythm. Awaiting Consultant's agreement to discontinue Amiodorone (hopefully soon) as this has done it's job but taken a toll on my husband's quality of life inc. weakness in his legs.

I do hope you manage to get some answers. Best wishes for the future

[sulli6van in reply to DoubleEm]

Thank you so much for taking the trouble to reply to me. I have seen the cardiologist he says it must be neuro - however, I have agreed with him to come off bisoprolol for 3 months as I am in normal rhythm and we'll see how it goes. The biggest problem is nobody seems to know. Thanks again and good health to your husband.

[Alphakiwi]

He might be drug intolerant like me. On them for atypical flutter. Gave me sore chest and sides when walking ,weakness and nausea and exetsise intoletance.Thats why ive had a pacemaker implanted and waiting for AV node ablation. I hope you get an acceptable situation soon because it only gets worse if untreated