Be sure to stay on top of your hemoglobin levels!!

[akenclark]

I have probably bored you with several posts kvetching about the side effects of beta blockers, particularly the extreme chronic fatigue making me quite breathless after climbing a flight of stairs. A few weeks ago, I was dragging myself out to do chores--shopping at Costco. My cell phone rang and one of my doctors instructed me to get my rear end to the Emergency ward because he had just received lab results of blood work and my hemoglobin was "dangerously low".

I received 2 units of blood and have been getting inter-venous iron infusions since. The change in my fatigue was immediate and dramatic (I can now climb the stairs without breathlessness--merely a slight rise in heart rate.)

So I now add anemia to my sleep apnea and my heart arrhythmia, all of which can contribute to a symptom of "chronic fatigue". Sorting out the right things to do to get some energy is ever more complex.

Be sure you do not slip into this situation.

[Hidden]

Thanks for sharing, hope you get it sorted soon, best wishes......

[akenclark in reply to Hidden]

Thank you.

[CDreamer]

Add B12, Folate & Ferritin levels to your monitoring.

Sounds like your docotor is on top of things. Hope you soon feel better.

[akenclark in reply to CDreamer]

Thank you. A puzzling thing about B12 is that the tablets contain huge multiples of the daily requirement. The requirement is (I believe) around 2 and one half mcg. The pharmacy sells tablets containing doses of 500, 1000, 2000, and 5000 mcg. Does that make sense?

[Hidden in reply to akenclark]

ncbi.nlm.nih.gov/pmc/articl...

Perhaps yes, if the underlying cause is malabsorption. Do you have low levels of B12?

[akenclark in reply to Hidden]

unknown....thanks for the heads up!

[Hidden]

Are you taking an anticoagulant? Will your anaemia be investigated?

[akenclark in reply to Hidden]

Thank you. I previously took the baby dose of Aspirin daily, But I suspended it entirely once this all came up. I had a colonoscopy and a CT scan (Computed tomography) looking for internal bleeding. Nothing found so far.

[Hidden in reply to akenclark]

Hopefully your docs will ultimately conclude that aspirin was the, not uncommon, culprit.

[akenclark in reply to Hidden]

Hopefully!!

[philologus]

Wow! That rang some bells.

I have been feeling tired and breathless but put it down to my Heart Failure.

I recently switched to a new GP and he ordered a blood test. I got the result yesterday. An infection in my blood, (now on antibiotic) pernicious anaemia and a low iron level. A repeat test was done yesterday and I'll get the result tomorrow.

I'll ask if the beta blocker I'm taking could be behind this.

Thank you for the information.

Regards,

George.

[momist]

Luckily, my anaemia was picked up years ago on a visit to the blood donors who sent me to the doctor for tests. I've been on B12 injections at 16 week intervals ever since. In my case, it's believed to be an inherited condition, as my father's sister also had this problem but was never diagnosed until shortly before her death.

I am on the lowest dose of Bisoprolol at 1.25mg per day, and I notice more the cold hands and feet, and easier weight gain, than any other side effect.

[philologus]

Is there a positive link between beta-blockers and reduced iron/ferritin levels or reduced B12?

[akenclark in reply to philologus]

Part of the problem with these drugs that we all wrestle with is that the universal answer to questions like the one you just posed is: "Maybe, for some people". I had a serious problem with depression when I was on one beta blocker. My mood changed dramatically when I browbeat my cardiologist into changing the drug. His going in position was that depression was a known side effect for "only" 5% of patients. (So we should all assume I'm just making it up???)

[KMRobbo]

Slightly related to this: I have just had some blood tests owing to my tiredness/ breathlessness following my two ablations in January and february. This breathkessness is nothing major but I felt it was odd so I consulted my GP. Everything ok but but B12 a bit low. GP not worried but wants another test in a few months.

I have investigated this and understand now that proton pump inhibitors are known to affect vitamin B12 absorbtion . I have been on lorenzaprazole which I was given ( I think) to offset the potential effects of the A/C Pradaxa (dabigatran) following my first ablation on the 29th jan. As I had already been on pradaxa for 25 days by then with no stomache problems, and I only expect to be on pradaxa for another 5 weeks, I have decided to forgo the lorensaprazole since last Friday to see if it helps with the tiredness /breathlessness. The warning leaflet for lorensaprazole does not advise of B12 issues but does mention tiredness, one in 10 and anemnia 1 in a thousand. I can't say I can tell the difference after 3 days but possibly would not expect to.

If i feel like superman in an other week I will advise.

[Asdfvv in reply to KMRobbo]

Get a vitamin B12 shot. It doesn't hurt.

[Asdfvv]

Flecenaide made me feel anemic. Once I stopped taking it, I began to feel more energy.

[KMRobbo in reply to Asdfvv]

I have already taken 3 days x 2000mg of tablets. If I don't improve I will take your advice and investigate an injection.

I am also on flecainide which I agree is tiring but that (unfortunately) was my norm. The recent breathlessness is in addition to that!