Fatigue

[kingsnorth]

I just posted a question about bisoprolol but think it went into the wrong forum so l will start again!! I’m taking 1.25 daily and feeling extremely fatigued is that normal for such a small dose, will my body get used to it?

[Finvola]

For me, that was normal on 1.25mg. Breathless, fatigued and unable to do several normal tasks in succession.

Other people get along OK with it but after 4 years of being fed up totally, I saw my GP and got changed to Nebivolol - cardiologist was happy with Bisoprolol!! I got my life back.

[kingsnorth in reply to Finvola]

Thanks l will give it a bit longer and if the fatigue hasn’t improved by the time l have had the rest of my tests l will see if l can have it changed.

[Elli86 in reply to Finvola]

A few people have mentioned nebivolol 🤔 no side effects worth mentioning when you switched to this? I’m still fatigued. No where near as bad as before but would be nice to not be tired all the time

[Finvola in reply to Elli86]

Elli, my main problem on Bisoprolol was that I couldn't do normal tasks one after the other but had to do one, rest, then another, rest and so on. Couldn't walk uphill or stairs for more than four steps. I'm probably still dampened on Nebivolol but I don't notice it in everyday life. One good thing is that Nebivolol 2.5mg seems to have blunted my ectopics which are less bothersome, if still unpleasant.

[Elli86 in reply to Finvola]

I had a very light mess about with kids and dad in garden playing football for literally 5 minutes and I was exhausted. Heart rate up to 190. I’m thinking it was the bisop. I’m always fairly tired on it as well. Thinking maybe changing might give me a boost until ablation

[kingsnorth in reply to Elli86]

Have they agreed to ablation what’s the criteria for it

[Elli86 in reply to kingsnorth]

Not sure what the criteria is in general but my EP said as I’ve tried flec and bisop and don’t agree with either then I’m prime candidate for ablation. Think also due to my age (34)

[Auriculaire in reply to Elli86]

I agree with Finvola. I switched to Nebivolol and found it better. I only take a tiny dose but would like to stop altogether. I am sure that as Fin says it still blunt things and I have less energy for tasks than I used to have but that could just be aging! On anything above half pf a 1.25 tablet of Bisoprolol I felt like a zombie.

[Elli86 in reply to Auriculaire]

🤔🤔 might be worth me trying the change over

[Fruitcake100 in reply to Finvola]

I was identical to that and much better on Nebivolol.

[Paulbounce]

That's a small dose Kingsnorth - however it doesn't mean you won't feel fatigued.

To answer your second question - it can take a few weeks (or more) for your body to adjust to a new med. I recall when I was on bisoprolol I felt like a zombie at first (it was higher dose than yours). It did pass and I got back to normal.

Maybe it's worth a call to your pharmacist to double check everything out ?

Enjoy your day.

Paul

[Staffsgirl]

I took Bisoprolol for about 18 months. Felt fatigued, easily breathless, with other side effects, too. It wasn’t until I came off it that I realised how bad those side effects were. I was a new woman when I came off it. 😉

[kingsnorth in reply to Staffsgirl]

why were prescribed it in the first place? did you have ectopics

[Staffsgirl in reply to kingsnorth]

AF. GP happy for me to stop Bisoprolol. Monitored BP for a while. Haven’t needed another Beta blocker. I keep Bisoprolol as a PIP, but haven’t needed to use it so far, nearly two years after stopping.

[Cumbremar5 in reply to Staffsgirl]

Me too as a pip doc said only to take if heart rate exceeds 100 bpm. I'm normally low with a heartbeat if 63 so taking bisoprodol daily was madness making heartbeat too low

[kingsnorth in reply to Cumbremar5]

My BP is high and HB on the high side my cardiologist wants it between 60-65 at the moment it’s in the 70s

[Elli86 in reply to Staffsgirl]

Are you still taking meds? If so which ones?

[checkmypulse]

1.25mg Biso also made me fatigued, couldn't get on with it at all. Stomach issues also. Off it now since ablations thank goodness.

[kingsnorth in reply to checkmypulse]

That’s good to hear. Did you have a ablation because of ectopics

[checkmypulse]

No, I was a PAF sufferer, very symptomatic, Biso 1.25mg was not much help, 2.5mg made me feel terrible, more tired, H/R low 40's, light headed, so quickly opted for procedure. , needed a second as is often the case and thankfully symptom free for 4 years.

[Hidden]

I started off on 5 mg Bisoprolol 11 years ago and earlier this year it was increased to 7.5 mg. No effect. However, in the beginning it was fatigue, fatigue, fatigue. I understand bisoprolol has two properties, one treating high BP the other HR control.Now I have a pet - AND VERY NON SCIENTIFIC THEORY - with AF there is a natural inclination for the heart to want to behave differently due to an electrical malfunction which involves an irregular beat as well as a natural desire to beat very fast. So Bisoprolol wants to control the heart beat by slowing it down - so you have these competing forces at work - one wanting to race away and the other working against it and in an unnatural way trying to FORCE it to slow down ..... no wonder the poor old body gets tired and fatigued with this battle royal going on in the chest. All that said I can't explain why the different beta blockers behave differently, something to do with their properties I guess.

Well, that's it - just sharing a bit of useless information with you all 😂😂😂

John

[Billblue in reply to Hidden]

Good information

[CDreamer]

Yes it seems to be quite common to feel extreme fatigue on Biso - I certainly did. No it didn’t get any better and my only regret is that I didn’t stop it as soon as I got symptomatic affects from it.

[KMRobbo]

I was asleep 40 minutes after every one of the eight 1.25mg Bisoprolol tabs i took. I woke up 4 or 5 hours later feeling terrible with aching chest and arms, and had terrible exercise intolerance being unable to run more than a hundred yards as my max heart rate was so low ( the week previous I was able to run 6.4 miles at 8 min mile pace).I then tried 25 Mg Atenolol for 2 weeks with similar but a lot less severe side effects, before my GP suggested I did not tolerate beta blockers and put me on Verapamil, a calcium channel blocker, which for me had no adverse side effects, but possibly was not as good at rate control. There are other beta blockers that can be tried.

[Silvasava]

I was on 10mg of bisoprolol for about 8 months and felt like a dishrag, could just about manage to walk to the end of the garden, like Finvola I changed to Nebivolol I expected horrendous effects from just changing from one to the other but nada, now down to 5mg of Nebivolol and much improved

[Ppiman]

I read once that the dose to effect relationship for bisoprolol is not linear, so that what seems a tiny dose, really isn't. I certainly found this when I was taking it regularly. The tiredness some people feel is a result, I suspect, of the change in heart function that the bisoprolol brings about. It seems that most people can cope with this, but some can't. I struggled with it when I had atrial flutter a couple of years ago, but recently I've had to take it again for tachycardia. This time round I haven't had the tiredness, for some reason.

Steve

[kingsnorth in reply to Ppiman]

It certainly sounds a weird one as I’m reading all sorts of opinions. This is a new journey for me l have been diagnosed with ectopics (lots) at the moment l have no idea what the different terms mean ie PVS, AFIB etc. I’m waiting to have a CT angiogram at which time I’m hoping my cardiologist will go through it all with me. I know that l have mild regurgitation and mild leaky valve but that hasn’t progressed since 2014. My blood pressure is coming down but still high

[Ppiman in reply to kingsnorth]

I wonder whether your body wasn't nicely balanced to work well with your higher blood pressure and that the bisoprolol, in reducing it, is making it complain a little? There seems to be some contention about blood pressures and what is "normal", but the medical consensus seems to be that the risk of living with a pressure greater than 140 / 90 outweighs the risk of medication.

Steve

[kingsnorth in reply to Ppiman]

My pressure is higher than that but coming down slowly. The thing is my BP has been high for years and on my medical notes it says “white coat syndrome” which l personally think isn’t the case.

[Ppiman in reply to kingsnorth]

I have just that; in fact, I think most people do. A cardiologist took my blood pressure last week. It was 150/76, but he said it was anxiety that has pushed the top one (systolic) up.

He recommended me to take my blood pressure at home, taking 3-4 readings a couple of minutes apart, first thing after getting up and before any hot drinks or breakfast, and whilst sitting and relaxing comfortably at a table with my elbow resting on it.

I followed his instructions and, lo and behold, reading one was 140/76, reading two was 117/75, and reading three was 116/75.

I’m finding that, even at home, the first reading is higher as I feel slightly tense but then the second and subsequent reading fall nicely.

If you haven’t got a blood pressure meter at home and fancy buying one, I’ve just got an Omron wrist monitor for a friend as a Warehouse return from Amazon for under £20.00 - a bargain.

I find that the wrist versions work well as they are far easier and quicker to use and so compact. Also, you don’t get the heart beat pulsing so much while they are reading which can raise anxiety and the blood pressure. The readings from my upper arm Omron and my wrist Omron are nigh on identical so accuracy isn’t an issue. If you do get a wrist one, keep in mind your arm needs raising to heart height - there’sa little green light that guides you on the Omron.

Steve

[kingsnorth in reply to Ppiman]

I do have an Omron one l got from Boots and like you my BP does verify l usually take 3 readings and email 2 of them to my GP as she requested. tomorrow when l have my blood tests done the nurse at the surgery will take an accurate reading.

[Ppiman in reply to kingsnorth]

Well, it might be high if you suffer white coat syndrome, I suppose. It’s only the top reading (systolic) that goes up though, I think.

Steve

[BillCook]

I had a similar experience to many above. I'm in persistent AF, and was put on bisoprolol by my cardiologist. I was never happy with it, but stuck with it until I eventually had a cardioversion, but NSR only lasted 5 days. I persisted with the bisoprolol, as the cardiologist was certain it would be beneficial - unfortunately the coronavirus kyboshed further cardioversions so it all dragged on. Anyway, after being on it for nearly a year (a relatively small dose, can't remember exactly what), I inadvertently miscalculated how many I had & ran out. It was a Friday evening, so no bisoprolol all weekend. By Saturday evening I felt so much better, and this persisted. My wife described the change as "amazing". My problem was that the symptoms I had weren't much different to those the AF was giving me (extreme fatigue, sleepiness, plus occasional light-headedness and mild nausea). But obviously the bisoprolol had both amplified the fatigue and increased the frequency of the more intermittent problems). I had absolutely no idea how much it was impacting me until I stopped taking it, but the improvement has persisted. I still need a rest and a short nap every morning & afternoon, but I can now do light work around the house and garden, take the dogs for a gentle walk for up to an hour, and I'm mentally more alert, My wife is so relieved: because I felt ill a lot of the time, I tended to be short-tempered and snappy, but that has largely gone thank goodness.

[Jajarunner]

I never got on with bisoprolol. In the end they decided 1.25 mg wasnt really doing anything (I still went into afib) except making me feel rough so they took me off it! They did suggest that in future I try atenolol if necessary.

[Cigarboxblues]

Sanjay Gupta videos will help you understand some of what you’re experiencing. They are a good standard for background and some self help.My tiredness is profound but a good bit is the mental lethargy I face on Bisoprolol and Rivaoxaban for the last year.

Ectopics (the skipped heart beat then the Big Bang to follow) is creepy but ‘normal’ but the AFib (palpitations) are exhausting. In my experience one precedes the other but it’s the tiredness that sucks. I’m no doctor and can’t give advice but can share my learning curve, as we all do on here.

Start to learn about yourself first and follow up with gentle research 1st hand with professionals or guides online.

We all suffer differently but are together in our support.

[kingsnorth in reply to Cigarboxblues]

ahh thanks l will have another look at Dr Gupta info on fb l did look early on in my journey as somebody else recommended l watch.

[Paulbounce in reply to Cigarboxblues]

Cigar wrote

"We all suffer differently but are together in our support"

+1

Paul

[Surreychica_1]

Made me feel dreadful. Thankfully the cardiologist changed them to another. I just stopped taking them they made my ectopic beats worse.

[Jetcat]

Yes it’s common to feel like that even on a small dose. I was taking 5 mg daily at one time and i felt drained for a long time. It also made me wheezey on some days too as if I had asthma.? I later read that it can actually aggravate asthma in some people.

[Griffin9]

I wouldn't go so far as saying I was fatigued, but I have been tired while I've been on the tablets. It could also be a side effect of lockdown and working from home. My get up and go is fading away.

One thing I have noticed is that sometimes the pupils in my eyes are very small, like pinpoints. It could be related to the medication.

[Ianp66]

Bisop did that to me before ablation which thankfully got me off it altogether. Like Finvola even a lower dose 2.5mg left me breathless and with no stamina having to stop in between tasks , and felt totally hopeless at hills or stairs as never before . Argued black was blue but gp insisted it wasn't Bisop to blame, but the afib and age etc, at 55! . But after ablation I felt loads better, had much more go but still felt held back, after 10 months my EP stopped it after my post ablation check up. Stopped immediately which in itself was a nightmare, coming off it was awful I found, I was on it for a couple of years for fast tachy / afib, the rate was controlled OK but struggled with it, feeling tired easily and a bit down .Now a year later no bisop and no afib, decent health, good stamina for my age, and I wouldnt take it again wouod want an alternative if needed , there are good alternatives like Nebivilol, which I read people getting on much better with, it's all down to me cost, bisoprolol being cheap as chips .

I'd insist on change if it's affecting you, I found even the lowest 1.25mg still gave me the symptoms you describe.

Ian