Hi there. I was diagnosed with persistent AF and have been on Bisoprolol and Apaxiban ever since. Cardioversion undergone which was not helpful and now await postponed ablation.
I constantly feel very sluggish and have put on nearly a stone in the last year.
I have been on a strictly calorie controlled diet for the last 5 weeks and have not lost a single pound! Most disheartening. Is this a common issue and can it be reversed? I know it cannot help with the AF and feel I am stuck in a vicious cycle.
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HettieHen
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I would strongly suspect Bisoprolol as the culprit. It does slow down the system ! I found it doubly difficult to lose weight when I was first put on Bisoprolol some years ago. Others have said the same. I only use this as a pill in the pocket these days( for all the good it does....) . It really doesn't agree with me at all and saps all my energy.
If these undesirable effects continue why not see if there is an alternative beta blockers which you could be prescribed.
Almost certainly down to the Bisoprolol. It slows down the conversion of thyroid hormones. Thyroid hormones are like the accelerator on a car, they drive how fast your body runs...... if there's not enough then the whole body rubs slow, including your metabolism and vice versus.
I’m a similar age to you and have been on Bisoprolol for a year and like you, have gained around a stone in that time which has made itself very much at home😡
I’ve recently switched to the calcium channel blocker Diltiazem, as the Bisoprolol has been aggravating my mild asthma. It’s still early days yet but, despite being in persistent AF I do feel better in myself and hope I’ll be able to start exercising again - it felt like I was constantly wading through treacle before!
As Jalia says, maybe it’s time for a chat with your cardiologist to see if an alternative might suit you better.
I had similar experience with Bisoprolol - terrible drug for me. Unfortunately the weight stayed on - if I lose it then it’s not for long. Age also has also had an impact as well as not being able to exercise because of muscle weakness. I also believe that Biso is metabolised very differently in women - note most of replies, if not all, are from women.
I’ve read various medical/pharmaceutical studies which all show that Beta Blockers have this affect and average weight gain on Biso is 2-5kg/year.
Interesting thought whether women metabolise it differently. I understand that drug testing is usually done on men.....am not sure if this is still the case. My understanding is that it's common to feel tired and lethargic on Bisprolol or any of the beta blockers. It's a general medication affecting the whole body whereas a calcium channel blocker medicine is target specific to the heart. It too lowers the thyroid hormone in the heart cells thereby slowing it down......but not the whole body. The downside is it can cause kidney damage so regular checks on kidney function should be done.
I have Hypothyroidism and effectively a beta blocker can simulate the symptoms of untreated or under treated hypothyroidism. Why any medic would give it to any patient with hypothyroidism astounds me......one medicine opposes the other. Bonkers.
Maybe because they don't know of it's effect on conversion of T4 to T3? I would bet good money that most of the docs who try to bully their patients into taking a statin have never heard of the mevalonate pathway. Many GPs knowledge of physiology is cursory . They also seem to be totally unaware of the differences between men and women in drug metabolism or that older drugs tested before the 90s are unlikely to have been widely tested on women or even female lab animals . Reason given at the time - all those pesky fluctuating hormones muck up the results !!!
Totally agree Auriclaire butt this was a Cardiologist! Surely should know better!! It was his registrar who rescued me from them as he plonked me on yet another beta blocker & went off on holiday to Africa.....meanwhile I crashed withing 24hrs of taking it. Registrar was lovely & promised me never again. The drug I'm on now is targetted, still slow t4 to t3 conversion but only in heart cells......so I have felt fine. The only downside is it eventually causes damage to the kidneys I recently discovered!!!
Well the hospital cardiologist who treated me when I was hospitalised after my first afib attack carried on as if T3 was cocaine despite the fact that my free Ts were well within range and I was only taking 9 mcg a day. Then he put me on 5mg Bisoproplol despite me being slightly asthmatic . The nurse even came along with a preventative inhaler before she doled out the pill and told me it might worsen my asthma!
I was not happy! After about 10 days on this level of Bisoprolol I felt like a zombie. I went to my GP and told him if I had to live feeling like this I would rather not live. He told me to reduce the dose by half but I actually reduced it to 1.25mg. When I saw my own cardiologist he told me I could stop it altogether after a couple of months. Now I take a tiny dose of Nebivolol - only .65mgs and take more as PIP for an episode. I just need to pluck up the courage to try the T3 again.
Bisoprolol has had an effect on my weight too. I had gained 1 1/2 stone since starting it. To loose any I’ve had to really restrict my calories to between 800 - 1000 daily and then even the slightest cheat will result in a gain.
I just don’t think that is a satisfactory answer and feels very dismissive when qualative feedback from women on this forum indicates difference. I’d like to see a gender breakdown of the studies you quote from and yet don’t reference?
Whilst most may imagine that calories count, recent research shows that not all calories are equal. Other studies show that it is what we eat and when not exercise and calorie counting which accounts for weight gain /loss and that is certainly my experience but THE most significant factor is our gut microbiology. I wonder the effect of beta blockers on that?
The clincher for gut microbiology is the result of fecal transplants on weight. Lots of examples of fat people becoming thin and vice versa with no other change in diet or activity levels.
Thanks for your reply. I completely understand the mantra of keeping calorie intake low and output high, however I seem to be living proof that it doesn’t apply to everyone! I have been on 1600 cal a day and do at least 20k steps a day - we have a smallholding and I am constantly on the go. I am vegetarian and eat a balanced, non-processed diet.
wow! What a question! Thankyou for asking it! I’ve been on Bisoprolol since 2018. My weight has gone up and up and I have a gastric bypass!! I wonder if it’s that? Appt in May at St George’s so will be asking Dr Li for sure!
Thyroxine does not affect the metabolic rate. T4 is a storage hormone . It is the active thyroid hormone - Liothyronine T3 which drives the metabolism and if the conversion of T4 to T3 is not adequately taking place the metabolism will be slowed. If beta blockers impair this conversion the metabolism will be slowed. Who sponsored the studies you have read? Were they done on women - remember women are affected 10/1 by hypothyroidism and if Beta blockers are slowing conversion they will be affected weightwise by them far more than men are. As CDreamer says let us see the gender breakdown in the studies you mention - though that is probably wishful thinking as there is hardly ever any gender specific reporting of results in drug trials . Wonder why?
Re weight loss clubs, I can't help commenting that whilst they are undoubtedly successful in helping very many women to lose weight their continued success relies on these women putting the weight back on and returning time and time again ! I know. I've seen it .
One of the symptoms of hypothyroidism is reduced appetite alongside weight gain. The opposite can be true of hyperthyroidism where increased appetite nevertheless is accompanied by weight loss . Before my hypothyroidism was diagnosed I put on a lot of weight DESPITE reduced appetite and increased physical activity as I was practising for my Bharatanatyam arangetram ( first solo performance of about one hour forty minute) .Bharatanatyam is extremely demanding as a dance form - my husband who plays squash reckons just as much if not more so! Why ? Because hypothyroidism reduces the metabolic rate and hyperthyroidism increases it. So if someone is only eating 1600 cals a day and despite being active is not losing or is even putting on weight then a thyroid issue is not unlikely as you state. Other symptoms can be subtle. I would suggest you aquaint yourself more thoroughly with thyroid disease ( like those of us who have actually suffered with it for 20+ years) before trotting out your half baked notions of it to us.
I think that is the point - we don’t know because there has not been the research - because historically research has been male biased, dominated by pharmaceuticals and/or university research funded. Also there has been no identifiable good reason - so far- to research. Hormonally and biologically and psychologically all genders and sexes are very different - will that make a difference? So many unknowns which is why I am impressed with the Zoe Approach because it can collect and analyse so much data cheaply, ethically and with great diversity. Only thing is we need to shift our perspectives from mechanistic cause & affect and focus more on Big Data to identify trends - which can then be drilled down through.
Yes it does as oestrogen is also a factor in thyroid function One of the things I learned at the beginning of my thyroid journey was that starting or an increase in HRT could mean that more thyroid hormone was needed . The thyroid is the driver of metabolism and the fact that far more women than men suffer from hypothyroidism suggests that gender is indeed pertinent. The onset of hypothyroidism often coincides with with perimenopause suggesting that the interplay of sex hormones and their disturbance at this time has an effect on thyroid health. The orchestrated "dance" of hormones in the body is very , very complicated and the fact that the differences in physiological responses between men and women has for so long been ignored has resulted for the most part in poor outcomes for women.
Well I guess I'm outside the norm as after 14 years of paroxysmal afib it became persistent last August. At first I was very worried as there was no cardiology appointment forthcoming. Being an anxious person I was already too slim. After a trip to A&E last February where the A&E doctor prescribed 2.5 mg Bisopropol ( I refused and said I didn't get on with it and would only take 1.25. I was discharged still in afib.Without a cardio appointment I then started experimenting with bisopropol and found that after a little while I became tolerant of it and increased my take to 2.5 mg along with 30mg Edoxaban ( my weight is under 60 kg)
Finally I got to see a cardio nurse and we agreed I would try 3.75 mg as my heart rate was a little too high especially when exercising.
I have for a long time taken magnesium glycinate, taurine and Coq10 100 mg.
I have never been offered a cardioversion or an ablation.
I am 77 years old, very active but not to an extreme, I play golf, swim, cycle, do yoga and walk.
Unless I push myself too hard I feel great, am never aware of my heart rate, struggle to find it and usually give up. My one lead Kardio usually showed a 70ish heart rate but I rarely bother with it now.
I have totally lost my feelings of anxiety as to whether I am going to ' blip' on the golf course, will this coffee trigger afib etc. etc. I eat reasonably but not overly sensibly ( I have a sweet tooth) and even drink a glass of wine, love my once a day cappuccino and still struggle to put on weight.
So we are all different but what I would say is those that enjoy exercise don't be frightened to exercise. Get on with it and enjoy your life. Your body will tell you if it doesn't like it.
Good luck to you. You will find the path which suits you. For me it has been a long journey of learning and this site is brilliant as I have learned so much from it. I just hope I stay as I am now for the foreseeable future.
You might not choose to be unkind but your first post on this subject proclaiming that beta blockers do not cause weight gain according to the studies you have read was, because it implied that those of us ladies here who have found exactly the opposite are deluded and are really undisciplined lazy over eaters. You might not have meant to imply that but that's the way it came over. As CDreamer pointed out it was dismissive . She also pointed out that she has read various medical/ pharmaceutical studies which show that Beta blockers do in fact have this effect so the exact opposite of what you are proclaiming. It is not your lack of knowledge that offends me. It is simplistically proclaiming something is true when the picture is more complicated . Thyroid disease and it's effect on metabolism is not simple and I think Fancy pants and Wavylines who have both aquainted themselves with the "minutiae" of the disease that has taken a toll on their lives and which is appallingly badly treated in the UK ,would both agree that your statements here about it are actually not correct in the context of this thread. As for your wife's aunt I would very much like to know when she was helping all these women with weight loss. As you are pushing seventy she must have been doing this some time ago. The situation with obesity today is far more complicated from a health environmental perspective- one factor being a much greater prevalence of endocrine disruptors that we are all exposed to. I bet she had failures too. It is well accepted that most people who lose weight struggle to keep it off as the body resets it's metabolic rate to fight against the famine it sees coming. This is an evolutionary trait and is part of the reason that so many struggle against obesity in times of plentiful food. We are the descendants of those whose bodies were able to withstand famines.
It is not outside the remit of the forum at all. Many women start their afib journey during the years when perimenopause starts and often thyroid disease rears it's head. Both of these hormonal disturbances can affect the function of their hearts. Again you are failing to take into consideration that we are different and trying to dismiss that.
The person who started this thread complained about her weight gain on Bisoprolol and asked if this was common. Several other female members said they had had the same problem . But you jump it with your " the science says no", which frankly I regard as being your typical knee jerk response whenever a product of your beloved Pharma gets criticised. In doing this as CDreamer first pointed out your were dismissing the experience not just of the individual who started the thread but the rest of the women who had concurred. You then say when pressed for a reference that it was one study on Metaproplol done on American women that you had seen on Facebook.. When I did a search "does Metaprolol cause weight gain" every single article that came up on the first page said that beta blockers could cause weight gain and that older ones like Metaprolol were among the worst offenders. The average weight gain was given as between 2 and 3 pounds but it was pointed out that this was average so some individuals might gain substantially more. So not only was your post contradicting the lived experience of many women on this forum, it was factually incorrect too. The "science" does not show that it is unlikely that weight gain will occur with beta blocker use, but all too likely. Maybe you should apologise to the women on this forum who have been struggling with weight gain on beta blockers for posting nonsense which I say again impiled that the fault was their's and not the drug's.
Hello again everyone. Thank you for all your replies on what it seems is an interesting subject that has an impact on many of us. However I never intended for it to turn in any way heated, and feel happy enough in the knowledge that I am not alone and that the weight gain is likely, if only anecdotally, to be related, if only in part, to the Bisoprolol. I am happy to leave it there.
Interesting discussion, but whatever the mechanism -- several in this paper here ahajournals.org/doi/10.1161... beta blockers like Bisopolol and weight gain often seem to go hand in hand.
This begs the question why beta blockers are so frequently prescribed by doctors as a first line treatment for almost any type of afib situation. Especially troublesome since maintaining a normal body weight is one of the most important things we can do to stave off afib.
Some people seem to tolerate beta blockers very well. However, if you're in the other group, which I am, time to reevaluate.
If you don't need your rate controlled, ask your doctors for a trial off beta blockers. If you need your rate control, ask about switching to a calcium channel blocker like Diltiazem.
I am sure you did not intend to offend me or anybody else. On reconsideration I was not offended by anything you posted - just irritated. The individuals who "liked " my response where I accused you of unkindness might have been offended or even upset . A more appropriate response would in my view have been to delete the original post with the incorrect information that beta blockers were unlikely to lead to weight gain.
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Beta blockers and weight gain
AF Association fact sheets 
Lose weight or your discharged!!! 
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