I'm on my 2nd bout of long COVID, 18 months in. A big part of my symptoms this time have been cardiac. Been to hospital a few times with suspected heart attacks, only to be told all my results are fine. Had echocardiogram, 48 hour monitor, all fine.After the last hospital trip, my doctor gave me bisoprolol to calm my heart rate and palpitations down. A low dose, 1.25mg daily. It has definitely helped and with no obvious side effects.
However, in recent months, I have noticed my heart rate will go up randomly once again, either for no reason at all, or when doing very gentle activities. When I say up, it's not that fast, it goes from mid 70s to mid 90s or maybe up to 110. However, I feel absolutely awful while this is happening, and I get a fluttering sensation in my chest. I am wondering if I have developed atrial flutter. I also get random stabbing chest pains on the left side, which are scary. Had an x-ray recently which found no issues in my heart or lungs.
Anyway, the point of all this... I spoke to my doctor about the fluttering etc, he is referring me back to cardiology, and in the meantime we agreed I would double my bisoprolol dose to 2.5mg a day. Since I did this 3 days ago, I have been having some really unpleasant symptoms - chills, shaking, headache, even worse fatigue than usual. I had an awful day yesterday. Spoke to my doctor again, he said that 2.5mg is a low dose, but that some people do react badly to beta blockers, and suggested going back to 1.25mg a day.
Has anybody out there had such a bad reaction to such a low dose of bisoprolol - does it seem a likely cause for my recent extra-weird symptoms? Thank you to anybody who has got to the end of this!!
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It sounds like it is the extra dose of bisoprolol that’s doing it and I have had similar. I’ve been on 1.25 mg now since last July and for 9 months before that, 2.5 mg, but on that dose, I felt very lethargic and didn’t sleep well, waking every 2 hours. Medics will repeatedly say that 2.5 mg is a ‘low dose’ or that 1.25 mg ‘doesn’t do much at all’ but I beg to differ. Strangely, my HR is exactly the same on 1.25mg as it was on 2.5 mg, but side effects are definitely less on the 1.25mg.
Sounds like this is the culprit then - seems bizarre that such an apparently small dose of something can have such an impact. I had no side effects at all on 1.25mg and thought it was some kind of miracle drug. 2.5mg and I've changed my mind!
You may be better to go back to 1.25mg as your GP has suggested. I’m much better staying on it. Either dose packs a punch. It doesn’t sound a lot in weight for either, but it certainly is.
If you get those fluctuations again, it could be something not related to the bisop, ( the investigations should tell you) or that the higher dose of 2.5 was stopping them breaking through ( perhaps), but you had those awful effects on the higher dose, seems you are caught between the devil and the deep blue sea 😳 do you have a Kardia machine or smart watch as that would record what is going on when you get the fluctuations?
I have been pondering getting a Kardia... I have an ECG booked in towards the end of the week, I'll see how that goes, and ask the doctor what they think of getting a device for home use...
A lot of medics and cardiologists recommend them for use at home at they’re really useful for capturing exactly what you’re going through now, as you can export the readings and send it off to them, or print them out and take them with you.
I found a Kardia was a very supportive companion after I began the PAF journey but the doc at my surgery was not at all interested in seeing readings and asked me not to send them! I only use it now to follow occasional episodes which only last a couple of hours after a flecainide tablet!
Some aren’t interested, I grant you & GPs might not be interested especially, but a cardiologist or an EP might. An EP I saw recently kept a couple of mine and was able to tell what was going on with my heart during an episode and was able to advise me more than I’d been told previously, so they do have their advantages.
I only saw an EP privately, sadly, as my surgery didn’t come up with anything after the lowest dose of bisoprolol was dangerous for me! Very sad that the NHS is not like it was! I found him through the AFA or possibly here!
My HR is 65 with no Bis. On 1.25 it goes below 50. So now I take only 0.6 (quarter pill) at bedtime only so that I have enough adrenaline to exercise during the daytime. Bisoprolol is a very potent drug.
Snap re the biso, which was why I was told to stop taking them (except when episode with very high heart rate but great if it works for you and “we are all different!”
Gosh, worse than me- I just started feeling increasingly tired as it brought my heart rate down very low and was told to stop taking them after only three days!
You are not alone with this type of reaction, I had terrible reaction to Bisoprolol- I now have a red alert on my health record to never be given it. Many posters on this forum have reported affects, more women than men. It’s not that unusual so push back with your GP.
If you don't tolerate beta blockers, ask instead for a trial of a calcium channel blocker like diltiazem. Many, including myself, tolerate diltiazem a lot better than beta blockers like bisoprolol.
As to your short flutter episodes. Don't guess what they are and don't let your doctors guess. Get a Kardia 6L and capture the events with an ekg. Then bring that ekg to your doctor and you can have more intelligent diagnosis and the correct treatment, if needed.
Interesting. I hadn't heard of those before. I think my heart rate issues are caused by disruption of my autonomic system, one of the many delights of long COVID, so the question is what would have the best effect in terms of calming all that down. I'll mention it to my doctor when I get my ECG done this week. And I will see if I can find £150 down the back of the sofa for a 6L...
In all honesty your best bet is to see a specialist cardiologist, EP. They specialise in heart rhythms & maybe able to advise better in regards to effects of long covid on the heart.I found all the beta blockers were awful & made me exceedingly ill. I tried propranolol, cardivilol & bisoprolol. I was put onto a calcium channel blocker Verapamil & then later on a slow release form. Has worked well. However like beta blockers calcium channel blockers have their side effects/consequences too. It's about the balance of what improves what to the side effects. So you need to be properly assessed/diagnosed so that you can make an informed decision on what can offer you the best outcome with the most minimal long term side effects.
I've been referred to cardiology again, so hopefully I can have all these conversations with a specialist. One risk of course is that I mention Long COVID and they switch off and say "nothing we can do for that".
What? That's awful!! They could at least try! My heart problems are due to cardio toxicity from successful cancer treatment. They used to say first of all that cancer treatment doesn't cause cardiotoxicity, then there's nothing they can do & now finally there are things they can do. I've a feeling this probably sounds horribly familiar to you with long covid! Lol.... Is there anyone researching it out there? Might be worth contacting them? It sounds like you might have to be picky about who you see....?
Very much depends who you see. My GP practice have been very sympathetic - helped I think by the fact that one of the GPs had long COVID themselves and were rough for 12 months with it. The respiratory specialist I saw early on was awful, tried to deny that I'd even had COVID and told me I was anxious. Complete waste of space. I know many have had experiences similar to the latter, unfortunately.
That's awful.... I've met a few of 'those' so called specialists.... Lol. Generally I don't mix well with them as I politely stand my ground. They don't like that & I did spot a nurse in stitches with laughter, tears running down her face as I quietly politely took one to task....(sadly usually male) The louder he shouted the quieter & calmer I became. I went elsewhere.... Obviously! The good ones are not arrogant, have great humility & listen carefully & care. These days I can spot them a mile off. You'll know the minute you walk in! Don't be put off..... Do your research first, thoroughly, then asked to be referred. I've been known to arrange a private consultation then go into a NHS list afterwards..... There are real gems out there but you do have to find them.How dare they suggest it's anxiety! 😤
I know exactly what you mean, and it's a common story with long COVID sufferers at the moment - there are the minority, who listen and who try their best, and there are the majority, who think they know best and have their egos damaged by patients who turn up to appointments knowing more about the condition than the professional! I'm sure it's the case with every condition that doesn't have a straightforward answer.
Indeed it is. Long Covid is new so it's so much easier to dismiss people then listen to them Up till about a year ago the medics discounted the thousands of women on estrogen blockers currently recommended for 10yrs, many who dropped them because of what the effects were. They were not listened to and we're told is was all in their heads. . Now of course research has finally proven it!! The long term effects are truly awful, many permenant. Taken decades!! So hang in there.... It's terrible what people have been left with. You are not mad or making it up. The medical world in the end will find it out but until then they will continue to dismiss patients complaints unless research substantiates them. All back to front if you ask me.
"It's all in your head" - the standard response, meaning "we don't understand it yet". The good doctors are the ones who genuinely listen to their patients instead of trying to fit them into a particular category.
I have near identical symptoms. The palpitations, as I call them, and a somewhat fast heart often start in the mornings at breakfast or when doing just about any activity. If I walk with my wife and ask her to take her pulse (we both use Apple Watches), then it's usually about the same as my own but she is unaware of hers whereas I am very aware of mine. If we run an ECG on the watches, both show NSR but mine will have a few ectopic beats in the 30 seconds, whereas she will have none. If I run a Kardia with advanced determinations, as they call it, mine will show "NSR with Wide QRS", reflecting the left branch bundle block that I have. I put my troubles down to that, myself.
I do try to ignore the palpitations, but if I am doing anything important (like looking after our 4-year-old grandson), then I will take a 1.25mg tablet of bisoprolol and it works well, much as you find.
The problem with bisoprolol is that the dosage and the effect it creates are not linear, and that doubling to 2.5mg might have a much stronger effect than you need. Look at it this way, if your heart is, essentially "normal" then you are forcing an unnaturally strong effect on a normal heart. For you (as for me) 2.5mg is quite a high dose, after all, and it's a potent betablocker, unlike say propanolol. I have a small op on Wednesday morning and asked my GP should double my dose to 2.5mg and he said that I should not. This is different from your GP's advice, but I think he might well say, reduce it back to 1.25mg.
I used to take the bisoprolol only on an "as need" basis, but with my AF becoming faster and a little more regular of late, I've been told to take it daily now, but only the smaller dose.
Thanks Steve, that's all really interesting. I didn't realise the effect of bisoprolol wasn't linear as the dose goes up - that helps to explain why I had such a catastrophic reaction to 2.5mg when I've been tolerating 1.25mg really well. It's hard ignoring the palpitations sometimes - my heart seemed to be really thumping heavily last night, although at a nice steady pace.
You’ll likely read on here that people with AF are more aware of their heartbeat, and while that might be so for some, I’d say there must be another explanation but not one I know. I think the palpitations when mixed in with ectopic beats is maybe different? Whatever the cause it’s hard to ignore - well impossible, as I’m currently finding as I sit with my family in a park in Luton while my grandson stretches his legs en route to home. Frankly, with this, I’d rather get home than play in a park! 🙄
I hope you make it home safely! I find it incredibly frustrating that I can't join in with family activities like I used to. My wife and son are planning a summer holiday away without me this year, because it's too stressful all round to try to do anything with me around! (which I agree with)
I do think many of us measure what we can and can’t do more carefully than people without heart issues. Even knowing that the heart itself is sound, and won’t suddenly stop, the anxiety always creates a little voice that tells otherwise. That is hard to ignore and defeat.
But, of course, we did get back safely, thank you! And the little grandson is sitting on our settee with his iPad while his mum and dad unpack at home. They don’t approve of “screens” but grandpa is kinder! 😉
The reason he said do not is probably because at one time there was a practice of giving patients a beta blocker before operations ( even those who had never been prescribed them for any condition). It was then found to actually be counterproductive with more post op mortality among those who got the beta blocker!
That’s interesting. I’m having a small op under local anaesthetic on Wednesday and have been told by my GP to take 1.25mg bisoprolol to ward off any AF in the three days beforehand when I’m not taking my anticoagulant.
P.S. I don't think that you will have atrial flutter, by the way. That produces a fixed and step-wise heart rate that is a fraction (1/2, 1/3, 1/4, etc.) of the atrial flutter rate of 300bpm (the atrium, that is, not the ventricles or pulse, i.e. a pulse of 155, 100, 60, etc.). That's what I started with in 2019 before my ablation that year.
I am pretty sure from your description that you have palpitations, i.e. a slightly faster than usual heart with some ectopic beats mixed in. With me, this generates anxiety, by the way, of varying amounts, and I am quite sure that that makes my symptoms feel far worse than they otherwise would.
My mother has had atrial flutter which is partly what made me think I may have it. Also the symptoms include the awful fatigue that I seem to get whenever my pulse goes up, even if it's only to 90 or 100. If my atrial rate is hitting 270 / 300 while that is going on, it might explain what is going on.
I don’t remember the fatigue so much except skied with the anxiety that came with it. It certainly would explain your feelings but with flutter, under exertion of any kind, I’d guess that your pulse would double rather than move linearly. That’s what mine was like in 2019.
I don't get on with Bisoprolol at all - even at 1.25 mgs dose. I've only taken it a handful of times and felt very peculiar each time. I'm super sensitive to medications and medics just don't seem to understand that people react differently.
So sorry you are going through this. I was put on 1.25 mg Bisoprolol in May 2021 when I was diagnosed with PAF. I was really tired and fatigued on it. Last week I came off it following my ablation last November. Despite AF nurses and EPs saying it was such a low dose is was very unlikely to cause such tiredness, I feel so much better now I’m off it!
I don’t understand why they say that. If it’s enough of a dose to have a positive impact on the body, then surely it’s enough of a dose to have a negative impact??!
Thank you Lyn. Sounds like you've had troubles of your own worse than mine! It definitely sounds like a low dose can cause big issues with some people. I'm certainly feeling more normal now I'm just taking 1.25mg in the morning.
Yes, I felt awful on2.5mg but which seems to be the 'default' prescription for AF here in South Africa, but halving the dose to 1,25 mg was amazing, I still enjoy the benefits, but the side effects are minimal.
25 .made me so breathless and chest felt constantly tight.It affects the lungs apparently.Swiched to Verapimil.for rate control.No probs except a bit of constipation.Good luck.
Don't think GP can prescribe a calcium channel blocker.... Has to be recommended by a cardiologist initially. I think that's correct.My heart beats fast all the time & then has the erratic beats at times (P-Afib bit). I've no idea why it beats fast... Never used to. Am told it is of sound structure though left ventricular has very minor damage still from treatment. Obviously if your heart beats faster then any exertion will add to it & you will struggle. I do suffer with fatigue.... Takes me much longer to do things as need frequent breaks. Frustrating!!
Ah - I see - that's worth knowing. I'll mention all this to the GP but won't be surprised if they say it has to wait until I see cardiology again. The fatigue aspect of long COVID has absolutely ruined my life - I can't do anything anymore without feeling dreadful.
They have, but they are only really geared up to provide lifestyle advice, they don't offer any diagnosis or medication. Waste of time really. My GP has been far more help - but there's only so much they can offer while the research into the condition is continuing.
Crikey.... Lifestyle advice.... Shucks that sucks! Like ME/CFS.... Life style advice.... Though they tried to say its mental at one point & enforced a graded exercise programme that did a lot of harm... They've stopped that now. Now the thinking is impaired microchondria. Well I'm glad the GPs have been more supportive. Re your heart I still think a good EP maybe more helpful than a generic cardiologist.
Another thing to consider might be that your heart may also race on effort because there is an energy source/access issue. This might also be rubbish!! Lol....
You are right. Despite my GP protesting otherwise Bisoprolol does have that effect of breathlessness for some people. Also some brands are worse than others. Sandoz is worse and I've had to gradually build up to 2.5. Nearly suffocated one night on the full dose. Terrifying. My pharmacist explained why different brands can have greater or lesser effects. Medreich was good but nowhere but the hospital pharmacy supplies it.
You are right. Despite my GP protesting otherwise Bisoprolol does have that effect of breathlessness for some people. Also some brands are worse than others. Sandoz is worse and I've had to gradually build up to 2.5. Nearly suffocated one night on the full dose. Terrifying. My pharmacist explained why different brands can have greater or lesser effects. Medreich was good but nowhere but the hospital pharmacy supplies it.
Hi I was given bisopropol when I first had a fib. I couldn't tolerate it v well either. It made me faint, actually fall over when outside in the park, fatigued/tired and generally unwell. I just take an anticoagulant every day and am waiting for an ablation. Best of luck. From a non-tokenwelshwoman. x
Thank you! I hope your ablation goes well. I'm reading about the side effects of calcium channel blockers, seems they can be as bad as beta blockers, depending on the individual. I will ask my doctor which is likely to be better for autonomic dysfunction, as they obviously work in different ways. x
They work very differently. Beta blocker slows everything down by affecting the conversion rate of thyroid hormones to a lesser or greater degree depending on which one & what dose. Which is why people often feel tired on them. Some beta blockers are meant to be heart specific.... Generally though they slow you down.
Calcium channel blockers are heart specific and work in a different way. The one I'm on can long termly affect the kidney function.
My EP said there are other drugs too but after these two types you are into drugs that have significant side effects & they only use them as a last resort.
I don't think there's any winners in the drug world re hearts.... a case of what gives you the least side effects & is most effective for you. That's the balancing act you walk.
My first go to is check vits minerals levels first & make sure they're optimal... Not just in range. It can really help. Big pharma can't beat the natural products who have zero side effects unless you take them to excess! But equally there's times when you just have little option but to reach out to big pharma.
I’m inclined to think that some of this is related to the after effects of Covid, but you really need to have an ECG and 24h ECG to see if there’s an intermittent arrhythmia. The body tends to be more sensitive to drugs and side effects in any post viral syndrome, and is also prone to orthostatic intolerance which can also affect HR and BP. But please get anything more serious ruled out.
ECG coming up on Thursday this week (I bet the results will be clear yet again). I will be asking cardiology for a multi-day heart monitor. I think like many people I am learning a lot about the joys of post viral conditions. It really isn't pleasant.
I’ve been living with ME/CFS for many years and deteriorated dramatically after a respiratory illness (pre Covid) which triggered my arrhythmias which eventually led to AF. I have orthostatic intolerance and low BP, but I just live with it now, it’s all become my “normal”. So many of the long Covid stories sound so familiar to people with ME/CFS, although there are different sub groups of people with long Covid eg people who have been in ICU have very different challenges from people who have had so-called “mild” Covid but afterwards have deep exhaustion trying to manage basic self care. None of it is good, though.
I have a lot of sympathy for anybody who has been struggling with ME/CFS following this experience. The medical profession has been telling them it's all in their heads for a lot longer than the long COVID community!
The “all in the mind” thing has not quite been my experience. It’s more been a case of “we don’t know what causes it, or how to treat it”. I have been to specialist CFS clinics and my experiences were very positive. However, the effectiveness of what’s on offer is very limited. Pacing and managing limited energy is useful but CBT techniques don’t do much and can’t change the reality of having to live with it. Many people say their experiences at CFS units have been awful, but my experience was positive overall because I had a very good therapist. My understanding is that long Covid patients are being offered something similar and I’m hearing the same criticisms and concerns. The sad truth is they can only help people manage their condition but there’s really no effective treatment and research is woefully underfunded. Unfortunately this leaves many desperate people vulnerable to quackery and I don’t think that helps either.
Couldn't agree more. It sounds like your own experience has been as positive as you could ever have hoped, given the historic lack of research and lack of treatment options currently out there. My hope is that there are now so many people out there with long COVID that it will force more attention onto post viral conditions generally, with the result that ME/CFS sufferers will finally start seeing some treatment options appearing.
Yes, it can be. For some people there are serious inflammatory consequences affecting the vital organs, for others it’s more similar to ME/CFS which I have been living with for years. And there are those who have a long-ish recovery period but they do make a full recovery. It’s not one condition affecting everyone in the same way.
Women seem to do much worse on Bisoprolol than men. Bisoprolol has been around for some time so it is very likely that it was trialled in the days when women were not included in clinical trials ( due to our pesky hormones).
Yes but for medical research purposes we were regarded as awkward. It is only recently that there has been any acknowledgement that we are not inferior male bodies except for the bits that are obviously different but that our whole physiology is generally affected by our hormones . Women on the whole do worse with side effects from drugs and vaccines but sex differenciation in reporting of side effects is still not done for most clinical trials! In the past they did not even use female lab animals for the pre clinicals apart from testing for birth defects.
It's incredible isn't it. I often think that as a white middle aged man I'm probably getting as much respect (for want of a better word) as anybody could ever hope for, and I dread to imagine what it's like for anybody who dares to be female, or non-white, or young...
Just an observation from someone who was diagnosed with lone atrial fibrillation 14 years ago and has spent that time trying to figure out what's causing it, but have you had your thyroid checked?
Bisoprolol does not seem to be one of the class of BBs reliably prone to affect thyroid function. At least by inhibiting conversion of T4 to T3, and co-enzyme Q10 - which is imperative to mitochondrial and therefore heart function - perhaps the most usual issue.
However, we are talking about complex feedback loops in highly interdependent systems. Whereas, doctors can be prone to take an overly narrow 'Whac-A-Mole' approach to prescribing for isolated symptoms: "Elevated cholesterol? Take this statin".
Which can be especially problematic in the presence of underlying, pervasive and ill-understood morbidity. Possibly like long covid. Precisely the sort of autoimmune condition likely to impact the thyroid, and entire HPTA-axis.
I would definitely take the advice given elsewhere to get that Kardia, I have something similar and it has been far more useful to understanding my condition, reassuring me and informing my doctors than all the Holter monitors and other costly paraphernalia combined.
And I would check out all the contraindications of Bisoprolol for something that might ring a bell. Responses like yours to medication can be diagnostically invaluable, and quite telling.
Besides which, I would get your thyroid checked. And use our sister thyroid site to have someone confirm that your results really look OK (you will find that doctors' ranges are for the birds, where the thyroid is concerned especially).
Medichecks do a thyroid finger-prick test (medichecks.com/products/adv..., which will set you back about £71 after £15 discount (BLUELIGHT15 works I have it on good authority, look for others, or for regular Thursday discounts). This will provide a full thyroid panel (including free T3 and free T4) and also provide information on vitamins B12 and D, as well as thyroid antibodies (there shouldn't really be any).
I would also endorse reading Dr Sarah Myhill's latest book (amazon.co.uk/Underactive-Th..., which like her resources online provide a commendably accessible insight into autoimmune and related conditions.
I am coming to the conclusion that my own AF has been closely associated with longstanding undiagnosed hypothyroidism all along, as well as ramifications of modern western diet and vaccinations.
Such everyday, seemingly unrelated and no account matters, left untended, can too easily put us on the doctors' radar. And then, as I say make us prone to a lot of heavy-duty, overly-formulaic point-and-shoot solutions, out of proportion to their causes, if we are not careful.
Hi. I am pretty sure my thyroid function has been checked at least a couple of times over the last 2 years. I've had full blood count tests which I'm sure included thyroid. I can't comment on what range the results were compared against, of course! I also take a CoQ10 supplement (amongst many others). I'll mention this to my doctor next time we speak, to see if he thinks a follow up is worthwhile.
Sounds good, but be aware that doctors tend to place too much weight on TSH being 'in range' almost to the exclusion of all else, if indeed they test for anything else.
Underdiagnosis and undertreatment of thyroid conditions is legion (more among woman than men, admittedly). In my own case I note I had a proper thyroid panel test right at the outset of my AF treatment. And, in retrospect, a significant, below-range free T3 result was totally ignored. Many GPs will not even request a T3 test. Let alone understand the result. And they can be even worse at joining the physiological dots these days. It's a time thing. Plus, they adhere to best-practice flowcharts that are designed to produce a cost/death minimisation solution to an aggregate problem. Not necessarily your problem.
Hi. Excerpt from results of the standard panel of blood tests I've recently had done via my GP (I think it's available to everyone annually or used to be):
"Serum free T3 level"
-
I assume the GP has not requested an FT3 test and there's not much I can do about that?
Others on here will be better able to quote chapter and verse about what GPs can do, or may be obliged to do, under certain circumstances to comply with best practice.
However, l think there is little doubt that they could order Free T3 tests for you in most areas (that such a test is available to them). They just choose not to.
So, the first thing to do is just to ask for one. They can only turn you down - and explain why. Which should be interesting...
But, long story short, unless you have a goitre the size of a tyre, you will probably have to make shift for yourself, by way of testing and getting any appropriate treatment.
Which is because, as I understand it (and you are probably already aware), UK medical doctrine demands the extirpation of T3 scrips.
Probably largely as a result of somebody (who does NHS procurement) acquiescing to a 100-fold T3 price hike from from the new private equity owner of the principal UK T3 drug supplier.
Consequently, a month's supply of T3 tablets that you can pick up in any price-controlled pharmacy in Greece (without prescription) for Euros 2.50 for 30x25mcg tabs still come in at tens of multiples of that price under the UK reimbursement regime (see below) - down from even more, following fines imposed on the PE firm concerned).
Too pricey for something amply dealt with by levo at a fraction of the cost.
So, obviously, the only rational response was to reconfigure the entire prescribing discipline for longstanding thyroid patients based on price.
What could possibly go wrong?
And the sad truth is that letting the tail wag the dog like this would not be so easy were there much grasp of proper diagnosis and treatment of hypothyroidism at all anyway.
Whereas, even most Endos are more concerned with diabetes than thyroid ailments.
Too often, TSH is the universal lazy touchstone, and a synthetic combination drug the universal cure-all, even if you are diagnosed hypothyroid in the first place and lack T3.
So, it's too bad if you just feel sick while your TSH is 'within normal parameters'. And, of course, the 'normal parameters' keep getting wider because they include more sick people!
If you are just a bad converter (from T4 to the active hormone T3) or, worse, have inherited a single or double deiodinase polymorpism (and don't know it), then you will be totally under the GP radar.
As a rule it pays to 'follow the money'. Nowhere more so than in GP diagnostic practice (testing) and prescribing policy. So, it is worth checking out e.g. NHS drug reimbursement prices: nhsbsa.nhs.uk/pharmacies-gp...
Thyroid function can change in as little or a month or two. Something could have changed and the blood tests are easy. I'd suggest getting them done. My TSH skyrocketed from normal to hypo (in low 20s) in less than 2 months. It's also a good idea to keep copies of all your lab results
Well said TeaFree. It's the big hidden condition, masked by absurd guidelines which prevent treatment until people become extremely ill, often for years & by then creating Co mortalities that could've been avoided if treated much earlier. Eg TSH top of range was doubled for no true research reason what so ever.... I notice one health authority area has increased the top tSH level to be over 15 now before treatment can start. It leaves me wondering if the medical profession have noticed a surge in consequent heart problems & obviously obesity, high blood pressure & cholesterol that goes with it! Never mind the myriad of other symptoms Hypothyroidism can present with.
Quite. It does make you wonder whether there is actually some wilful denial afoot, such are the inadequacy of diagnosis, the sheer obduracy of treatment (if any), the breadth of population affected, and the universally severe consequences of neglect. In the face of simple, cheap, safe, easy and longstanding, proven thyroid interventions - with NDT, or T3. It's one condition that would have been better diagnosed and treated 50 or even 100 years ago than today. And yet GPs will seldom look much beyond TSH (and don't get that this isn't even measuring the thyroid per se). Then discard test values below an absurdly high range, when what is optimal for any individual can be very different. And the sheer prevalence of the condition (because of its neglect) is constantly hiking the range anyway! It's worse than mad. It's criminal. As Dr Myhill points out, there is a very well proven inverse relationship between maternal TSH level and child IQ. So, this is no trivial matter. And, as you point out, whereas the importance of maternal TSH below 1.5 is recognised by GPs for mothers to be, how come it is not the norm for the rest of us too? And how exactly can any woman be sure she won't get pregnant with an inappropriately high TSH (i.e. potentially low newborn IQ, and other morbidity) if it it is not maintained that way the whole time? My point to the OP was simply that problems with the HPTA-axis are the elephant in the room and intimately connected with the plague of autoimmunity, MS, CFS, ME etc.. Well worth checking thyroid status out before doing anything else. But don't take any welcome, but half-digested "all clear" from 'range-bound' medics or testing outfits at face value. Look to your symptoms - if it quacks like a duck...
Hi, I eventually discovered that covid/long covid has given me Afib. I am now over that and the last episode was a year ago... you may also get better. I had random heart pace changes and still do.... I think this is the after affects of covid. But no Afib or other issues.
My reactions to bisoprolol were headaches and generally feeling below par on 2.5mg. Once the doc said my afib was linked to covid, he took me off the bisoprolol and now I have it as back up. Docs told me that if I have an Afib attack to take 5mg and rest.
I bought a Kardia 6 lead detector when I had the last afib attack. It recognised I was in afib and I still use it now and again to make sure I am not in afib.
Hi! Thank you for this - sounds like you were in the same boat that I am in now. Very glad to hear you got over long COVID - I did the first time I got it, after about 8 months, but then got reinfected and got long COVID again, which I now don't seem to be able to shake off. Sounds like I need another conversation with the doctor about why my heart rate is going a bit crazy and how best to calm it down.
Flecainide works well as a pill in the pocket. The link with covid is interesting - I had an episode around the time I must have been infected near the end of January and have had a few others since but they never last more than a couple of hours with an extra flecainide pill and occasionally 1.25 biso if very fast which it doesn’t seem to be these days. Good luck with finding what works for you as we are all different. I’ve had fatigue (and the PAF) since having shingles five years ago and off course that is another of the side effects of flecainide but as I’m 79 and had many active years prior to this, I’m fortunate to still be around!
We are all different- the doc wanted me to take 2.5 daily but I said I was very sensitive to drugs so she agreed to 1.25 but that turned out to be too much for me as it brought my heart rate down dangerously low!
Not all beta blockers cause similar side effects. I briefly took metropolol and needed to stop as I had bad pain in both hands to the point of barely being able to use them or move fingers. Taking sotolol now with no problems. Ask doctor to try a different beta blocker.
I couldn’t tolerates Bisopropol 1.25mg and felt like I was waking in mud. The cardiologist and Gp didn’t think such a small dose would make me feel so tired but I was then prescribed Verapamil. Brilliant…. It has stopped the tachycardia (at about 180ish) and I have far less episodes of AF which used to follow the tachy stuff. Everyone is different and finding what is right for you can be difficult. Good luck.
I think that's the second vote for Verapamil... I will speak to my doctor or possibly the cardiologist about it, depending on who is allowed to prescribe it. Thanks for the tip!
I was taking 1.25 bisoprolol twice a day having palpitations, cardiologist halved it to 1.25 once a day, but have developed Atrial Flutter so waiting for Ablation, history, quad heart by pass 1999, heart attack 2004, Atrial fib 2013 then cardioversion, then Atrial Flutter last year
Wow. That's not great. I already had brain fog and fatigue when I started taking 1.25mg daily - makes me wonder whether I would have been "free of side effects" if I wasn't already feeling rough...
although he doesn’t have heart issues, my husband has been prescribed bisoprolol and responds to even a very low dose like 1.25. Some people respond to far less of a medication than others. Which is why the daily dose is anything from 1.25 to 10mg. We are all so very individual. Hope you feel better soon. 😊
1.25mg, the lowest dose, was too much for me- fortunately the pharmacist had taken interest in me - the doc hadn’t even arranged a follow- up appointment. He took my pulse and told me to stop taking it after three days!! We are all different!
so interested to read this, I’m on 2.5, week 7, all my body feels like flu aches, get sweating and terrible neck and headaches. Never felt so rough in my life. I have SVT and right bungle branch block. Not sure how much longer I can tolerate these tablets!! Seeing my cardio consultant this Friday.
Interesting posts. I was originally put on 2.5mg Bisoprolol and yes, couldn’t cope with that, reduced to 1.25mg but that seemed to cause problems, so I took 1.25mg every other day. It takes my hr low over night and when sitting. I recently had problem with AF, high hr. I take flecainide, 100mg x2 day, told to increase to 150mg x2 day and take the 1.25 Bisoprolol every day but its causing low Hr more (low 50’s) which isn’t ok for me. I’d been ok since October 2021 and just a recent odd episode maybe due to long flight and long day. My cardiologist is saying change from flecainide and Bisoprolol to another medication. I can’t get my head round being SO good for so long to now the problems with this.
Reading about flecainide and its side effects, that doesn't sound like much fun at all... What is your cardiologist suggesting instead, out of interest?
Hope you get it sorted. Are you still taking the original make of flecainide, Accord, which works for me unlike the presumably cheaper stuff I was given last time! Not any more!! And even 1.25 mg of Bisoprolol brought my heart rate down to low 40s so take only if having an AF episode with very high HR which very rarely occurs. Good luck finding what works for you as “ we are all different”!
still in AFib grrrrg. High Hr all day since Wednesday early hrs. The Bisoprolol is Sandoz and Flec 100mg is Accord the 50mg is Tilomed 🤷🏼♀️ I don’t like taking generics but often have to have what I’m given 😡
Hope you have taken an anticoagulant as you don’t want to have a stroke and perhaps it might be time to ring 111 who will no doubt send an ambulance. Good luck with getting it sorted.
Good luck and don’t blame you re 111- when my husband urged me to ring we ended up entertaining a lovely group of paramedics including a student who was studying at the university where my daughter had just obtained her MA and a guy who was going to see Ronnie play at the snooker the next day - we were good friends by the time I finally got into the hospital and it was a further 7 hours or so before I was seen! It turned out to be acid reflux as later discovered I now have a hiatus hernia but the pills are not good for AF so I do an exercise every day that is supposed to push the stomach back down through the diaphragm!
I’m finding it all very daunting, I didn’t actually feel poorly prior to starting on beta blockers, a crazy high heart rate tok me to A and E then SVT diagnosis, even more strange I had major leg surgery last Sept and no sign of any heart issue, so very confused!
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