Morning all,I'm experiencing some symptoms that are probably caused by my medication.
So after a long journey not feeling well since pace and ablate, and recent blood tests showed my thyroid TSH levels were low and BNP levels 3x higher than normal and still have AF.
Had a radioactive scan on thyroid last week awaiting results and and another echo planned next week.
Currently taking propranolol for thyroid which is supposed to help with blood flow also and deluxetine for anxiety.
I get out of breath when walking, constantly fatigued, irregular sleep patterns, chest discomfort, weakness in my legs, dizzy spells, no energy and generally feel under weather.
I asked the doc if I could stop the deluxetine as I felt it my be contributing to some of the symptoms and don't really feel much benefit since taking it, go was happy for me to stop this med weaning off it over two weeks then stop all together.
Since weaning off it I have had diarrhea watery stools and stomach discomfort for the last 10 days, can't keep off the toilet, my stomach is bloated when I try and eat and never had a normal bowel movement for over 10 days.
I feel rubbish, up most of the night and just can't focus.
Bouts of nausea, aches, sweating and can't regulate my body heat, freezing cold then sweating to the point I have to change my clothes. Some days I h have a bath 3 times a day to get warm, my feet can get as cold as ice.
I have no energy, lost interest in most things, can't exert myself without feeling out of breath and weak and definitely not looking forward to going back to work next week!
Written by
Nomis21
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I’m really sorry to hear how rubbish you’ve been feeling and I agree, it does sound like the meds. I don’t have any experience of having a pacemaker either, but I do have a limited experience of taking propanolol .
How long have you been taking propanolol? I do wonder if it’s that, that may be causing a lot of your problems? I took a very low dose of propanolol only once for my AF and my feet literally went like ice for several hours, so much so, it was painful. For some people, I believe this can be less noticeable, but I couldn’t face taking it again. I take a different beta blocker now and I’ve never had any coldness. Beta blockers generally can also cause the symptoms you describe as breathlessness and disturbed sleep. I know I suffered from that initially on bisoproprol ( another BB) too.
The diarrhoea etc could still be a withdrawal symptom as coming off meds for anxiety can cause all sorts of effects, which hopefully may settle. Are you able to take any OTC meds for the upset tummy?
I’m sure others will come along soon to help more with the other medication, but perhaps it’s not the Duloxetine that is causing your issues.
I am first going query prescribing Propanalol for Thyroid??? Propranolol is a Beta Blocker which is prescribed to control high BP and high heart rate and yes it would cause some of your symptoms - mainly breathlessness and fatigue. But then so would underactive, untreated Thyroid dysfunction which could also cause arrhythmias.
I don’t know too much about Thyroid dysfunction but there are many on this forum who do but suggest that you post numbers - What exactly was your TSH? & your BNP? Also look on the Thyroid forum.
What is your BP? Are you monitoring it at home? Many GP’s will ask you to do a 7 day chart and if you don’t have a BP machine, provide one for you. Ask.
When did you start Propanalol? Sometimes it takes 2-3 weeks to get used to a new med and initial reactions to settle.
I assume you mean that you stopped Duloxitine, serotonin inhibitor? If so did you stop or reduce slowly? These are powerful meds with extreme affects and cause withdrawal like symptoms - on top of that starting Propanalol?
Are you seeing a specialist who is advising or general practitioner? It could be that Propanol was prescribed as a ‘holding’ drug until the results from the test come through and a more rounded picture of your health problems arises.
To answer your question of is it drugs or disease directly - could be either or withdrawal from meds and I would suggest different symptoms relate to different factors.
I would suggest you speak directly to your doctor and ask them to tell you exactly what each drug does. Propanalol, like all beta blockers, will dilate your blood vessels to lower BP - thus improving blood flow - this could cause your BP to flucuate or drop suddenly and thus you could experience dizziness, weakness, reduced heart rate or fast heart rate. Without it your BP could cause much more serious problems so for the moment you are between the Devil and the Deep Blue sea.
I wouldn’t think about going back to work until you know more from your tests.
PS - I just read your other posts and it seems you do have a complex medical history. WPW is beyond most people’s experience on this forum. You also are Pacemaker dependant after Pace and Ablate which again is outside of most forum members experience. Please go back to your doctor to discuss these symptoms.
Re-read you post re Duloxetine and see you titrated over 2 weeks.
Hi, I had similar symptoms after a long spell of AF which I think caused a degree of heart failure which since your BNP is high would apply to you. Some of my symptoms were caused by being treated for high BP although my BP had gone down naturally to the level of low BP. The AF should not be affecting your heart function since that was point of the ‘ablate’. I would be wanting to see a cardiologist asap. I suggest you post on the BHF forum as well as Thyroid.
I am sorry you are having such a bad time and wish you a better New Year ❤️🩹
I didn’t want to alarm you in my previous reply but I see Buffafly hit the nail on the head - heart failure - mine was the same diagnosis even tho echo was ok - consultant had no idea what caused it! I was given diuretics for fluid retention
Am afraid if you google it it sounds like much of what you have, certainly the gut symptoms, are classic withdrawal symptoms from Duloxetine . Am sorry you are going through this.
Many of your symptoms do sound very familiar and are all linked with typical pharmaceuticals such as beta blockers (propranolol is a real suspect I would suggest as it is not cardiac specific) and AF itself. I was horrified when I saw my BNP levels were off the scale but the doctor just said that this was fairly normal with AF, though I had convinced myself I had heart failure when I first saw the figure in my tests!
I'm fortunate in that I am retired so don't have to face going to work and coping but even so the daily round of getting chores done, dog walking and any physical effort is always difficult.
Some people take much longer to wean off SSRIs - months or even a year going very very skowly in titrating down. GPs are often ignorant about this. Unfortunately like with weaning off a beta blocker you don't know until you try weaning off a drug how long you as an individual will need to do it without getting horrible withdrawal symptoms. Normally low TSH would indicate an overactive thyroid. Diarrhoea can be a symptom of overactive thyroid . You need to have other thyroid tests freeT4 ,free T3 and thyroid antibodies done to see if it needs treatment. If your gut problems are a result of stopping the dulexetine you have 2 options - tough it out or go back on a reduced dose and titrate down more slowly.
Hi I take the lowest dose of propranalol to help with heart rate and am getting breathlessness on exertion and fatigue (other possible causes have been ruled out) I've tried bisoproprol and atenelol and had to stop both due to breathlessness and other weird symptoms. I don't know what to do now, the docs attitude seems to be that it comes with the afib but the pharmacist I see is convinced it's the meds. Have started slowly cutting the propranolol down but it will take months as even cutting down a small amount seems to cause strange withdrawal sensations in my head. Nightmare.
I've felt miles better since stopping my metformin. Not as breathless or feeling rundown heartbeat seems alot calmer and my toilet habbits are back to normal.
Stopping ANY ssri in just two weeks is just plain MADNESS!! It took me over three years to get off the SSRI I was taking and I very strongly recommend people NEVER take it. Sadly, too many doctors give these out like effing candy disregarding how addictive they are and how much they screw up your nervous system and your gut. I stopped my SSRI in 2016 and to this day, I still have a screwed up digestive system. You see guys/gals, SSRIs affect Serotonin, but what the docs don't tell you is that one of the biggest nervous systems in the body is found in your gut, the Enteric Nervous System, and a lot of Serotonin is both produced and used in the gut.
Since getting off of the SSRI I have constipation, belching, acid reflux, gastroparesis, and a whole slew of other symptoms which docs are literally incapable of doing squat about.
I would strongly recommend you taper off GENTLY, over the course of many months. Two weeks I believe is a nightmare.... if you can tolerate it, fine, but I have not known anyone on SSRIs getting off of them in just two weeks (despite that being the official recommendation which is nuts).
Many thanks for this advice, I totally agree with the fact it's to easily handed out, I wouldn't have taken it if I knew of the complications and side effects. Doc told me 2 weeks, day taking, day not then stop, but as you say I don't hink it's as easy as that!
duloxetine is a very powerful Snri,even at the lower doses for anxiety-it pushed one of my loved ones into extreme psychotic mania 6 years ago and he never fully recovered. It is difficult to wean off it and there are online support groups I believe,devoted to it or titrating off other psych meds. I do believe it can be contributing to your symptoms but I am not a doctor…
Your Pro.......... is a beta blocker and is for your heart.
If your TSH is high below .5 then you are hyper. - thyroid.
The thyroid is making too much thyroxine if you are not on synthetic thyroxine and have your thyroid.
In beknown to me my thyroid went heywire due to undiagnosed throid cancer. But you may have one or other diseases causing the thyroid to have problems.
A carotid arteries scan showed a shadow on my thyroid. A biopsy proved it to be the slow growing papillary one.
It sounds they will get to the bottom of your thyroid problems.
In the first instance it could be false alarm and another test will show in the normal range TSH .5-4.2.
If you need your thyroid removed DO NOT have RAI procedure to kill it but have a thyroidectomy. Also have it fully removed not just one lobe.
My surgeon directed 1-2 bag saline drip (started 5am) and 1 hour before surgery a blue drip (which was thicker). It guided my Surgeon to tie back this and that and to protect the voice box leads in and out.
I read my operation in the big book "ATLAS of Head and Neck". Marvellous and written by top Thyroid Surgeon MR GARY CLAYMAN.
My Surgeon & I both follow him.
Like what I did in 2020 that I made my own decision to refuse RAI post thyroidectomy and toxic suppression - which what you are in. I felt bad when my TSH was .7. I am anti Radiation and Chemo at anytime.
Now Mr Gary Clayman says if a patient is LOW RISK of cancer return, it is the patient who should decide whether to follow the old guidelines of above or not.
You are in a toxic situation which is hard on your heart.
I take Diltiazem 120mg AM for high pulse.
I take Bisoprolol 2.5mg PM for BP.
TSH between 1.5-2.5. Surgeon's instruction. 125mg Synthroid (thyroxin). But minus 25mg up to 3 days in 4 weeks.
So it looks like your thyroid problems caused your AF. Mine did.
Happy New Year from NZ. Our street experienced Fire Works at 10pm and 12 midnight.
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Persistent Afib
SYMPTOMS OF AN EPISODE ??
Pace and Ablate - Symptoms of Heart Failure after pacemaker and AV node ablation 
Change of Meds, dropped warfarin, started on Riveroxaban
