Around the 10th December, I had cause to go to the GP regarding some horrible nose bleeds I had been suffering which had caused 3 short hospital stays in November. I was not coping well with the stress. The GP said it was a form of trauma, what I was going through and would take time to disipate.
At the same time he noted my pulse and declared it too high. My permanent AF has always run high. I was on 2.5mg Nebivolol beta blocker but he doubled it to 5mg to bring the rate down. It has worked to some extent. My resting rate is now more likely to be high 70's and sometimes low 80's.
But since Christmas I have been so exhausted. I'm hypothyroid anyway and can never get my medication right for that, I'm always under medicated and struggle to raise it. So tired is my standard life. Slow and no stamina. But this is much worse.
I don't know if it's the receding stress of November (I'm still stressed about it but not so badly), the extra beta blocker or this wet, dull, grey and miserable January.
Does this sound like a beta blocker problem?
I already have big problems with swollen ankles and feet so when they put me on Amlodopine for high BP in hospital, despite me pointing out my swollen legs, it all got worse. So it looks like a calcium channel blocker isn't a solution either!
Written by
FancyPants54
To view profiles and participate in discussions please or .
For what it's worth .......... on 10 December, were you already on beta blockers, i.e. Bisoprolol or Nebivolol . I'm a bit unclear.
The reason for my query is that a few months after I started on beta blockers ( Bisoprolol 5mg in Jan 2010 ) I started developing full flow, nose bleeds - all occurring at random, but, nevertheless all equally dramatic for me at the time. Jan 2010 was the time I was diagnosed with paroxysmal AF and in addition to blood pressure meds and statins I was already on, my Cardio Consultant at the time then put me on Warfarin and Bisoprolol 5mg.
At first I thought maybe Warfarin was the trigger for the nose bleeds. Anyway, I went to my GP and she said - quite firmly - it'll be the Bisoprolol. She checked as I was taking it in the morning, then she said, take it at night. Not had a nose bleed since ... not one. Not ever. Sorted ! Since then I have moved along the beta blocker food chain, from Bisoprolol to Nebivolol ........ took them at night - no problems. Following my consultation with another Cardio Consultant in April 2024, he moved me onto Sotalol (40mg in morning and 40mg at night ). Still no problems.
You talk about your current heart rate being high 70's - I am wondering what your blood pressure readings are ? Also, I am wondering why they chose to put you on Amlodopine as there are at least two other BP meds that are available, Ramipril and Felodopine. Might be worth asking the questions. I'm lucky where I am as not only do I have a Boots Pharmacy who offer consultations by appointment but my GP Surgery also employs a full time Pharmacist who is also available for appointments. My current BP is now in the range of 132/80 with HR of around 74.
Even though all my meds have my AF totally and very well controlled ....... the tiredness is always with me, always ... some days worse than others particularly with this totally crap January weather.
I wish you well and hope that you soon start bouncing around now that Spring is just around the corner.
Thank you for that. I don't "think" the nosebleeds were beta blocker related. I have been on Nebivolol for years. I take it at night. They do, of course, react in hospital to the anticoagulant and stop it immediately when in for a bleed. On the last hospitalisation, which was only 2 days, they had me stop my anticoagulant and put me on a drug to help clot the nosebleed! That seemed a bad idea to me.
My BP was high in hospital. But then I was pouring blood and had been told there were no ambulances for hours so we had to drive there ourselves, half an hour on rough country roads. Then packing shoved up none to carefully, then a long further drive to Oxford hospital and repeat the A&E process all over again! Yes I was stressed and my BP high. But I was obviously stressed the entire time I was in because the BP didn't go down much. So on the second visit they put me on the Amlodopine. I pointed out my visibly swollen ankles and feet as they told me what they were going to do and asked them if it was a good idea given the problem I already had. But they did it anyway. It made my feet and ankles so painful and so swollen I couldn't get anything on them other than Crocs.
By the time I was home and calmer, the BB and the Amlodopine sent me into a spiral of anxiety and further stress. Cold sweats and feeling faint. It was too much. So I stopped the Amlodopine and started to feel better quite quickly. I have a BP monitor and my BP was OK. Higher than it had been before my calamities (I fell hard on concrete a week before the nosebleeds and tore my rotator cuff in my shoulder and bruised myself all over) but nothing to worry about.
But in December I saw the GP because I was suffering from high anxiety over the nose situation and he said my HR was too fast and needed to be brought down and muttered words like heart failure (just to stress me further) and referred me to cardiology. I didn't protest that because cardiology dismissed me in 2020 and I've not seen anyone since to keep tabs on me. The appointment is in April so they can't have considered me urgent. I'm going to ask to be referred to an EP I think, when I see the cardiologist. I've never seen one and I'm fed up of being ignored. Meanwhile from New Year on I have felt like I've been hit by a truck. Exhausted. Brain fogged. Eyes not focussing to read, even with my glasses on. Instant exhaustion if I do anything. Can't even force myself to put the washing on let alone pass the vacuum around. I have a business, it's not doing well with me like this. I am managing to ship orders out once or twice a week but that's all I'm doing. I wake up exhausted. My legs and particularly my feet hurt like hell and I can barely walk. I was not this bad before Christmas. So last night I broke my BB in half and took the 2.5mg I'd been on for years. There is a GP at the surgery who has a special interest in the heart. I usually try to see him about heart issues but in December I had to see who I could get and it wasn't him. I'm going to make an appointment with him and see what he has to say. Doubling the BB wasn't the answer, like Amlodopine wasn't the answer. My QoL has been rubbish through January. Not that January helps! Dreary month.
So after that long ramble, I don't think the BB caused the bleeds but the anticoagulant made them impossible to stop without packing. They were coming from an artery at the back of the nasal passages inside my head. Thank you for your response though. It was nicely considered. Fingers crossed neither of us have that issue ever again.
After going through 2 Beta Blockers Metopolol and Bisoprolol. not fully controlling my Heart Rate, 186 bpm, I was breathless and as my h/rate settled at night with a h/r 47 avge and caused pauses. Bisoprolol 156 Day, no breathless and no pauses.
Then 2 years 3 months later went privately and he introduced CCB Diltiazem, Safer anti-arrhymnic med. I take a low dose 120CD mg AM. My h/rate day is 100 or under. This made it possible to have a further 2 operations in 2022 and 2024. Not heart.
The NZ Heart Foundation Nurse advised me to separate CCB and BB by 12 hours.
No swelling .. well occasionally when I drive 5-6 hours and in heat but if I put my feet up with a pillow long ways inside bed I prevented the swelling.
Your CCB is reknown for swelling and bad risks for some of a heart attack. Amiopine.?
Your heart specialist should change you.
Have you got your thyroid? I haven't as thyroid cancer, I find it easy to keep to TSH 1.7 by following the rules around taking thyroxine. Early AM best to take, wait 1 hour before food. No milk or iron wiyjin 4 hours. Minimum greens, no soy, no chlorine or fluoridated water.
Do not eat liquorice.
Its been 5 years ago operation. I changed to Synthroid because it is very reliable. Container locked, has an expiry date, has condensation round thing in it. Always be prescribed month x 90 pills. It is calculated by your weight . I have to a l have ittle above 22. So T4 could be 23-24. Also I don't fast so I've had my dose earlier that morning. Just ignore that level as you need x amount to keep you at that level. If T3 is low take 2 brazil nuts each day.
Tiredness can be experienced with BBs I was a zombie on Metopolol. But it could be your low thyroxin intake. Increase it best to keep you out of being hypo.... Normal TSH level is above .4 - 4.2.
Try that and see if you can climb out of where you are at.
I take PRADAXA 110 at 10am and 10pm. I leave 2 capsules out at evening and 1 remains there for the morning. Keep htdrated.
Thanks Joy. I stopped the Amlodopine within a week of leaving the hospital. See my reply above about that. I didn't need it once I was home. And last night I halved my BB and took 2.5mg which is what I was on for years. I can't go about like a zombie. My HR at this level is likely to go back to anything between 85-120bpm but I'd rather that for the time being than feeling so exhausted and broken. I have a cardiology appointment in April.
As for the thyroid, I do have one, it's shrunk now. I don't know why I am hypo. It came with menopause, but I don't have high antibodies whenever I've looked. But I have never been able to stabilise the dose of that medication. My results are never quite what I expect and I never feel any energy from it. I've tried Levo, T3 and Levo, T3 only, and now I'm on Armour NDT with a top up of Levo. My results are way too low for optimal. I struggle to reach 50% ref range, in fact I struggle to reach 40% most of the time. But increasing the dose usually makes me feel worse quite quickly and whatever adjustments I make bare little change on my blood results. I've just done them all again, twice in a week. Taking the test in two different ways to see what the difference was. It made almost no difference at all.
I do all the usual recommended things for taking thyroid meds. I do wonder if the BB just throttles it. Interestingly though, after the last results came in I dropped my Levo top up by 12.5mcg and added another 1/4 grain Armour to my 2 grains a day. It's only been a couple of days but in the past doing that made me feel unwell quickly. This time so far it hasn't. And I'm sitting here thinking that the hissing in my ears is a bit quieter this morning.
I take 125mg Synthroid daily. Stopping the BB it did affecr my Symthroid intake. ell, it did at first and I reduced Synthroid by 25mg.
But 6 weeks later my TSH was 12! What - never been higher than TSH 3.
So I'm on a regime of Synthroid 125mg firsr day and 150mg 2nd day. I have calculated that I am. reducing my TSH by .300 daily.
So I will probably be TSH 7-8. Still a long way to go!
You say that your thryroid has shrunk? How did it do that?
I have read that that those with trouble with levels Hash... Hypo or hyper end up having their thyroids out. So easy to keep to a level. I noticed that back in 2013 my TSH was 1.9.
I question your Armour brand. Get your Dr to prescribe Synthroid. It comes in 25mg 50mg 100 150 200 at least. These are in mg and not mcg. mcg is way less. I take 1000mcg daiiy . SOLGAR and when I tried to replace the brand the chemist said that anything else meant I had to taje a lot of pills. I am deficiebt so now I order from Naturius NZ and it comes fro Spain. I refused B12 injections.
By taking mcg and that low is not enough.
What is your T4? That gives your level of what your body makes in Thyroid, Para thyroid and Pituitary Gland.
But hyper with a thyroid is difficult to take away but hypo can be easily kept at a level by taking levo - Synthroid is levo... I found the bulk purchase f the first levo.. I was given was most unsatisfactory.
I am still tired especially my eyes with driving long distances. I slept 2 hours late afternoon and 7.5 hours last night.
I have found that it is the BB that gives me a different fatigue.
It takes 2 specialists to sort you out - 1, a Heart Specialist for your heart abnormalities for AF, I have a systolic heart murmur slight, severely dilated left atrium the most difference from normal.
2, a Surgeon for me as the Endocrinologist would not stand for 'refusing Metoprolol', refused rAI treatment post thyroidectomy, or TSH suppression. Also not waiting the 6mths after the stroke to have the Thyroidectomy.
With the thyroid cancer there is no Cardiologist in my Triage Team. But I've still got the Endocrinologist.
Unfortunately I do not have a Holestic Triage team.
I questioned the RAI Scan. No Synthroid for 3 weeks! Low Iodine Diet for that time. Ibto 2 of the regime my surgeon came back and said "we have changed it to a PET Scan. Missing 2 mornings of Synthroid I was out of normal range TSH 4.9.
I'm happier on Armour NDT than I ever was on just levothyroxine. We can't get Synthroid on the NHS, but that's just another levothyroxine. I have a genetic problem with the Dio2 gene from one parent so I seem to need a bit of T3 to help things along.
No idea why my thyroid is small, but it was scanned for me about 2 years ago and that was the result. No way would I have it taken out if it were not cancerous though.
I typed mcg by mistake. My levo dose of 37.5mg a day + 2.25 grains of Armour. If I don't take some Levo, the action of the Armour lowers my FT4 too much. I don't feel well with it below reference range. It's about 40% through the range at the moment and I'm hoping to get that a bit higher if I can raise my Armour further in a few weeks time.
Today, with the lower beta blocker dose starting to take effect, I haven't felt tired enough to need a sleep and neither have I fallen asleep. First time in weeks. And my painful feet and legs have been a bit less painful so that I have been able to do quite a few jobs, again for the first time in a long time. The downside of this though is that my HR is rising. My resting rate so far today (11pm) is 86. On the bigger BB it was in the 70s. But I'd rather have a higher heart rate and feel more normal than feel like a zombie. Trouble is when I add T3, the HR goes up a bit more!
I will see how I feel when this dose reduction of BB beds in and the increase of a quarter grain of Armour beds in too. I have felt like a different person today.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Post ablation quitting beta blocker
Beta blocker causing rash?
Flecainide - with or without beta blocker.
Beta blocker withdrawal
