Beta Blockers

[Pastlives]

Hi, I have just been diagnosed with Grave's disease and I am on Carbimazole 20 mg and beta blockers. Stared the first just before Christmas and it seemed to curb my hunger straight away, and recently my heart rated has normalised. However I have been on Beta Blockers for 1 week and I have started to experience insomnia - which is new for me. My T3 level is 27.0 pmol/L, T4 58.3 pmol/L and TSH<0.01 mIU/L.

[pennyannie]

Hello Pastlives and welcome to the Graves Disease Forum :

My only ' new ' symptom was insomnia and why I went to the doctor in the first place !

Do you also have there the ranges for the TSH, T3 and T4 readings please ?

All 3 readings ' look like ' those of an overactive thyroid and to know for sure which Auto Immune disease you are dealing with we do need to know which antibodies were found over range and positive in your initial blood analysis,

The proof and medical evidence of Graves is generally written as a TRab and reading something like a Thyroid Receptor blocking / stimulating antibody - do you have any details reading as antibodies ?

There is no cure for Graves - it is an Auto Immune Disease - and all the Anti Thyroid drug does is semi-block your new daily thyroid hormone production so slowly these high T3 and T4 readings will start to fall back down into the ranges and hopefully your symptoms alleviated while we wait for your immune system to calm from whatever has triggered and upset your body''s equilibrium.

Quite why your body's immune system has turned and started attacking your thyroid is the question and a whole other conversation - and just to say with Graves each persons journey seems to be unique to them though common triggers seem to be stress and anxiety.

There can be a genetic predisposition - maybe a generation away from you - with someone having a thyroid health issue -

Graves can occur because of a shock to the system - like a car accident or sudden unexpected death of a loved one - or - for some it seems to simply appear - totally - ' out of the blue ' .

If your heart is involved a beta blocker is also prescribed as Graves is considered life threatening is not medicated and again, hopefully after a few weeks on both the AT drug and the beta blocker you should start to be feeling more comfortable.

As your T3 and T4 start to fall back down and towards the ranges both the AT drug and the Beta blocker will likely be titrated down as the end goal is for your T3 and T4 to fall back into the ranges, and your symptoms relieved with your thyroid resetting itself and this episode being just a ' blip ' and you getting on with the rest of your life - drug free.

The NHS allocate around a 15-18 month window with the AT drug and believe this enough time for your immune system response to calm down - however we do now have some research which is detailed under :

pubmed.ncbi.nlm.nih.gov/338...

please be aware that the NHS also recommend RAI thyroid ablation as a definitive treatment option but we do now also have research on this as under :

ncbi.nlm.nih.gov/pubmed/306...

Please read the PIL ( Patient Information Leaflet ) as there is alternative to Carbimazole if you find this drug upsets you - request you are switched to Propylthiouracil - PTU for short.

Are your eyes involved ? Dry, sore, watering, painful - please make sure you only use Preservative Free drops and ointments - whether you buy OTC or even those prescribed.

For all things Graves Disease you might like to dip into elaine-moore.com

Don't be surprised if your post moves across to Thyroid UK - as we generally merge these 2 forums together.

I'm with Graves and post RAI thyroid ablation back in 2005 and now manage lingering Graves, Thyroid eye disease caused by the RAI and hypothyroidism and now self medicate as the NHS have refused me full spectrum thyroid hormone replacement.

[Cavapoochonowner]

Hello there,I have Graves and at the beginning when my thyroid levels were very high I suffered insomnia. I think it is a normal symptom of the disease.My mind was racing all the time,and my body fidgity.I was shattered but couldn't sleep. As my levels slowly came down this improved.I also found that if I took my proprananol after tea time I had a very restless night.I am on proprananol still as a migraine preventative and always make sure I take my last dose of the day no later than about 5pm.Hope this helps.

[Pastlives in reply to Cavapoochonowner]

Thank you, this is really helpful. My main symptoms have been hunger, weight loss, palpitations, racing pulse (esp. at night) and some occasional difficulty swallowing (scary!). Not sleeping has happened with the beta blockers. Been waiting for the Endo to write based on anti body blood test. Before 5pm a good tip. Thank you.

[pennyannie in reply to Pastlives]

All these symptoms are common when the thyroid is being attacked by stimulating antibodies - and hyper-functioning - and hopefully once you have been on the medication a week or two your symptoms will ease :

With Graves Disease you can have either blocking or stimulating antibodies controlling your thyroid function at any given time - so can experience extremes of symptoms - and for some people - these 2 extremes of symptoms can cancel and burn each other out with the patient feeling relatively normal for them.

If the AT drug doesn't resolve symptoms - an alternative option is Block and Replace whereby the AT drug dose is increased to fully block any new own daily thyroid hormone production but a measured dose of T4 prescribed so your T3 and T4 do not fall too far through the ranges.

If you go into Thyroid uk - the charity who supports this forum - thyroiduk.org there is page listing both hyper and hypo symptoms - and it just might help you understand your situation better.

I remember eating for England and loosing weight - for the first time in 50 odd years - but it didn't last long - all of your symptoms should be transient - just give the medication time to build up in your body - please rest up and be kind yourself -

though I know when everything feels ' heightened ' it's difficult to turn oneself off :

[Pastlives in reply to pennyannie]

Thank you - what you have shared is really helpful. Hoping I don't over eat in the meantime.

[Cavapoochonowner in reply to Pastlives]

Yes,I had all those symptoms too as well as a return of my migraines.The beta blockers helped me until I could get on the carbimazole to bring my levels down.

[Pastlives in reply to Cavapoochonowner]

Hi. Thank you - I am not liking the beta blockers - it is tricky to know when to take what. I am trying taking the BB earlier, and the carbimazole before bed with my progesterone for HRT.

[Cavapoochonowner]

Yes,I used to take my proprananol after breakfast, dinner and tea.I also used to take my carbimazole at bedtime.My thinking was if I had any side effects I would be asleep and not notice them.