Graves and Beta Blockers

[Angiepangie9]

Morning,

Coming up to week 4 of medication (40mgs carbimazole) and I’m pleased to report that I’m feeling so much better. I’m back to work next week. My question is when do you stop the beta blockers? I have had to switch from atenolol to propranolol to bisoprolol due to asthma symptoms. I’m desperate to stop them (slowly) now the hyper symptoms have gone. What are people’s thoughts? Thanks 😀

[Fruitandnutcase]

I didn’t ever take beta blockers because I have asthma so I had to sit it out until the carbimazole (40mcg) kicked in. So it looks like it isn’t strictly necessary to take them as part of your treatment which I imagine means you could gradually reduce then stop but - I’m not medically qualified.

I was given propranolol by my rheumatologist, it was a three month course that tapered down to nothing by the end of the three months. I had a proper schedule to follow reducing by a certain amount every week or it may have been every two weeks, can’t remember.

Basically after the initial large dose I started tapering for the next three months. So depending in how much you are taking someone should be able to help you reduce. You’ve been on them for a while so get proper advice, don’t think you should just stop. Did you get a steroid card to carry with you from the pharmacy when they were prescribed? I didn’t but then I discovered I should have had one and asked for mine.

Why don’t you speak to your GP or pharmacist about it or even call your endo’s secretary and ask them.

[Angiepangie9 in reply to Fruitandnutcase]

Thanks, yes I will do that and thank you for your reply. I guess Just wondered how long others stayed on beta blockers after initial hyper symptoms settled.

I didn’t even know I had underlying asthma until commenced on the beta blockers and now would like to be off them!

[MaisieGray in reply to Angiepangie9]

I just wanted to add that beta blockers generally, but propanonol especially, have more than just a symptom-calming role in hyperthyroidism. Propranolol importantly helps control the symptomatic tachycardia and tremors associated with thyroid storm, but additionally may help the necessary reversal in the reduction in systemic vascular resistance associated with the condition. There is also data that shows propranolol is known to inhibit the monodeiodinase type I enzyme responsible for conversion of T4 to T3; and this reduction can result in the production of reverse T3, whose expulsion from the body can be inhibited by the betablocker. So consideration of whether it's continued use or its withdrawal, is necessary, is dependent on a combination of factors beyond simply no longer having a fast heart rate.

[Fruitandnutcase in reply to MaisieGray]

Back then I would have loved propranolol. When I was given it for my inflammatory arthritis just that short while tipped me into Type 2 diabetes which was very annoying as I was never warned it could happen. Fortunately I was taking part in a big Pre Diabetes study and my annual check up for that was soon after I started the steroids so it was discovered very early on. I found a really helpful book on how to reverse your diabetes and ate and exercised myself out of T2. It was weird because I know of people who have been taking steroids long term and also people who have taken larger doses than I did and they are OK.

There’s a lot more to steroids than meets the eye.

[turntablez]

I only had the beta blockers for 2 weeks until I saw my endocrinologist and then just carbimazole.