Beta Blockers?

[woody72]

Hello,

I'm after some advice I have had an under active thyroid for over 10 yrs I am on 125mg a day and I have started have palpatations my doctor is talking about giving me betablockers for this,does this sound right?

Thanks in advance for any help

[Marz]

Do you have any blood test results you could share - with ranges. Perhaps you are under medicated or you may have poor conversion from T4 into T3. Palpitations can be linked to both Hypo and Hyper thyroid issues. There are other causes - have they been ruled out - LOW Magnesium - LOW Iron - LOW T3 ... ??

[woody72 in reply to Marz]

Hi wow thanks for the info they have only sent me for tsh and t4 blood tests and have been uping and downing my dosage over the pasr 10 yrs I have finally got an appointment for an endo so will try and get more tests done.I haven't got my results as they keep saying they are on paitent access but they keep disappearing. I will ask for more tests and get hold of my results

[Marz in reply to woody72]

Have you researched your Endo carefully - is s/he a Thyroid Expert ? They mostly deal with diabetes and have little knowledge of the Thyroid. My advice would be to have the CORRECT testing done privately through Thyroid UK - SlowDragon has posted a link for you - and then return for advice here.

You are legally entitled to copies of your results - with ranges - as labs can and do vary If you are going to see the Endo - then you need the FULL testing done before you go to make the appointment worthwhile !

[shaws Administrator in reply to woody72]

TSH and T4 are not informative enough for us, the patient, to recover our health. We need TSH, T4, T3, Free T4 and Free T3. If initially we've been told we have an Autoimmune Thyroid Disease (the commonest form) we'd have thyroid antibodies in our blood and it is the antibodies that attack the thyroid gland. It is also called hashimoto's.

If your doctor has been adjusting dose according to your TSH, no wonder you don't recover. TSH is not a thyroid hormone it is from the Pituitary Gland and when thyroid gland is failing the pituitary gland tries to flag up more hormones and that's why TSH rises. The aim is a TSH of 1 or lower and FT4 and FT3 in the upper part of the ranges.

Levothyroxine is T4. T4 is an inactive hormone and it has to convert to T3 and it is T3 which is needed in our millions of T3 receptor cells, the brain and heart contain the most.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

As Marz says, there are many common issues that cause palpitations. Looking for the cause, not a stocking plaster is best option

Propranolol (beta blocker) can affect Thyroid hormones

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Ask GP to test vitamins and thyroid antibodies

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Come back with new post once you have results and ranges

[woody72 in reply to SlowDragon]

Hi thanks for all the info will go back and ask more questions and get results and ask more questions when i have a better idea. THANKS

[SlowDragon Administrator in reply to woody72]

Suggest you email Dionne at Thyroid Uk for list of recommended thyroid specialists

As Marz says, most standard endocrinologists are only Diabetes and often very ill informed on Thyroid

Getting FULL Thyroid and vitamin testing is first step

Most/many thyroid patients need to test and supplement regularly some or all of these to remain at good levels

Atrial fibrillation can be due to low FT3

I was stuck on propranolol for over 20 years. Turned out to be gluten intolerant and multiple vitamin deficiencies. Not an uncommon problem with Hashimoto's. More on my profile. Only got well will fantastic help on this forum

[Coachv]

HI

as noted you need the thyroid test results. I had atrial fibrillation (have you been diagnosed with this, what are the palpitation symptoms?). However after much treatment including beta blockers it was found that the symptoms were likely caused by a slight over-dosing of thyroxine. When I adjusted my dose the symptoms have not recurred. In the meantime I found that I was exceptionally sensitive to beta blockers and cannot take them. Obviously everyone is different and millions of people take these for heart problems. All I would suggest is that you get as well-informed as possible, and don't put up too long with debilitating side effects from medications unless there really is no alternative. If you have atrial fibrillation then there is a forum on health unlocked. I do my own thyroid blood tests as the GP is now unable to get the free T3 test done by the NHS lab. Also some people are helped by supplements such as magnesium.

[shaws Administrator]

Your doctor should ensure, before giving you beta-blockers, that all of your thyroid hormones are optimal.

These are TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. TSH 1 or lower, FT4 and FT3 in the upper part of the ranges.

Few if any doctors test all of these. Those he wont or cannot (they've been instructed I think to only Test TSH and T4 and these are not too informative if we feel bad) we can get privately through one of the recommended labs and they are home finger pin-prick tests.

Too low a dose as well as too high can give us palpitations which can be quite worrying when we haven't experienced these before.

Levothyroxine is taken, usually first thing with one full glass of water and wait an hour before eating. Food interferes with the uptake of the hormones. Some prefer a bedtime dose, in that case if you've had a a meal around a 3 hours gap between it and levo but if a light meal a less time is fine.

If you need to take betablockers they can affect the uptake of levo, so I'd take it well apart.

[Nanaedake]

I would only consider taking betablockers if you actually have a heart problem which you will need a referral to a cardiologist for. Betablockers have side effects and block conversion of T4 to T3. A doctor prescribed betablockers due to thyroid symptoms and a cardiologist told me to stop taking them. So, you need to do as people above say, post thyroid test results here and insist on referral to cardiology if doctor suspects a heart problem.

[woody72 in reply to Nanaedake]

Hi I have had a 24 hr cardio trace and they found nothing wrong so I did think betablockers was just to hide a symptom rather than sorting the real problem

[Nanaedake in reply to woody72]

Well, that's very reassuring that your heart is fine. Good thing you got it checked out!

[MaisieGray in reply to Nanaedake]

To clarify, decreased thyroxine to triiodothyronine conversion is caused by some, but not all, beta blockers; and beta blockers are prescribed safely and appropriately for conditions other than those relating to the heart - essential tremor being one.

[SlowDragon Administrator in reply to MaisieGray]

Propranolol does affect Thyroid conversion

[MaisieGray in reply to SlowDragon]

Yes absolutely, I was responding to the blanket statement "Betablockers have side effects and block conversion of T4 to T3".