Does propranolol impact TSH levels on thyroid t... - Thyroid UK

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Does propranolol impact TSH levels on thyroid test - subclinical hypothyroid diagnosis question

Mj1986 profile image
6 Replies

Hello,

I was wondering if anyone can help. I was diagnosed with subclinical hypothyroidism after a set of fertility tests (my husband and I have been trying for a baby for over a year). I have been taking propranolol for anxiety for about 3 years now roughly 4 times per week at 40mg. I have read that impact TSH levels of thyroid test and in some cases even cause an underactive thyroid. Is this true?

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Mj1986
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shaws profile image
shawsAdministrator

I am assuming you've not yet been diagnosed as being hypothyroid? Is your 'anxiety' due to too little thyroid hormones:-

If your doctor did not do a Full Thyroid Function Test and only a TSH/T4, I'd suggest you get a Full Thyroid Function Test - NHS wont do it but we have private labs that do them and they are home pin-prick blood draw. If you decide, make sure you are well-hydrated a couple of days before and if you were taking thyroid hormones you'd allow a gap of 24 hours between dose and test and take afterwards.

You draw blood at the earliest possible, fasting (you can drink water). If you were also taking levothyroxine you'd allow a gap of 24 hours between last dose and test and take afterwards. I shall give you a link and we have several labs.

You need TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. GP should test B12, Vit D, iron, ferritin and folate but wait until after your thyroid ones are taken. You then have a bigger picture. of your health.

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

Usually, propropanol is prescribed if hyPERthyroid.

MaisieGray profile image
MaisieGray

I have read an abstract of one in vitro study on porcine thyroid follicles that concluded Propranolol has a direct antithyroid action, by inhibition of iodide transport in the intact thyroid follicle. Whether or not this has been more recently replicated in vivo, in humans, and what might be the scale of the impact, I don't know. However, it is known that Propranolol may inhibit conversion of T4 to T3, and instead cause its conversion to reverse T3. It's also thought that Propranolol can inhibit the elimination of the reverse T3 by inhibiting its conversion to T2. In quite an old study of the effects of Propanolol on heathy individuals, there was also a rise in FT4, which would seem to contradict the antithyroid idea - except of course, that one study was in vitro on porcine cells and the other in vivo on healthy humans. However, these effects are all dose dependent, so how much effect might be seen in your blood levels, of taking 40 mcg 4 times a week, is hard to say. I've taken a Propanolol for a few years now, and even when I was taking 80 mcg daily, didn't feel any noticeable difference in symptoms or see any alteration in blood test results.

SlowDragon profile image
SlowDragonAdministrator in reply to MaisieGray

Whereas I found significant difference in Thyroid results after finally getting off propranolol

SlowDragon profile image
SlowDragonAdministrator

Anxiety is a common hypothyroid symptom especially with autoimmune thyroid disease, which is by far the most reason for being hypothyroid

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

TSH should be under 2.5 when TTC

verywellhealth.com/infertil...

Pregnancy guidelines

thyroiduk.org.uk/tuk/about_...

gp-update.co.uk/files/docs/...

You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Come back with new post once you have results and ranges

Mj1986 profile image
Mj1986

Thank you that's very helpful. I will definitely get the full Thyroid test done. I was somewhat hoping if I came off propranolol my TSH levels would go back down naturally and I may not need medication (Dr has told me that as I am trying to conceive they need to treat subclinical thyroid with thyroid medication).

lynnwin profile image
lynnwin

Ive been on propranolol for 14 years originally had it for hyperthyroidism with other meds’ to bring my thyroid back in line I’ve since gone hypo and on thyroxine I haven’t noticed a change in my thyroid I have private and nhs bloods done and my thyroid seems fine .. I’ve also increased from 10mg twice a day to 15mg twice a day I did try 20mg twice a day but felt sleepy 😟 my GP said this is still a low dose as for anxiety people have up to 60mg or more ? I’ve never heard of it affecting thyroid results but as I’ve increased a little I will check my thyroid again soon .. Best get your full thyroid panel checked as I had awful anxiety before I was diagnosed hypothyroid xxxxx

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