Experiences with Propranolol with Hyperthyroidism?

[T808]

Hey everyone, just curious on peoples good or bad experiences with propranolol when we have Hyperthyroidism or needing to take replacement T4 T3 etc. I heard it can mess up conversion of T4 to T3. All input appreciated as I was just put on 10mg 2x a day of propranolol 🙏

[Cavapoochonowner]

hello there, I have graves disease and have been on proprananol twice.The first time was in 2018 when I was first diagnosed to control my hyper symptoms until I saw an endo and could start carbimazole.It worked well to control the fast heartrate and shaking.I slowly decreased it as the carbimazole started to work.I was on it for about 3-4 months and found it very helpful in helping me cope with my symptoms.I have had to start it again to control a fast heartrate and a worsening of my migraines caused by becoming overmedicated.Again I am on 20mg 3x a day.My migraines have eased (touch wood) and my heartrate has slowed.I have been taking it since June last year .I have again gone slightly overmedicated on a dose I was previously ok on so for me it doesn't seem to have affected my T4/T3 conversion.This is my experience and for me I have had no problems with proprananol.Hope this helps.

[T808 in reply to Cavapoochonowner]

It does help hearing this. I too have Graves disease. I had radioactive iodine about 20 years ago and have been on 150mcgs since then with no issues. All of a sudden as of 3 months ago became severely overmedicated. They are doing an ultrasound of my thyroid tomorrow with some additional tests to make sure it didn't suddenly come back to life a little bit. Because even lowering my dose to 137mcgs had me still way overmedicated. So they dropped me to 100mcgs. That might be too little now but only time will tell. I tried to argue to try 112.5mcgs first but they are too worried about my inappropriate sinus tachycardia.

What was your time line? How long were you okay on a certain dose before becoming overmedicated? Thanks again 🙏

[shaws Administrator in reply to T808]

I still take 1 propanol each night before I sleep.

[T808 in reply to shaws]

How many mgs? Any nightmares?

[shaws Administrator in reply to shaws]

I am hypothyroid but was prescribed propanol due to having severe palpitations during the night and I had many overnight recordings and Cardiologist couldn't understand why. They were very strong palpitations and I had to wrap ice-bags around my neck and sip ice-cold water and I was also on levothyroxine.

His recommendation was that I take one Bisoprolol 2.5mg on going to bed. I have taken it for a long time now (about ten years or more). I have had no problems with palpitatations since taking Bisoprolol then and I think it is also due now taking T3 only.

I have tried not taking Bisoprolol but I think body is used to it now. I sleep well without any disturbances.

I've never had nightmares - my body is calm without any sensations.

[T808 in reply to shaws]

That's sort of what's happening to me now since they lowered my dose from 137mcgs to 100mcgs. I keep waking up with adrenaline rushes an hour or 2 after I go to sleep. And I keep needing to pee like 10x even when it's not much when I wake up with these episodes. When I take propranolol before bed they seem less severe. And I'm able to get back to sleep quicker. The docs here have me all messed up. They seem in over their head. And I can't get in with an Endo for 2 more months. 100mcgs doesn't seem like much for a man who's 79.5 kilos (175lbs) with a supposedly dead thyroid.

[shaws Administrator in reply to T808]

If you take your thyroid hormones early a.m. you could try taking it before bed as long as your stomach is empty for a few hours previously.

Quite frankly I doubt there's many "experts" who can diagnose/treat a person with hypo as our old doctors used to

[Cavapoochonowner in reply to T808]

hello there, my stable dose was 40mg carbimazole and 100mcg levothyroxine per day.I was steady on this from march 2020 until the end of september 2020 when my endo wanted to see if I was in remission.I had to stop all tablets but within 2 weeks I felt bad again so had a blood test and my T4 was in the 60's.I had to start again and worked my dose of thyroxine up and was back on same dose by March 2021.This seemed ok but I started getting weekly migraines and a high resting heartrate which resulted in a visit to A and E.They said I was slightly over medicated so my levothyroxine was reduced to 50mcg per day .I have slowly worked up to 100mcg/75mcg on alternate days(average around 89mcg per day ) but my latest bloods still show slightly over.I'm awaiting contact from my endo as to how much to reduce by.Maybe 4 days at 75mcg and 3 at 100mcg instead of the other way around.All I can think is my graves must have flared up.My thyroid eye has become active again.I am on the waiting list for a thyroidectomy after alot of soul searching.My profile has all the details of my journey if you care to take a look.People talk on here of finding your "sweet spot" regarding medication dosage and unfortunately that seem to take time.Hope this has helped.

[T808 in reply to Cavapoochonowner]

I'm going to read more about this. Thanks for your input. It's strange that our sweet spots change over the years depending on many factors. Finding my new sweet spot can't come quick enough haha.

[shaws Administrator]

When I was first diagnosed as being hypothyroid and given levothyroxine I was plagued with palpitations - especially during the night. I took propropanol before I went to sleep.

The cardiologist was puzzled and was contemplating putting an implant into my heart 'to see what was going on'. Just then T3 was added to T4 (liothyronine to levothyroxine) and my palpitations improved and I then took T3 only and have had no palpitations since.

[PurpleNails Administrator]

I have hyper from toxic nodule not Graves and was given Propranolol 40mg 3x per day. 2 months later the specialist said you don’t need it anymore - stop taking, but it should really be reduce slowly.

Stopping abruptly made me quite unwell with migraines, so GP resumed it as migraine prevention. I have managed to very slowly reduce to dose but not cease it completely.

After the month I stopped it my FT3 had spiked disproportionately so it did show an affect FT4 to FT3 conversion.

Propranolol use can lower magnesium. I now use a magnesium supplement. I think I must have needed it long before I read about replacing magnesium depletion from propranolol. I previously had quite regular eyelid twitching and this rarely occurs now.

[T808 in reply to PurpleNails]

Yes, I was taking 10mg 2x a day. But was worried about coming off it later. So I've been taking 10mg in the morning and 5mg at night. Eventually since they lowered my levothyroxine quite a bit, I'm worried about my pulse going too low at night over time if I stay on a higher dose of Propranolol. Trying to give myself just enough and make it easy to wean off. It's definitely helped over the passed couple days. I've been able to get around like Normal.