Weaning off proprananol

[Cavapoochonowner]

Hello everyone,I have Graves disease and had a thyroidectomy in June 2022.I am having conversion problems ,even with a very over-range T4.I know proprananol can reduce T4 to T3 conversion and am looking to try and wean off it.

My GP put me on 20mg 3x a day as a migraine preventative. I also take 20mg amitriptyline every night as a preventative. The latter had been working,but if my T4 was high the migraines came back so I started the proprananol as well.It has worked,but now I am getting my T4 in range myself,my T3's aren't very good.

Before trying T3,I want to try everything else and I know you have to reduce proprananol slowly.Has anyone done this and how slow is slow?

Thankyou for reading and any advice greatly appreciated.

[PurpleNails Administrator]

I was on 40mgx3 & after being made very ill by specialist who said to stop it completely the GP re-prescribed it as permanent migraine preventer.

I reduced it by lowering it by - 10mg a day, every WEEK. So a quarter of a (40mg) pill per day.

You have 20s so you could try half. Check the pills aren’t sustained release. You can break standard but sustained shouldn't be broken. Ask dr to prescribe 10mg in higher quantity so you can control the reduction gradually.

Got down to 10mgx2 per day and was a stretch - so currently 10mg x 3. Occasionally increase up to 60mg. The prescription I have is flexible.

High FT4 seemed to increase migraines too.

[Cavapoochonowner in reply to PurpleNails]

Hello,thankyou for the advice.I have reduced my levo by 25mcg per week and already feel better.I'll start today with the reduction of proprananol and play it by ear,maybe reduce to 10mg 3x a day until I feel settled and OK on that.The tablets I have are 10's anyway.I'm going to do another blood test in about 3 months so I'll be able to see if it has made a difference.Thanks again.

[SlowDragon Administrator]

I was on 40mg (as 4 x 10mg) per day for 19 years. And hypo due to hashimoto’s

Was able to SLOWLY reduce propranolol after going gluten free

Reduced by 5mg per day……waiting 3-4 weeks

Then reduce by further 5mg waiting another 3-4 weeks

Repeating this slow reduction until on just 5mg daily

Then cut to 2.5mg daily

Then cut completely 1 day per week

Next week 2 days per week

Etc

Took around 5-6 months

[Cavapoochonowner in reply to SlowDragon]

Thankyou Slowdragon,I will reduce very slowly and make no attempt to rush.I will do bloods again in 3 months and see if it has made a difference.

[humanbean]

I've never been on propranolol but I have been prescribed bisoprolol, another beta blocker.

One of the things that beta blockers do is slow the heart rate and reduce blood pressure. I take the bisoprolol because it slows down the heart. I have tachycardia.

I was put on amitriptyline years ago for pain relief. It did work slightly - but it also triggered the tachycardia to begin with, a known side effect listed in the Patient Information Leaflet. As a result I had to come off it.

I'm just pointing out that when people are put on multiple drugs the side effects can combine to make things worse or to cause things in the first place.

I found out eventually that my tendency to develop tachycardia was actually caused by low iron and ferritin. I fixed the low iron myself (it took years because of poor absorption), but sadly the tachycardia had become semi-permanent by the time my iron and ferritin were good, and I have to take beta blockers every day now.

I am convinced that the tachycardia wouldn't have developed if it wasn't for the low iron and the amitriptyline.

I am annoyed about having been given amitriptyline in the first place. When the drug was first developed it was intended to be used as an anti-depressant, not as a pain reliever. And of course, anti-depressants are given to women like sweeties. If doctors had given me proper pain relief instead of something to "calm me down" I might not have developed the tachycardia at all.

[Cavapoochonowner in reply to humanbean]

Hello there,I started on the amitriptyline in 2014 as my migraines had become unbearable while my son was diagnosed with a serious illness.Of course at the time all I was concerned about was being able to look after my son.I didn't really look into the long term implications.It worked until 2021 when my thyroid levels were all over the place,but my GP didn't want to increase my dose,so he prescribed proprananol which has worked.I obviously have conversion issues so I am trying another beta blocker prescribed by the pharmacist at my GP's.It's metaprolol (also suggested by the migraine Trust as a preventative).Hopefully it will still be as effective and help my conversion problems.I haven't started it yet(got to pick up prescription),but hope to start on Tuesday, a straight swap she said.I hope I can get it as she said she hadn't prescribed it for a while.

I do feel I get palpitations sometimes,and because my T4 is over range at the moment(I have reduced levo by 25mcg per week) my blood pressure is raised and my heart rate also.

I joined the OurFuture Health research programme,and the lady mentioned it.Hopefully the new beta blockers will help.

I have tried to wean off amitriptyline a couple of times,but I wasn't able to due to side effects (insomnia and feeling I could cry at any moment).I will try again once I

feel my thyroid levels are more settled.It's very frustrating to have to take more tablets to counteract side effects of others.

Thankyou for your insight,I will update the forum of the results,I will do another blood test in 2-3 months.It may help someone else.

By the way I also took bisoprolol once when I went to A and E with a bad migraine so it may be an alternative for me if this is no good.