beta blockers

[Aj2690]

Hey! I was recently prescribed beta blockers for the physical symptoms of anxiety. When talking with the Dr they mentioned they’d usually give them to sufferers of thyroid conditions anyway (I have Hashimotos). Just curious why beta blockers would be prescribed? Is it due to the anxiety you can get from thyroid conditions or something else?

Thanks!

[Buddy195 Administrator]

Although hypothyroid with Hashimotos I, like several other members here, initially presented with ‘hyper like’ symptoms (including heightened anxiety, palpitations, tremor, rapid pulse etc) and for this reason was prescribed beta blockers for a short period of time. I didn’t take them for long, but they did help when I was at my worst (I ended up in A and E with the rapid heart beat etc).

As far as I’m aware, Beta blockers are not widely prescribed to those with hypothyroidism, but may be offered to those experiencing ’hyper like’ symptoms or ongoing anxiety issues.

Increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if thyroid medication or key vitamins (ferritin, folate, vitamins B12 and D) are not optimal.

[Aj2690 in reply to Buddy195]

Ahh okay, I suspected that might be the case, thanks. Wanted to check it wasn’t specific to heart issues as I know that can also stem from thyroid issues. I also take anxiety meds as it’s an issue for me too, some days worse than others which is why the beta blockers are handy 😁

[Tina_Maria]

If thyroid patients are under-treated, they can suffer from anxiety and perhaps even panic attacks.

Beta blockers block the the release of adrenaline and noradrenaline, which are stress hormones. This results in a number of effects, including a lower heart rate, so the heart beats more slowly and with less force. Beta blockers can also block the kidneys from producing angiotensin II, a hormone that raises blood pressure. They can help to widen veins and arteries to improve blood flow. Beta blockers can also act as anti-arrhythmic drugs by reducing the effects of the sympathetic system on the heart. If you take beta blockers such as propanolol, you should take them at least 4h away from levothyroxine, as they interfere with the conversion of T4 to T3.

However, the primary reason for the anxiety and the stress response in hypothyroid patients is the lack of thyroid hormones, and that should be addressed in the first instance, not treating the symptoms that are caused as a result of the low hormone levels.

Have you had a recent thyroid function test? You need to test TSH, T4 and T3 to see where you are and I suspect that T4 and T3 may be low. Even if doctors state that your thyroid levels are 'normal', this means nothing, as they can be anywhere within a wide reference range and if your levels are low in range, you may be symptomatic, which can include anxiety.

A normal replacement dose is 1.6 mcg levothyroxine per kg of weight. So if someone weighs 63 kg, they need 100 mcg levothyroxine replacement. This is documented in the NICE guidance, that physicians should adhere to:

cks.nice.org.uk/topics/hypo...

[Aj2690 in reply to Tina_Maria]

Wow that’s good to know, thank you. I’ve suffered with anxiety for years but wouldn’t be surprised if it was worsened by my thyroid being attacked. I regularly test my TSH and adjust my dose, funnily enough had bloods taken today. I’m hoping to get pregnant which my Dr knows so we’re aiming for 1 🤞so my levels are optimal 😁💓

[Tina_Maria in reply to Aj2690]

If you are just testing TSH, it will still not tell you where your levels of T4 and T3 are, and I doubt that these will be included in the test. Even if your TSH is 1 or below, your T4 and T3 may still be low in range and therefore not sufficient. Please don't rely only on your TSH, if your T4 and T3 levels remain low, you will not feel better and this could also impact your ability to conceive.

I have included a link that should be of interest, low levels of T4 can interfere with the release of eggs from the ovaries and can impact on fertility:

mayoclinic.org/diseases-con...

[Aj2690 in reply to Tina_Maria]

Don’t worry I have a Thriva test waiting to be done 😁 I do one once a year just for a full MOT check. Pity the NHS can’t do it but hey ho.

[Tina_Maria in reply to Aj2690]

Ah no worries, I was just concerned as you have just mentioned TSH. Good to have a full MOT and check up. As they say, if you want something done properly, you have to do it yourself!😉

[Aj2690 in reply to Tina_Maria]

Exactly 😂

[Jefner in reply to Aj2690]

same here, suffered with it for many years even before being diagnosed. Even worse now and just won't go away