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Propranolol ER and Tiredness

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by soxfan, Feb 16, 2013.

  1. soxfan

    soxfan Senior Member

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    I just started on 60 mg of Propranolol on Thursday and it is making me really tired. I feel like I want to just close my eyes and sleep. It is just adding to the fatigue I already have but in a different way.

    I was wondering if anyone else had this experience when starting this medication. My husband is a pharmacist and told me it is a side effect but my body should adjust in about a week. In the mean time I am trying to get through the day without crashing into bed....

    It hasn't really done much for me yet except make me sleepy but I am working tomorrow and will be on my feet for a 7 hour shift so that should be a good test to see if it helps....
  2. Valentijn

    Valentijn Activity Level: 3

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    If you have low blood pressure issues (instead of or in addition to POTS), one side effect is that it can make hypotension worse, which can cause a feeling like a specific sort of fatigue.
  3. soxfan

    soxfan Senior Member

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    My BP is usually in the "normal" range however I have never taken it when I am at work standing which is when I have the most problems.
    It just makes me sleepy like I just want to lay down and take a nap. It isn't as bad today and the past few so maybe my body is getting use to it I hope.....
    Will check my BP at work tomorrow and see what it is doing when I have been standing for a while. I usually don't start sweating and getting fatigued until I have been on my shift for a few hours...then the problems kick in (blurry vision and lightheaded after bending over). I don't believe I have POTS....had tilt test last summer.
  4. maryb

    maryb iherb code TAK122

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    Good luck with it - do keep an eye on your blood pressure, I never got used to it - just made me feel ill and also very very cold - I came off it despite the doc saying I shouldn't, I remember counting out those little beads to taper off it ughh.
    The hospital put me on it after I was admitted with the feeling of terrible pressure in my head, they never told me what it was- they didn't know what else to do, couldn't be bothered finding out - (costs too much you know)
    I found out when I got home it was Propanolol WTH.
  5. adreno

    adreno 3% neanderthal

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    Blocking norepinephrine will increase fatigue, this is a normal reaction. You could try an angiotensin II receptor antagonist instead, they do not cause fatigue.
  6. soxfan

    soxfan Senior Member

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    I will see how I feel tomorrow at work. Doctor wants me on it at least 2 weeks....if I can't handle it then I will let him know and we will figure out something.
  7. Patrick*

    Patrick* Formerly PWCalvin

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    Yes, I had the same issue on propanolol. I found that I couldn't (or didn't want to) take it as an every-day drug. Now I just keep it on hand for times when tachycardia gets really bad.
    soxfan likes this.
  8. soxfan

    soxfan Senior Member

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    I think I am gonna have to quit it...I am so sleepy today I am basically useless. I am on my 5th day and it is as bad as ever...I was really hoping this was going to be a good med for me.
  9. SOC

    SOC Moderator and Senior Member

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    Maybe you just need to give it time to work properly? Nothing is quick with this illness. **sigh**
    soxfan likes this.
  10. taniaaust1

    taniaaust1 Senior Member

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    It may be the normal response in non ME/CFS people but II personally havent found that to be the case and it may not be the normal response in us.

    I get more fatigued when my norepinephrine is high as that often means Im not as careful with what Im doing eg (wired so that is driving me) and with that comes more tired.. and hence then more fatigued while sitll having high norephinephrene.
    eg high noradrenaline causes the horrid "wired and tired" or when anxiety due to the norephinephrene that starts to burn one out to. High adrenaline= more insomina=more tiredness due to lack of sleep.

    Feels better with tendancy to get less tired with the norepinephirine down then when its up. ME people dont have the ability to be running (with energy) on high adrenaline for long at all....
    soxfan likes this.
  11. soxfan

    soxfan Senior Member

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    Doctor said to give it a week...he wasn't totally convinced OI is my problem but was willing to give the meds a try. I checked my heartrate at work on sunday and it never went above the mid 80's so I have no idea what the problem is. He really didn't know what the sweating is all about either. I had 6 episodes of breaking out in the sweats...maybe it is adrenaline kicking in? I definately come home from work wired and extremely tired internally.

    I definately feel like I am always running on adrenaline and when I slow down to rest it won't shut off....??????
  12. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Is this your usual Dr?

    GG
  13. soxfan

    soxfan Senior Member

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    yes....Dr. D in Concord
  14. PNR2008

    PNR2008 Senior Member

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    I don't understand why you are on a high dose. For my IO 20m helped for years and I took it at night to sleep better. It can cause fatigue even when taken for migraines. Maybe you need to start alot lower like most ofthe drugs we take.
  15. soxfan

    soxfan Senior Member

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    My doctor actually thought he was giving me a low dose and told me to up it if I felt the need....thanks...I will ask him about this. I believe he gave me the 60mg so that it would help me while I was at work on my feet for 6-7 hours at a time.
  16. Questus

    Questus Senior Member

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    Adreno, do you have a link to any data that supports the theory that blocking norepinephrine increases fatigue?

    Am blocking a lot of norepinephrine, (Mine is over 1400), and am using Methyldopa to quiet the sympathetic nervous system.

    I've not heard the theory that blocking NE increases fatigue, although I feel like I'm struggling with even more fatigue since I started blocking NE. Thanks for sharing any data you find. Without data, I can't assume that's why I'm feeling more fatigued.

    Btw, Have gotten a lab order from an endocrinologist to have my catecholamines tested in a 24 hour urine test. (Not for hyper-pots) but so she can see if the high NE is exclusive to hyper pots and not indicating another problem.

    Wondered why all hyper pots catecholamines testing is done with plasma and not a 24 hour test. A blood draw is like a snapshot. A 24 hour urine test measures levels over 24 hours so high levels and low levels are all counted. Your catacholamine levels rise and fall in a 24 hour period. If anyone knows the answer to that, I'd be interested.

    Best,
    Questus
  17. adreno

    adreno 3% neanderthal

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    Norepinephrine increases arousal, wakefullness and sympathetic activity, so I would hardly call this a surprising effect.
    http://www.mayoclinic.com/health/beta-blockers/HI00059/NSECTIONGROUP=2
  18. Questus

    Questus Senior Member

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    Thank you, but I'm not taking beta blockers, so this information does not apply. Beta blockers are not used to block NE or to treat a hyperadrenergic state.

    An extreme amount of norepinephrine does not increase energy, in fact it's exhausting because it not only causes chronic sleeplessness but being in an extreme and chronic high adrenaline state is exhausting.

    Am still interested in any data that states that blocking norepinephrine causes increased fatigue.

    Thank you for sharing any information on this if it exists. I've done exhaustive research on the hyperadrenergic state and have not found any information suggesting that blocking high NE causes fatigue.

    Am guessing that in my case it's a 'process', meaning that my NE has been so extremely high for such a long time, that now that I'm sleeping fairly normally, it's going to take time to get reoriented to a sleep/wake schedule, and the feeling of increased fatigue I'm experiencing is simply a result of that process...Going from one extreme to another.

    Best,
    Questus
  19. adreno

    adreno 3% neanderthal

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  20. Questus

    Questus Senior Member

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    Let me reply respectfully, I don't need or want to to be insulting.

    While beta blockers do act on catecholamines, I'm referring to a hyperadrenergic state, as in hyperadrenergic pots.
    (Beta blockers are used commonly for regular pots, NOT hyperadrenergic pots.)

    Less than 5% of pots patients have hyperadrenergic pots, it's rare. So out of desperation, and a need to sleep, I've done a tremendous amount of research on this. My norepinephrine level is over 1400.

    In a hyperadrenergic state, the need to to block norepinephrine is the number 1 goal, as it's the norepinephrine level that dictates hyper pots.

    Vanderbuilt and Mayo have all published extensively on this. The number two drugs to treat hyperadrenergic pots are Clonodine and Methyldopa, neither of which are beta blockers.

    Again, beta blockers are not used to treat hyper-pots. I wish they did work on hyper pots, I would have gotten better long ago.

    Some beta blockers can cause fatigue, but as I said they are not used to treat a hyperadrenergic state.

    I'm done commenting here. I'll comment on the hyperadrenergic state elsewhere if I feel it might be helpful to others.

    I recognize this mine is not the typical type of pots, so would not expect most people to know about it, I've had to learn the hard way about how an extreme case of hyperadrenergic pots is treating.

    Best,
    Questus
    Vincent likes this.

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