[Kjkerr241]

#1018067

Hello,
Ken here,43 recently diagnosed with Graves. I have been reading and learning so much, thanks! I was told to take 40mg propranolon 2x daily along with 20mg methiamazole 3x daily. I do not normal go against Dr.s orders but I am extremely resistant to taking the propranlolon. Last visit bp was 130/70 pulse was 60. Please advise….thanks

[Bobbi]

#1062511

The best thing to do is talk with your doctor about it, and explain your reluctance, and ask WHY the drug was prescribed in your case. If you know the "why" it may make it easier to swallow the pill at the moment. Or, when the doctor finds out how you feel about taking medications, (s)he might say it isn’t necessary. But the problem is that you are now entering a long-term relationship with your doctor, and it helps in the long run for the doctor to trust you to be compliant with instructions. With that trust, when you go in, at some point (as we all tend to do) not feeling well, your doctor’s first thought will not be that you didn’t take the prescribed meds. (S)He will look for another reason.

I can tell you that in general, the propanolol is prescribed to protect the heart. Elevated levels of thyroid hormone make the heart beat abnormally fast (which — over time weakens the heart), and also interfere with the "electrical" system of the heart that keeps it beating in the proper rhythm. Arrythmias can occur, which are terribly dangerous. The propanolol has an additional "bonus" inasmuch as it helps to alleviate tremors, and also allow us to sleep a tad more until our thyroid hormone levels are back in the normal zone. So it helps us to "feel" better. But as to why YOUR doctor prescribed it for YOU, there may be other reasons, as well.

Wishing you better days soon.

[snelsen]

#1062512

Sorry you have joined this Graves’ club. But the end of the story is that you will go back to your "old self!"
I think you got some very good information from Bobbi, and I agree with what she said.
But I also agree with you, and understand why you are asking the question. It is totally reasonable that you question taking propanolol when your heart rate is 60. So your next step is to call the endo, tell him your pulse rate and BP, and tell him your concern. Ask if it will make your heart rate too low, which I am guessing is your concern. It is a reasonable question. There will be continuing need to have good communication with your doc, so this is the beginning.

I can tell you from my own experience that when I call my endo, (in my case, we do email also) and it such a reassuring feeling to know that he respects what I have to say. Also, it did take a couple changes to find right person.

Since the incidence of Graves’ is much less in men, it will be helpful for you to check out the search box, see if you can find posts by men. I know they are there, but not sure what words to use. Maybe male is a good start.

How are you feeling? Are you familiar with some of the typical feelings of hyperthyroidism? As you take the ADT’s (anti thyroid drugs, you will feel much better.) But as Bobbi said, the stress and danger to your heart is a real one; that is why a beta blocker is prescribed. After you talk to your doc and get a plan and understanding and rationale for taking the drug, you will know how to manage it.
Do write again with an update.
Shirley

[Bobbi]

#1062513

I used the phrase "abnormally fast" in my first response deliberately. My normal resting heart rate might be 70. So, if I went in hyperthyroid and had a resting heart rate that was 80 that might not seem "fast", but it is about 14% faster than normal. And it might mean that for my own particular heart’s condition, it is "too fast." Many folks who exercise a lot have very low heart rates normally. But people who are currently in cardiac trouble — heart failure issues — could also have that same low heart rate, and it would not be healthy FOR THEM. So the number itself doesn’t necessarily mean a whole lot. It’s a comparison with normal that counts. And it has to take into consideration whether at the pace it is going, whether or not the heart is pumping efficiently.

[Kjkerr241]

#1062514

I guess I need to open up a line of commmunication beteween me and my doctor. Funny thIng is that I heard him consulting with another MD outside the exam room…didn,t know much about Graves. I think maybe I should contact my insurer and ask if they have any programs and other doctors more knowledgeable.

[snelsen]

#1062515

i agree, Ken. It is critical and essential for mental and physical health to have a doc who "gets" Graves’. Lots of enods focus on diabetes, since everyone and their brother is developing diabetes. But there ARE endos who are very familiar iwth Graves’, who understand the relationship of labs and how you feel, and who realize that there is no mandate that says the way your feel must match your labs. This is a very complicated disease and complex disease process, and it is with us for a lifetime. You deserve a well informed doc, and a good working relationship with him/her.

There is a reference on this website of endos who specialize in Graves’. Check it out.

If you would like me to ask my endo (I am in Seattle, and go to the UW medical center here) if he can provide a reference of a couple names in your area, send a PM (personal message) telling me where you are. I have done this before and he is happy to help if he can.
Shirley

[Kimberly]

#1062516

Hello – Agree with the others that it’s definitely worth double-checking with your doc on the Propranolol.

Here are the endo referral sites that Shirley mentioned:

http://www.aace.com/ and http://www.thyroid.org/.

On the AACE site, you might have to scroll down a bit to see the “Find an Endocrinologist” link on the left-hand side of the screen. Be sure and select the specialty “thyroid dysfunction” when doing a search on this site, as many endos primarily see patients with Diabetes.

On the thyroid.org site, hover over “Public & Patients” (towards the top center of the screen) with your cursor, and then click on “Find a Specialist.”

Hope this helps!

[Kjkerr]

#1062517

So I never did need the propranolol after all…that was great. Since March 2011 I have had quite the Graves adventure. Initially on 20mg 3xdaily for a little to long before mess were properly adjusted downward, ending up overtly Hypo for a couple of months, off the ATDs for a while before returning Hyper in Nov 2011. Always had problems with the methimazole, it just did not like me.
Have RAI scheduled in 2 weeks…we will see where that goes.
My wife and I are owner/operators of a small diner and stress and heat are daily companions. I am not sure under those circumstances how likely it was to achieve remission.

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