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[Donnadoobie]

Back story. I was 24, slim fit ( gymnastics and dancing) when I went to the family planning clinic to ask for the contraception pill. They took my blood pressure and it was very high ( can’t remember the exact numbers but bottom number was definitely in three 100’s). Had lots of investigations, including an overnight stay in hospital and everything came back normal. Was put down to genetics ( Mum was diagnosed at 29, daughter has  also been diagnosed at 29). Was put onto 160mg of propranolol a day in 1987.

Diagnosed as pre diabetic in 2012, controlled with diet, last A1c in 2024 was 39. Did go to 49 in 2015 when I changed my diet.

Fast forward to a few years ago when I started having issues with cholesterol. High LDL, low HDL and raised triglycerides. Statins have been mentioned every test for the last 5 years but I won’t take them

Anyway, the point of this post.

While reading a researching cholesterol and discovered that propranolol lowers HDL and raises triglycerides. After managing to switch my GP to one who was happy to work with me, I have been reducing and trying to eliminate the Propranolol.

In case you were worrying about what that has done for my blood pressure then don’t, since following a keto/low carb diet and making sure I do 10,000 steps 98% of the time my blood pressure has reduced. To the point where after a recent request for a week of bp results they called to tell me my bp was too low (average 105/62). I also take Candesarten 8mg.

If anyone has experienced the withdrawal from Propranolol, you will understand that it needs to be done slowly. It causes extreme anxiety and palpitations, to the point where I feel I am going to die ( experienced when I forgot to reorder my repeat prescription and over a weekend, have to gat emergency dose from a pharmacy). Started reduced split doses, initially 80mg x 2 per day and fit down to 30 mg x2.  All was going well until I got a nasty virus over December and January and had to increase the dose to 40x 2 but have I got back on track. I have been on 10mg x 2 for the last week and bp is steady, resting heart rate has increased a little bit nothing to worry about, even though I do worry.

I was so concerned at one point that my bp was low that I started testing on my husbands bp machine and comparing. They weren’t so different as to worry but was so nervous about checking on his machine that I swear I am the only one who can get white coat syndrome at home!

I managed to speak to my GP on Thursday who said don’t rush and come off the last bit and take my time.  I am concerned about how this will affect my lipids ( before anyone asks I have issues with taking Statins but that is another thread).

I think the anxiety issues are causing most of my issues and thinking maybe I need something for my low level anxiety. Beta blockers like propranolol are prescribed for anxiety too. I have googled beta blockers that don’t affect lipids and have come up with one called Carvedilol, also prescribed for anxiety. Anybody have any experience with this drug?  It is supposed to reduce total cholesterol including triglycerides and doesn’t lower HDL.  I have a very good relationship with my GP and may discuss a low level dose to help me with the anxiety.  BP is absolutely fine 106/70 this morning.

This is a really big deal for me.  I have been on these drugs for almost all my adult life, 38 years!  I have no idea what normal heart rates feel like.  Mine has been 55 - 65 when sitting down resting and in the 80’s when moving around, obviously higher when exercising but now it is 67-89 when resting and 90-115 when moving around ( some if this is with withdrawal and some anxiety too) and it feels horrible. I was happy in that comfort zone of an unstressed heart and low resting heart rate, which has now increased in my Fitbit from 55/56 to 62!

Long shot. Has anyone come off propranolol? How did you cope and what happened to your blood pressure? I am hoping the worst is over but have been incredibly anxious this week. I am stressing so much and won’t discuss with my husband as he says I worry too much and am making it worse ( he is probably right, I am an over thinker)

Any advice welcomed.

[CLKD]

Does it need to be done slowly?  I stopped overnight with no problems.

There mayB bounce back anxiety so if that is troublesome - depending on how often you take it - give a couple of nights/day breaks between each dose.

I was started on 80mg 3 times a day for 3 weeks dropped to 80mg twice; morning and night. Followed by 40mg at night for 3 years then 20mg for another 3 years.  Then I stopped.

Stop checking your heart rate because that will push it up!

BP will be different because betablockas are to lower it under stress.  Why do U want to stop taking it?  If 40mg suits you, mayB continue?

[Donnadoobie]

Generally it should be stopped slowly.  If I forget to take one my heart rate goes crazy, I feel wobbly on my legs and get really bad anxiety.  It is advised not to stop taking without medical supervision.  I have had to withdraw very slowly and even that has given me issues.  I was taking 160 mg a day for 38 years.

As I mentioned, I wanted to come off it because this particular drug was messing with my cholesterol results, which they bang on about every test. Propranolol raises triglycerides and lowers HDL. 

My GP is very supportive but like most GP’s these days it is hard to speak to one.  My bp is fine but I am not coping with the rise in heart rate.  I don’t need to check it, I can feel it and it feels horrible.

I just want this drug out of  my system and grasping at straws as to what I could take as an alternative, now I have experienced the anxiety issues it is bringing.

I cannot help having health anxiety.  I have developed it after menopause and I think mostly because I have had a lifetime of blood pressure checks, blood tests for cholesterol, liver function and kidney function and sugar, after developing hypertension at 24.

As an over thinker, trying to be healthy. ( fit, active, healthy weight, sugar now under control) it seems a cruel twist of luck that leads me into discussions about my health with doctors constantly ( it is mostly around cholesterol now)

I have issues with statins, which I don’t want to bring here and am probably already labelled as a difficult patient but I have my own experiences that have led me to think the way I do about medications.

Sorry for the rant.

[CLKD]

You rant away!  Statins - though they didn't tell us - will raise blood sugar levels  my levels freaked out the Nurse 18 months ago ........ telling me that I was pre-diabetic.  Well nope etc..

Health anxiety may become worse as hormone levels drop off.  It's quite common and varies from lady to lady.  I've had panic attacks since the age of 3 and now have a go-to emergency drug when it floors me.  I've also found Bachs Rescue Remedy throat spray of use: two small squirts and never thought whether it would work/not.

If it's the Betablocka causing other tests to be 'raised' then why R 'they' worrying in particular?  Is it because they get paid to prescribe statins?  As above with my Nurse there isn't any joined up thinking,  nor do they remember that BBs will cause a lowering of any test.  DH has white coat syndrome so we have a machine at home: on which I measure Zilch  .



Do U overthink B4 symptoms kick in?  I'm OK until my anxiety levels rise  . Otherwise I could take on the World!

Why can't you get to C/speak to a GP?  I can get an appt within 3 days if it's an emergency, either with my GP or a Nurse Practitioner.  Or it's 2-3 weeks wait. 

[Donnadoobie]

Our go practice is pants at the moment.  My husband went in to ask if I could have telephone appointment with my go and they said no they would ask the pharmacist to ring me 🙄

Symptoms generally bring on the anxiety, rather than the other way around.  I have always know about a missed dose because of the symptoms.

You have to think. That I have been on this medication for almost all my adult life.  I don’t know what ‘normal’ feels like.

I have a sceptical view of the pharmaceutical companies, doctors are nearly following directions and are not always up to date with latest research.  I followed the diet advice all my life, low fat, low calorie etc.  left me very over weight and pre diabetic.  I changed my diet.  I eat more fats, very few carbs and more calories and weigh almost 4 stone less.

I could write about 3 pages of this forum about what I feel about statins.  Yes they can raise blood sugar and joint and muscle pain too but that is another story.

30mg of propranolol seems to be suiting me better than 20.  If I can switch to another medication that doesn’t mess with the lipids I will feel much happier.  Next mission!

NHS reports these as side effects of withdrawal

Sweating
Anxiety
Shaking
High blood pressure
Irregular heartbeat
Chest pain


Also their is this on lipids

propranolol not only increases serum triglyceride levels and very-low-density lipoprotein cholesterol, but decreases total high-density lipoprotein cholesterol,

[CLKD]

Normal would be a starting point if I knew what it should feel like  .  I can't look much further than half a day at a time 

One needs fats to burn off fats, calories to burn off calories.  Too much info in the last 40 years telling us what might/not be bad for us, depending on who is sponsoring any Research!

Kalorie is of course an element of heat ......... [did I spell that right?]  .  But young girls and occasionally lads got that incorrect and thought that calories were 'bad'.  So cut out dairy and other goodness that our bodies need to build, repair, heal.  Granny always said 'a little of what you fancy'  .

As well as until the late 1970s kids exercised routinely because Dad had the car so we either cycled or walked everywhere.  Then LAs sold off sports fields for building sites leaving kids depleted of places to exercise which had a knock-on effect.  We also had DS [domestic science/cooking] classes weekly.  I still can't cook  .  All done with fresh ingredients..........  I can meander for England, I'll go away now 

[bombsh3ll]

I can understand you wanting to be off the beta blocker however you have spent the best part of your adult life on a high dose, and withdrawal is going to have to be done at a snail's pace.

In the meantime, the the beta blocker cannot be the only factor influencing your lipids given that these have been tested diligently over the years and only recently became an issue.

So whilst you undertake a cautious withdrawal I would ensure all other bases are covered - for example have you had your thyroid checked recently? Also menopausal estrogen loss typically results in deterioration of a previously healthy lipid profile, so consider if this could be affecting you and whether you wish to treat this, which often works just as well or even better than a statin in women.

Fish oil supplementation is also very effective at reducing triglycerides - I take it for another reason and my triglycerides are extremely low.

We are often told nothing can be done about a low HDL but exercising at a high level can actually increase this.

Exercise will also help to lower your resting heart rate over time.

[Donnadoobie]

Thanks bombshell311

I am for and active and generally walk in excess of 10,000 steps a day, weigh around 60-63kg for a 165cm woman.  I eat well and could not understand why my triglycerides were higher ( not overly but over by a few points) and never could get my HDL up, despite taking regular exercise and eating fish ( omega 3 supplements give me terrible reflux),  eggs and other HDL raising foods until I discovered it could be my medication.  Sadly my LDL refuses to go lower than their cut off point for statins but that seems to reduce each time I have a blood test too!🫤.  Trying to balance sugar levels and cholesterol is a juggling exercise.  I prioritise sugar as diabetes is a higher risk factor to health than high LDL, in my opinion anyway.

Have been reducing since beginning of November, have hit a few bumps along the way and had to increase for a few weeks but have reduced again and have now hit another bump.

I will take it slowly but I am just trying to look at other options as it seems to be the anxiety, which I had not been prepared for.  Will update as I progress here.

[bombsh3ll]

I forgot to mention in case it might be an option for you, if BP is low/normal but the elevated heart rate is causing discomfort, there is a medication called ivabradine that is used to slow heart rate alone.

This might be a good bridging option for you to come off the beta blocker.

It is not usually prescribed in primary care however but a cardiologist may be willing to consider this.

[CLKD]

Apparently the NHS guidelines for when to prescribe Statins has varied in recent years   .......... our GP explained very clearly the why's and wherefores of taking/not.  No problems other than my raised blood sugar levels 

[Donnadoobie]

I forgot to mention in case it might be an option for you, if BP is low/normal but the elevated heart rate is causing discomfort, there is a medication called ivabradine that is used to slow heart rate alone.

This might be a good bridging option for you to come off the beta blocker.

It is not usually prescribed in primary care however but a cardiologist may be willing to consider this.

Thank you, that is really helpful