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Old 01-17-06, 11:02 AM
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Beta Blocker?

I'm currently on a beta blocker (Inderal[Propranolol Hydrochloride]) for headaches due to high blood pressure. I've only been taking them a few days but I get the feeling that they sometimes make me feel "washed out" during my normal commute (after 15-20 mins). Is it possible the medication is messing about with my blood sugar levels? I noticed that they are not recommended for diabetics (I am not one). I was thinking of adding some glucose to my normal riding drink to help out.

I must admit that the medication has not had any other discernible affect.

Any suggestions would be most be welcome.
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Old 01-17-06, 12:29 PM
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Originally Posted by ukmtk
I'm currently on a beta blocker (Inderal[Propranolol Hydrochloride]) for headaches due to high blood pressure. I've only been taking them a few days but I get the feeling that they sometimes make me feel "washed out" during my normal commute (after 15-20 mins). Is it possible the medication is messing about with my blood sugar levels? I noticed that they are not recommended for diabetics (I am not one). I was thinking of adding some glucose to my normal riding drink to help out.

I must admit that the medication has not had any other discernible affect.

Any suggestions would be most be welcome.

YESIt will affect your riding, but is not down to sugar levels.

Beta blockers reduce the Heart rate. I went on them for a spell and before taking them I had a heart rate of around 150 when riding, and a max of 170ish. On the beta blockers- I could not get the heart rate above 130 and it took a lot to get it up to that. This meant that blood flow around the body was reduced, and I was breathing very hard and could not not rid of the lactic acid in the legs. I had to ride with a heart rate of less than 110 to get myself in a suitable riding condition, and that meant I was slow, and the faintest hill meant slowing down even further.

Mind you, for the year I was on them- I had no headaches, and I think it got me in training for the slow pace that I now ride at.

A temporary cure to get back to riding was instead of taking a pill in the morning- I took one the night before a ride, and then took one soon after finishing the ride. That worked for me, but I got off them over the next year by gradually reducing the dosage. Do not suddenly stop taking them without consulting your doctor.
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Old 01-17-06, 02:44 PM
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Would sure like to see some more comments on the side effects of these drugs. I'm trying to get back into shape after a several year lay-off. I've got high blood pressure and high cholersterol, mostly to due heredity. The doctor gradually raised my Cozaar to the current 50mg over a ten year period. I ate oatmeal and bean sprouts for six months that had almost no effect on the cholesterol. Went on 40mg of Lipitor that helped some but it took adding 10mg of Zetia to move the cholesterol under 150. I did a lot of hiking until 5 years ago but stopped due to a variety of reasons. Have been bicycling for a year but just can't seem to get the strength to move on up the hills or average much above 13 mph. Thought most of it was due to aging, I'm 51, but now beginning to wonder about the medication having a negative effect on the muscles.

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Old 01-17-06, 04:27 PM
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Originally Posted by Trek Al
Would sure like to see some more comments on the side effects of these drugs. I'm trying to get back into shape after a several year lay-off. I've got high blood pressure and high cholersterol, mostly to due heredity. The doctor gradually raised my Cozaar to the current 50mg over a ten year period. I ate oatmeal and bean sprouts for six months that had almost no effect on the cholesterol. Went on 40mg of Lipitor that helped some but it took adding 10mg of Zetia to move the cholesterol under 150. I did a lot of hiking until 5 years ago but stopped due to a variety of reasons. Have been bicycling for a year but just can't seem to get the strength to move on up the hills or average much above 13 mph. Thought most of it was due to aging, I'm 51, but now beginning to wonder about the medication having a negative effect on the muscles.

Al
Beta blockers slow the heart rate as I have mentioned. I am on Symvastatin at 20mgs per day, but that is as a precaution to stop high cholesterol.I can see no side effect at all. I was warned that it could cause some muscular discomfort, but if I do get them I put them down to growing pains. I have found that if I am very good and stay off the pastries, 5 fruit and veg a day, cut out eggs altogether BLAH,BLAH,BLAH---In other words do everything they say I should for prolongued periods- My cholesterol levels drop a fraction. Unfortunately we measure differently in the UK. so cannot give you a comparison on levels, but it only drops a max of 5%, from not a very high level from normal. I would rather still have the odd cake or 3, as I do not have to worry about cholesterol.

Back to food again I see- so do you have a bun in the US. called a lardy cake- A very sweet bun made with a lot of animal fat and they are fantastic. They seem to have diappeared over here since the Greens took over our eating habit advice. Once did a 100miler on 3 of them and I steamed the ride.
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Old 01-17-06, 04:58 PM
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Be carefully with betablockers! I forgot to tell my doctor that I had a heart rate of 35 / minute (I rode a lot at that time and for me it seemed to be quite normal). So he gave me betablockers and my heart rate decreased down to 30 bpm.
Later I had a 50+ -check and my doctor stopped these betablockers. I now take some other pills which don't decrease heart rate.
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Old 01-18-06, 12:55 PM
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You might want to talk to your doc about some other medication for BP reduction. There are many possible meds to take, each with its own advantages and disadvantages. I'm taking a diuretic for BP reduction, and I've experienced little in the way of side effects, and there's been no impact on my cycling. Beta blockers are notorious for making exercise difficult, because of the reduction in heart rate. Your mileage may vary, and your doc may have a very good reason for having you on a beta blocker. But it'd definitely be worth having a conversation about it.
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Old 01-19-06, 01:57 PM
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I take ACE inhibiters and bata blockers and I am diabetic. None of it effects my riding. I still get my heart rate up to the max rate and I don't feel pooped out at all. I do watch what I eat and don't carb load at all for a ride. I do eat an hour or so before I ride if I can and I eat more meat than carbs. I have no colestrol issues.
Talk to your doctor and tell him/her how you feel get checked for diabeties and all that other over 50 suff. If you need to loose some weight it makes a huge difference in how you feel and your blood pressure. I have lost 60 lbs and my BP droped about 10 points on both ends and my resting hart rate went form 75 to 62. I ride 16 miles a day. Joe
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Old 01-22-06, 02:50 PM
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propanalol crosses into the brain and can make you feel wiped out from a direct effect on brain chemical transmission


ask your doctor to try one that can't get into the brain (like atenalol)--it might not affect you the same way (hopefully it is effective for the headaches)


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Old 01-24-06, 11:08 AM
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I am an avid cyclist who takes a beta blocker for headache prevention. I started about a year ago on a very low dose of Nadolol. Took it for a month then doubled the dose (still was considered low).
I took it in the morning.

I hated the very tired feeling, it also made me feel cold, have lousy dreams and of course pretty pooped on the bike.

I went back to half the dose and have stayed there (20mg daily) and I take it now at bed time not in the morning. I also take other medications for headache prevention as well (Atacand, an ARB).

At the low dose I am on now of the Nadolol it doesn't bother me at all. I still get headaches but that's another story.
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Old 01-24-06, 07:26 PM
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I was on Beta blockers for migraine prevention for 2 years. I was training for a few different things and found that I wasn't getting past a certain level. I stopped taking the blockers and after 3 weeks I was able to push my heart rate up where it was doing me some good. My endurance seem to increase and my climbing became better. This was not directly because I quit, but because I could train at the next level with my heart rate top end increase.

Of course my doctor read me the riot act (and rightfully so) for quitting inderal without his guidance. I was just tired of the lack of performance and the slight sluggish feeling. With my increased level of fitness, my migraines have been in better control and I still inject Immetrex (sp?) when they come on.

Good luck and talk to your doctor. There are a lot of new drugs out that might fit your needs better.
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Old 01-25-06, 07:39 PM
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I'm on Atenolol (1st cousin to Inderal) for mild hypertension and now rare migraine headaches. I've never noted any difference in excercise tolerance, even though my HR doesn't seem to get about 130 or so no matter what I do. Yet I keep up with everybody else and pass enough 30 year olds to keep me happy. I loved Imitrex/Zomig and all their look alikes when they came out (they worked like magic) but then had a stroke after taking one. So like all medication, beware of the rare oddball bad reaction. I think my recumbent bike keeps the headaches away and does more for BP than all the meds in the world. Tapering off now.
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Old 01-25-06, 08:47 PM
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I try as hard as possible NOT to take triptans for migraine relief. They work, but since I work out almost everyday, I don't trust them. My neuro says it's OK to exercise vigorously 4 hours after taking one, but I would not do that. So I suffer.
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Old 01-26-06, 12:20 AM
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This will seem like we are hijacking this thread to talk migraines...and I guess that is true.

I am one that cannot function with a "runaway" migraine. I can't work, ride or be a human being so I "shoot up" the Immetrex. I knew that there were certain odd side effects, but a stroke?

My doctor (who is good and thorough) is human and doesn't know everything. However his research indicates that after taking an injection, it would be okay for me to exercise. He knows that I cycle and backpack and use the medicine to allow me to continue.

Has anyone read anything about not doing physical activity after a stat dose and where can I read or research this info? Thanks...
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Old 01-26-06, 11:34 AM
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I asked my neuro (he is the head of the university hospital headache clinic) re: my concern about some risk associated with vigorous exercise and triptan use and asked him how soon after taking a triptan is it safe to exercise vigorously. He said he did not think there was a problem but would get back to me.

He sent me an email saying he had discussed this issue with a colleague who is more familiar with this topic and said I was right there are some potential issues but that 4 hours seems to be a safe window.

Most doctors are not used treating healthy people, let alone athletes who are constantly pushing themselves.

This would be particularly true for migraine sufferers and their physicians, since many/most migraineurs are reduced to living their lives in dark rooms and as a result of their condition are not the most active population.

Triptans are vaso constrictors and are contraindicated for people with known heart disease, uncontrolled high BP, etc. They are effective and have proven safe if used in moderation, but from what I have read (sorry no sources at this time) vigorous exercise is not the ideal thing to be doing after taking one. I try to wait 12-24 hours myself. I also find I get more rebound headaches when I use them compared to other abortives but that is another issue.

No question they are better than narcotics and most other meds used to abort migraine.
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Old 01-26-06, 02:22 PM
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Originally Posted by bobkat
I'm on Atenolol (1st cousin to Inderal) for mild hypertension and now rare migraine headaches. I've never noted any difference in excercise tolerance, even though my HR doesn't seem to get about 130 or so no matter what I do. Yet I keep up with everybody else and pass enough 30 year olds to keep me happy. I loved Imitrex/Zomig and all their look alikes when they came out (they worked like magic) but then had a stroke after taking one. So like all medication, beware of the rare oddball bad reaction. I think my recumbent bike keeps the headaches away and does more for BP than all the meds in the world. Tapering off now.
Atenolol was the one I used to take, but like you, max HR of 130. This did affect my riding as I normally rode at around 150, and Lack of oxygen in blood did affect me. As mentioned- my cure for a ride was to take one the night before- or even miss it out, but take one immediately after the ride.

I did not associate it at the time, but for the year I was on atenolol- I did not have one single headache- let alone a migraine.
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Old 02-07-06, 10:51 PM
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I have been taking Atenolol for 4 years and now I have stopped. This can be scary, so for what it's worth, here is my experience that may help someone else.

I am 52. 4 years ago I had 3 stents inserted into coronary arteries. No MI and no heart damage, just angina - lucky - had lots of collaterals from Aikido training. This was followed by 2 years of heart-smart dieting, but no weight loss and no exercise due to a terrible fear of dropping dead.

Finally got used to the idea of dying (eventually), so I started swimming with a squad. When I got aerobically fit enough doing this I added cycling with the local club. We are a touring club, but mid-week training rides are outright races - guess this is true of most clubs.

My Cardio has had me on Lipitor40, Atenolol, Tritace, Aspirin - standard vanilla regimen - and like any good slave, I have followed this protocol diligently for 4 years.

At my latest checkup I did a stress ecg to total exhaustion (at my request) - with the expected results after swimming a gazillion laps of the local pool and riding all over SE Queensland. The Cardio, a triathlete himself, looked at my exercise logs, max HR's into the 150's, and declared that the beta blocker had to stay, "it doesn't seem to be working very well anyway", and "stay under 140 or else....".

Well, I thought about this afterwards and it occurred to me that if the beta blocker isn't working very well then why am I taking it, and putting up with the horrible side effects. Swimming, I could just barely get my HR to 140 after a sprint and cycling the best I ever got was 155 on a "wall". Of course, all this was accompanied by serious performance limitations.

Skip forward a bit - lots of reading and research on the internet.

I have done a deal with my GP. I look after my health and decide what drugs I take, and he monitors my health to ensure that we achieve the expected results. Being an orthodox GP, he's a bit nervous about this, but open minded enough to take the journey. As for the Cardio - I think we will tell him AFTER it all works. If you don't hear from me for a LONG time, then I guess it didn't work!!!

So, the current protocol is: (10g ascorbate, 5g lysine) divided dose (Pauling therapy), 150mg CoQ10, 2g proline, 500IU VE, Super B, 3g arginine, niacin (titrated dose). Really, seriously smart eating plan. Lots of swimming and cycling - 6 days per week, one rest day, one day intervals on hills, 3 days weight training - little processed sugar, no homogenised milk, lotsa fish, good oils, no spuds, etc.

This is working already. Getting off the statins and taking CoQ10 has made my muscles work better than they have worked since my teens. The beta blockers interfere with CoQ10 production also, so that's the additional benefit of stopping them. I never had high BP so stopping the Tritace is no big deal. The aspirin I still take, but the latest research indicates that the enteric coating on the pill has an anti-inflammatory effect which contributes as much to CV risk reduction as the aspirin inside the pill.

That just leaves the beta blocker. What a ***** to get off!!! I went 3 weeks on half dose. It felt like I was going to explode. I could not sleep for the pounding in my chest - I got the shakes, my HR went ballistic. When it got really bad I would take another half a pill, and occaisionally a valium, just to get to sleep. The only time I felt comfortable was when I was riding HARD - then everything settled down, I could get into a rythm, and ride along by "feel" - same with the swimming.

After a few weeks it all got better, so I cut the dose to zero, and then the whole process repeated itself.
Is it worth it? - hell yes. Is it hard? - you bet it is. Will I ever use them again? - never. Just make sure your GP knows what you are doing and works with you through the process.

So, what about real world outcomes?

Within a month of starting all this I felt better than I had ever felt - ever. My previous best swim session was 2.4km with a 400m straight (no rests) - in less than a month I did my first 3.1km session with a 1km straight, and felt like I could go another 1km without even trying - I just ran out of daylight. I can now ride with the "fast men" and not get dropped and it feels good - hell, I've even got riders on MY wheel now!!! The hills aren't as scary now either, and I'm not the last to the top anymore.

It took a while to get used to the big numbers on the HR monitor, and then there was the waiting for the "bigMI" - fall off the bike, show's over folks!! But it hasn't happened yet - I listen to my body and go by feel and I think that's better than any HR monitor. If I feel like I'm going to explode, then I probably am and it's time to back off.

I look at it this way. The cummulative absolute (not relative) CV risk reduction from the beta blocker and the ace inhibitor and the statin is actually much less than the risk reduction that I could achieve by doing something much safer than cycling on public roads. Although the risks of the side effects of these drugs is low, the consequences are dramatic, to say the least (skeletal and cardio myopathies, transient global amnesia, blah blah).

These days I'm more concerned with my state of health on my last day than on what particular day that may be.
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