# Suggestions on how to taper off atenolol (beta blockers?)



## slivola

Hi everyone,

I wanted to get your suggestions on how to gradually taper off atenolol (beta blocker). My endocrinologist said once my thyroid was in range, then that means the 30mg of methimazole that I had started taking were working (I began 6/11/12). I had been taking 100mg atenolol every night before bed. A few weeks ago I lowered it to 75mg. Yesterday I got my vitals checked and my pulse is down to 60 and my blood pressure was 96/56 and that was after running up a flight of stairs and being stressed from being late. I'm going to lower it to 50mg but was wondering how long I should stay on it before lowering to 25mg. Maybe a few weeks? All of my vitals and lab results are below.

Thank you for any suggestions you have!

5/24/12: 107/55
6/11/12: 110/59
*8/2/12: 96/56*

Pulse:
5/24/12: 110
6/11/12: 113
6/26/12: 90
*8/3/12: 60*

T4 FREE (range 0.8-1.5 ng/dL) 
6/7/2012: 3.08
*7/30/2012: 1.3*

T3 (range: 58-159 ng/dL) 
6/7/2012: 341 
*7/30/12 : 118*

TSH (range: 0.35 - 4.00 uIU/mL) 
6/7/2012: <0.01
7/30/12 : <0.01

TSI 6/11/12: 345 (range <125)
TPOAB 6/7/12: 79.3(range <5.6ml)


----------



## Lovlkn

I've been told you should take up to 4 weeks to wean yourself down. 75mg is a pretty large dose. Since you tolerated the initial 25mg reduction why not start there for 10 days and reduce another 25mg then start the final reduction over the next 10 days. If you have any symptoms such as anxiety or racing heart or high blood pressure you need to contact your doctor and stop your reduction.

The key is reduce and see if symptoms re-appear.

You really need to insist that your doctor begin running the FT-3 instead of the T-3 on you when labs are done. Large doses of atenolol reduce high FT-3


----------



## slivola

Thanks for your suggestions. I've been on the 75 mg for about 2 1/2 weeks. I'll reduce to 50mg and stay on that for several weeks. I will check with my doctor about the Free T3. I wonder why he runs the Free T4 but not Free T3. I've read that some more old school doctors feel the T3 is more accurate than the Free T3. I bet mine fits that category since he approach seems to be a little dated. Thank you!


----------



## Lovlkn

I have had both FT-3 and T-3 run at the same time - personally I think the range is too large. I also do not feel it is as accurate and will share labs run.

FT-3 3.0 (2.6-4.8) T-3 81 (80-200)

FT-3 3.3 (2.6-4.8) T-3 103 (80-200)

FT-3 2.8 (2.6-4.8) T-3 97 (80-200)

See what I mean?


----------



## slivola

That's interesting thank you for sharing those. Your results seemed to be in a similar part of the range with both the Free T and the T3 (lower end and lower end, etc). But yes T3 has a much larger range. I have found amazing information at Elaine Moore's website in Q&A. She explains most people feel better when the labs are near the higher end of the normal range, especially for the T4 since that responds faster to medication dose changes.

I have Kaiser and apparently they do not offer the Free T3. On occasion, I can order it from a private lab and pay out of pocket (about $100) but I can't do this every time I get my labs done! I will consider doing it at certain points in my treatment when I feel like I need more information. I'm really unhappy with my endocrinologist. After doing research this weekend, I have learned that my current labs which are in the higher end of normal are ideal, and my endo suggested that I just continued on 30 mg until mid Sept. All of the research shows that this will put me into major hypo. Even the conservative FDA recommends going to 5-15mg but Elaine Moore's research shows that was an older range and the new range is 2.5-10mg.

Thank you for your comments because I believe it was you who had first expressed concern that even dropping to 20mg could make me hypo quickly. I don't think I would have researched this as much if not for your comment!


----------



## Lovlkn

slivola said:


> That's interesting thank you for sharing those. Your results seemed to be in a similar part of the range with both the Free T and the T3 (lower end and lower end, etc). But yes T3 has a much larger range. I have found amazing information at Elaine Moore's website in Q&A. She explains most people feel better when the labs are near the higher end of the normal range, especially for the T4 since that responds faster to medication dose changes.
> 
> I have Kaiser and apparently they do not offer the Free T3. On occasion, I can order it from a private lab and pay out of pocket (about $100) but I can't do this every time I get my labs done! I will consider doing it at certain points in my treatment when I feel like I need more information. I'm really unhappy with my endocrinologist. After doing research this weekend, I have learned that my current labs which are in the higher end of normal are ideal, and my endo suggested that I just continued on 30 mg until mid Sept. All of the research shows that this will put me into major hypo. Even the conservative FDA recommends going to 5-15mg but Elaine Moore's research shows that was an older range and the new range is 2.5-10mg.
> 
> Thank you for your comments because I believe it was you who had first expressed concern that even dropping to 20mg could make me hypo quickly. I don't think I would have researched this as much if not for your comment!


www.labcheckusa.com had a TSH, FT-4 and FT-3 lab panel for around $85.00


----------



## slivola

I'll go and get this done. Do you think this is a good point in time to have it checked, or do you think I should wait a few weeks to see how I respond to the 10mg dose? Thank you for any suggestions you have!


----------

