Say Goodbye to a Racing Heart with Propranolol
Living with POTS is a bit like trying to run a marathon with your legs tied together – you can make progress, but it's slow, frustrating, and exhausting. You know how when you stand up too fast, you sometimes feel dizzy? Imagine that, but it happens almost every time you go from sitting to standing. My heart races like I've just sprinted, even if I've only walked to the fridge.
I have to plan my days around this. Mornings are the hardest; sometimes I have to sit on the edge of the bed for a few minutes just to make sure I don't faint. I never leave home without my compression pants, a water bottle, and my salt tabs, but despite those, I'm still struggling to keep my symptoms under control.
Propranolol and Heart Rate Regulation
Beta-blockers, such as propranolol, known for their heart rate-regulating capabilities, have proven to be a key ally in the management of symptoms such as tachycardia and palpitations - symptoms that often dominate the landscape of POTS and Long COVID. By dampening the overzealous cardiac response and providing a steadying hand to a racing heart, beta blockers can help patients reclaim a sense of normalcy and engage more fully in daily life activities.
Taming Tachycardia and Palpitations with Propranolol
For many patients experiencing the discomfort of a racing heart or palpitations, propranolol can be a game-changer. These symptoms are not only distressing but can also interfere with daily activities and overall quality of life.
Propranolol can help by:
Slowing down the heart rate
Reducing the force of the heart's contractions
Lessening the frequency of palpitations
The Science Behind Propranolol
Beta-blockers, like propranolol, function by blocking the action of certain chemicals, like adrenaline, on the beta receptors found in the heart and blood vessels. There are 3 types of beta receptors: beta-1, beta-2, and beta-3.
Beta-1 receptors - Found in the heart and kidneys where they increase heart rate and the force of contractions by the heart while also helping the kidneys release renin to regulate blood pressure.
Beta-2 receptors - Found in the lungs, arterioles of skeletal muscles, and the uterus where they help with bronchodilation (opening of the airways), vasodialation (widening of the blood vessels), and muscle relaxation.
Beta-3 receptors - Found in adipose tissue, or fat calls throughout the body where they play a roll in the breakdown of fats.
In the treatment of tachycardia and palpitations, beta-blockers target beta-1 receptors in two crucial ways:
Beta-1 Receptor Blockade: These medications specifically target beta-1 receptors in the heart, which are responsible for the heart's response to adrenaline. By blocking these receptors, beta blockers effectively slow the heart rate and reduce the force of each heartbeat.
Reduced Stress Response: By diminishing the body's reaction to stress and anxiety, beta blockers can prevent the rapid heart rate and palpitations that may be triggered by stressful situations.
Safety and Efficacy
The efficacy of beta blockers in controlling heart rate and preventing palpitations is well-documented. They are a standard treatment for high blood pressure, certain types of arrhythmias, and are also used in the management of anxiety.
While beta-blockers are generally safe, they are not suitable for everyone. They must be used with caution in individuals with asthma, certain heart conditions, or those with a predisposition to low blood pressure. Starting with a low dose allows for careful monitoring of the body's response to the medication.
The Path Forward
Whether you have been living with POTS for years or only began experiencing symptoms after COVID-19, beta blockers like propranolol may be able to help you better manage your heart rate and improve your quality of life. Its safety and efficacy in the treatment of POTS and other symptoms seen with autonomic dysfunction can help address many of the symptoms, such as tachycardia and palpitations, that you live with every day. If you are interested in exploring beta blockers like propranolol as a treatment option, consult with your healthcare provider or visit RTHM Direct to learn how this treatment option can help combat autonomic dysfunction and get you back on the path to better health.
Follow the Science
Propranolol and other beta blockers works to treat tachycardia, palpitations, and other symptoms of autonomic dysfunction, such as palpitations and tachycardia seen in dysautonomia and other comorbid conditions like Long COVID and ME/CFS.
Melanie Dani, Andreas Dirksen, Patricia Taraborrelli, Miriam Torocastro, Dimitrios Panagopoulos, Richard Sutton, Phang Boon Lim Clinical Medicine Jan 2021, 21 (1) e63-e67; DOI: 10.7861/clinmed.2020-0896
Desai, A. D., Boursiquot, B. C., Moore, C. J., Gopinathannair, R., Waase, M. P., Rubin, G. A., & Wan, E. Y. (2022). Autonomic dysfunction post–acute COVID-19 infection. HeartRhythm Case Reports, 8(3), 143-146. https://doi.org/10.1016/j.hrcr.2021.11.019
Deng, X., Zhang, Y., Liao, Y., & Du, J. (2019). Efficacy of β-Blockers on Postural Tachycardia Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis. Frontiers in Pediatrics, 7. https://doi.org/10.3389/fped.2019.00460
Mearns, B. M. (2009). Low-dose β-blocker for POTS. Nature Reviews Cardiology, 6(12), 733. https://doi.org/10.1038/nrcardio.2009.181
Moon, J., Kim, DY., Lee, WJ. et al. Efficacy of Propranolol, Bisoprolol, and Pyridostigmine for Postural Tachycardia Syndrome: a Randomized Clinical Trial. Neurotherapeutics 15, 785–795 (2018). https://doi.org/10.1007/s13311-018-0612-9
