From the Guidelines
Beta blockers are not typically used to treat hypothyroidism, but rather to manage symptoms of hyperthyroidism.
Relationship between Beta Blockers and Hypothyroidism
- There is no established relationship between beta blockers and hypothyroidism, as beta blockers are primarily used to treat symptoms associated with excess thyroid hormones, such as those seen in hyperthyroidism 1.
- The hemodynamic changes typical of hypothyroidism, including bradycardia, mild hypertension, and decreased cardiac output, are not typically managed with beta blockers 1.
- In contrast, beta blockers, such as propranolol, are commonly used to treat symptoms of hyperthyroidism, including increased heart rate, tremor, and nervousness 1.
- The use of beta blockers in hyperthyroidism can help reverse some of the reduced systemic vascular resistance associated with the hormonal disease and inhibit the peripheral conversion of T4 to T3 1.
- In some cases, beta blockers may be used to control ventricular rate in patients with hyperthyroidism and atrial fibrillation, although treatment is primarily directed toward restoring a euthyroid state 1.
- It is essential to note that hypothyroidism and hyperthyroidism can coexist with heart failure, and thyroid function tests are recommended in all patients presenting with heart failure 1.
From the Research
Relationship Between Beta Blockers and Hypothyroidism
- There is limited direct evidence on the relationship between beta blockers and hypothyroidism, as most studies focus on the use of beta blockers in hyperthyroidism 2, 3, 4.
- However, one study suggests that hypothyroidism is accompanied by a marked decrease in sensitivity to sympathetic agonists, with an increase in peripheral vascular resistance and arterial stiffness, which may be affected by beta blockers 5.
- Beta blockers are not typically used to treat hypothyroidism, but may be used to control symptoms such as hypertension, which can be associated with hypothyroidism 5.
- In hypothyroidism, calcium-channel blockers (CCB) and diuretics are often recommended for blood pressure control, rather than beta blockers 5.
- Autoimmune causes, such as Hashimoto's disease, are a common cause of hypothyroidism, and beta blockers are not typically used to treat this underlying cause 6.
Use of Beta Blockers in Thyroid Disorders
- Beta blockers, such as propranolol, are commonly used to treat hyperthyroidism and thyroid storm 2, 3, 4.
- Beta-1 selective beta-blockers, such as atenolol and metoprolol, may also be used to treat thyroid storm, and have been shown to be effective in reducing symptoms and improving outcomes 4.
- The choice of beta blocker may depend on the specific clinical context and the presence of underlying conditions, such as heart failure or asthma 3, 4.