Exercise tolerance after coming off Beta Blockers

[MtBiker]

I'm 52 and had avr for a bicuspid aortic valve in early June. I got back on the bike two months after surgery. Before surgery I was very active and rode about 3 to 5 times a week. I was pretty religious about walking and doing as much as I could to stay active in the two months before I was cleared for biking. I went to cardiac rehab for a few weeks, but it was depressing and I didn't feel I needed the motivation to be active. I was on beta blockers until last week when the doctor let me go from 100 mg/day to 50 mg/day (for a week) and then to nothing. My bp is a bit high, so he said to double the lisinopril, which is not supposed to affect performance much at all.

My exercise tolerance had been improving so that I was up to about hour and a half to two hour rides at a moderate to slow pace. Hills and technical trails really get me and I end up resting often.

After dropping the beta blocker last week, I was hoping that my heart rate would be able to keep up with the workout better, but I feel like my exercise tolerance has dropped from where it was the week before. I'm hoping this is just an adjustment to dropping the beta blocker. It seems like the story of my recovery (and of most here) is two steps forward, one step back. I'm curious what others have experienced after coming off beta blockers.

 

[epstns]

I would give it some time. Although the metoprolol (I think that's what you're taking) has a relatively short half-life, its effects can linger for a while. I'm down from 100 mg/day to 25 mg/day and have felt a great improvement in exercise tolerance. It has been a while now, so I can't really recall the time frame though. I still can't get my heart above about 150 under load but that, for me, is a complicated story. The beta blocker has some effect, but I also have a pacemaker and if I am being electronically paced, it will only go up to 150. If I am naturally pacing, I can get up to the 160's. I just cannot control whether I will pace naturally or not on any given day.

Hang in there. I'll bet it improves after a couple of weeks.

 

[Tom C]

I was on 100 mg/day for a number of months after surgery in April. I then went down to 75 for a while and am now on 50 mg/day. Each time I stepped the dosage down I actually felt worse for almost a week. It scared me somewhat, because I so wanted to blame my afternoon exhaustion on the beta blocker. When I didn't feel immediately better, I started to worry it was my heart. But no, my heart is fine; it just took a bit of time for my body to adjust. I'm not tired at all now and feel great. Your workouts should start improving soon.

 

[RunMartin]

I take beta blockers (Bisoprolol) but only 1.25mg and I have been told I do not need to take them if I can tolerate it. Over the last year I have had periods of a few weeks when I did not take the beta blockers. I did not notice a huge difference between them due to the low dosage. With racing it just took the edge off my speed with the beta blockers. I have done 56 races this year so (most are 5K Saturday morning races on the same course but some are quite long) and the differences in time do not correspond whether I was taking beta blockers or not. Your surgery was only a few months ago and your body is still probably readjusting.

 

[MtBiker]

Ive been off the beta blocker now for a few weeks and my exercise tolerance seems to be improving a little bit at a time. The remaining effect is that I'm very sensitive to cold. My extremities get ice cold easily when biking or skiing. I'm assuming this will go away over time. I'm only on 20 mg lisinopril at this point for somewhat high bp. Moving in the right direction.

 

[AZ Don]

I walked regularly after surgery, added stationary bike after 1 month, swimming at 2 months and biking around 3 months. The only effect I ever noticed from metoprolol during exercise is that my heart rate will be a little lower. I don't feel any different.

 

[OldManEmu]

I was on beta blockers for a year after my first surgery in 2004 and I couldn't get my heart rate above 120’s no matter how hard I tried. I always felt with high intensity aerobic exercise I couldn't get near my true capacity. One year on from surgery, beta blockers discontinued and my heart remodelled I had no such concerns. I was only on beta blockers for 3 months post my second surgery as my heart didn't need to remodel only recover from surgery. I resumed spin classes at the gym 3 months after my second surgery and have gone back to 4 1 hour classes a week with no problems.

 

[TheGymGuy]

When I was coming off the beta-blockers my heart rate was slowly going up at both REST and under load. Of course, beta-blockers were doing a great job in maintaining it nice and low, but sluggishness and lower exercise capacity sucked. Anyhow, after getting off of them and consistently training I saw changes within weeks. No beta blockers, no slugishness, better resting heart rate and a much higher exercise capacity and tolerance.
So, push on, train often, and changes will come.

Hope this helps,
GymGuy

 

[MtBiker]

I'm now going on 2 months off the beta blocker and 8 months post surgery. My HR is back to a resting pulse around 60 and I can get it up to the high 160s during exercise. It took several weeks after I stopped the BB for my heart rate to settle into a more normal pattern. At first it would spike really easily to 150 or so right away when I started to exercise.

Feeling good and starting to get my endurance back a little at a time.

 

[coffeelover]

Very interesting thread about beta blockers and exercise...just wondering if others have experienced side effects even with a small dose prescribed?

 

[T in YVR]

Side effects? For me, its been cold extremities (feet/toes/fingers) and significant dizziness when standing up too quickly.

I get an echo next month and they'll decide whether I stay on Metoprolol and Coversyl (ACE Inhibitor). Hope to get off them if my heart has remodeled well, but its only been 4 months since surgery (although my LV has already dropped 1 cm in diameter). I am planning on signing up for my 1st ever triathlon late this year, but am holding off until I see how this goes with the drugs, heart rate and remodeling etc. It's interesting to hear everyone's experience with exercise post beta blockers...

 

[clay_from_nj]

Very interesting thread about beta blockers and exercise...just wondering if others have experienced side effects even with a small dose prescribed?

In the months since surgery, my lightheadedness when going from a crouch to standing is milder and less frequent. Taking carvedilol 6.25mg twice a day, I recently tried out the "fitness test" on a Lifecycle at the gym. I pretty easily got my heart rate up to 160 so I think that at this low dosage there isn't much effect.

 

[epstns]

I guess I'm the poster child for unpleasant side effects - maybe because I was on a fairly large dose of metoprolol. The ones I had include:
1. Abdominal bloating, gas
2. Sluggish - felt like I was dragging a sled full of boulders everywhere
3. Reduced exercise tolerance
4. COLD extremeties
5. Stomach cramps and other digestive issues
6. Light-headedness when rising from a crouch
7. Wild, wierd dreams
8. Unexplained weight gain

Now, after reducing my dose from 100 mg/day to 25 mg/day (timed release metoprolol succinate), I only have the cold hands and feet. Exercise tolerance is much better and I feel more like I expected I would feel after vr surgery.