Graves disease General info Community Group
This is a collection of information gathered for our members.
Regarding the differences between Atenolol and Propranolol
Starting with this by Elaine Moore, phrased here in the most common way it is found elsewhere .
***Beta adrenergic antagonist drugs are an integral part of the treatment protocol in Graves’ disease. Although they have no direct effect on thyroid function, they are valuable in ameliorating cardiac and nervous symptoms. While propranolol was the first drug of this class used to treat thyrotoxicosis, newer cardio selective agents such as esmolol, atenolol and metoprolol are also prescribed. Propranolol is primarily used since it has the advantage of inhibiting the conversion of thyroxine (T4) to the more potent triiodothyronine (T3).***
http://www.ithyroid.com/graves_trea...
So let's get more specific.
***During propranolol treatment T3 decreased from 4.6 to 3.9 nmol/l, while no changes were observed during atenolol treatment or in the control group.***
http://www.ncbi.nlm.nih.gov/pubmed/...
***Some minimal effect on thyroid hormone production however also comes with Propranolol - which has two roles in the treatment of hyperthyroidism, determined by the different isomers of propranolol. L-propranolol causes beta-blockade, thus treating the symptoms associated with hyperthyroidism such as tremor, palpitations, anxiety, and heat intolerance. D-propranolol inhibits Thyroxine deiodinase, thereby blocking the conversion of T4 to T3, providing some though minimal therapeutic effect.***
http://en.wikipedia.org/wiki/Hypert...
Check out these guys.. they only tested Atenolol ..unfortunately coming to the wrong conclusion.
***hese data do not support the hypothesis that the beneficial clinical effects of beta-adrenoceptor blocking drugs in thyrotoxicosis are mediated by an action on the peripheral metabolism of thyroid hormones.***
http://www.ncbi.nlm.nih.gov/pubmed/...
Anyway.. you can find similar studies when you are on one of the PubMed studies I linked to. Just follow "Related citations" on the right side of the screen there. That's always interesting. I've gone way far off my original search topic there, doing that.
Starting with this by Elaine Moore, phrased here in the most common way it is found elsewhere .
***Beta adrenergic antagonist drugs are an integral part of the treatment protocol in Graves’ disease. Although they have no direct effect on thyroid function, they are valuable in ameliorating cardiac and nervous symptoms. While propranolol was the first drug of this class used to treat thyrotoxicosis, newer cardio selective agents such as esmolol, atenolol and metoprolol are also prescribed. Propranolol is primarily used since it has the advantage of inhibiting the conversion of thyroxine (T4) to the more potent triiodothyronine (T3).***
http://www.ithyroid.com/graves_trea...
So let's get more specific.
***During propranolol treatment T3 decreased from 4.6 to 3.9 nmol/l, while no changes were observed during atenolol treatment or in the control group.***
http://www.ncbi.nlm.nih.gov/pubmed/...
***Some minimal effect on thyroid hormone production however also comes with Propranolol - which has two roles in the treatment of hyperthyroidism, determined by the different isomers of propranolol. L-propranolol causes beta-blockade, thus treating the symptoms associated with hyperthyroidism such as tremor, palpitations, anxiety, and heat intolerance. D-propranolol inhibits Thyroxine deiodinase, thereby blocking the conversion of T4 to T3, providing some though minimal therapeutic effect.***
http://en.wikipedia.org/wiki/Hypert...
Check out these guys.. they only tested Atenolol ..unfortunately coming to the wrong conclusion.
***hese data do not support the hypothesis that the beneficial clinical effects of beta-adrenoceptor blocking drugs in thyrotoxicosis are mediated by an action on the peripheral metabolism of thyroid hormones.***
http://www.ncbi.nlm.nih.gov/pubmed/...
Anyway.. you can find similar studies when you are on one of the PubMed studies I linked to. Just follow "Related citations" on the right side of the screen there. That's always interesting. I've gone way far off my original search topic there, doing that.
This is a PDF file:
http://thyroidguidelines.net/sites/thyroidguidelines.net/files/file/THY_2010_0417.pdf
Use index on the upper left side for easier access.
Regarding length of treatment, it is now agreed length of time is determined by the patients preferences. Now that's official ! :)
Quote:
Low-dose methimazole treatment for longer than 12–18
months may be considered in patients not in remission who
prefer this approach. 2/+00
Most patients with newly diagnosed Graves' disease have no ocular involvement. Moderate-to-severe and active GO or sight-threatening GO are rare at presentation and rarely develop during ATD treatment. Most patients (>80%) with no GO at baseline do not develop GO after an 18-month follow-up period. Remission of mild GO occurs in the majority of cases.
http://www.ncbi.nlm.nih.gov/pubmed/23408569
This is important to help reassure patients
with Graves’ disease
http://www.thyroid.org/wp-content/uploads/publications/ctfp/volume6/issue8/ct_patients_v68_6_7.pdf