What is the role of propranolol in the treatment of subacute thyroiditis?

Updated: Mar 23, 2021
  • Author: Stephanie L Lee, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Patients often find great relief from tachycardia, palpitations, anxiety, and tremor with beta-blocker therapy. Beta-blockers may be used if symptoms of adrenergic stimulation are troublesome. Propranolol is generally recommended because of its central nervous system (CNS) effects; it also has the theoretical advantage of inhibiting conversion of T4 to T3 at higher doses. Beta blockade can usually be withdrawn in 2-6 weeks.

Exercise caution with the initial dose of propranolol; patients may become hypotensive, because they are often dehydrated from a decrease in the oral intake of fluids and increased perspiration from thyrotoxicosis. Beta-1 selective agents (metoprolol or atenolol) have more convenient dosing and are better tolerated.

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