r/dysautonomia • u/rucan66 • 1d ago

Question Does upping your dose of ivabradine help with exercise or physical activities?

My cardiologist started me on low dose ivabradine 3 weeks ago. It has worked well to keep my resting heart rate at about 80 bpm and walking around 110 bpm, but if I do something more strenuous like hand washing the car or raking my heart rate will still jump to 140 bpm like before I started ivabradine and I feel very shakey and jittery just like before. When I take the ivabradine even at low dose it leaves me feeling tired and nauseous, weak with low energy and a little lightheaded and sometimes not so bad. But it doesn't stop big heart rate spikes when I am using my arms to do physical chores. I don't know if I should try and up my dose of Ivabradine. Did a higher dose lower your heart rate while doing more difficult activities?

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u/atypicalhippy 1d ago

That shaky jittery bit might be noradrenaline, suggesting the hyperadrenergic version of POTS. You might want to talk to your cardiologist about that.

I was on ivabradine, which brought my heart rate down. More recently I've gone onto Guanfacine, which reduces noradrenaline action, and brings my HR down enough that I've gone off the Ivabradine. This is working well for me.

I still couldn't do something like hand washing a car though, or most other household chores. I've got someone coming in to help me manage the house.

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u/rucan66 1d ago

I have hyper adrenergic pots symptoms caused by my doctor putting me on a beta blocker I didn't need and coming off cold turkey leaving me with over sensitized beta receptors for 16 months now.

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u/Ambitious-Can4244 1d ago

Can other BP medications cause this? Or just beta blockers?

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u/rucan66 1d ago

I believe benzos can also cause autonomic dysfunction

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u/Sad-Goal-1510 23h ago

Yup, I spent 2 years using vallium on and off (not abusing, following instructions but regular use for panic attacks) and once I stopped completely my POTS symptoms were completely debilitating

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u/amsdkdksbbb IST 1d ago

Obviously this differs from person to person, depending on the cause of your dysautonomia, but my cardiologist upped my dose once I was strong enough to start exercising again.

It helps keep symptoms under control while you recondition. It’s actually been so tempting to increase the intensity of my exercises, but my doctor warned this would happen. And made sure I understood to be really careful and avoid cardio etc.