beta blockers should be considered in all patients with significant hyperthyroidism
beta blockers ameliorate many of the acute symptoms of hyperthyroidism - eg. tachycardia, tremor, restlessness - within 1-2 days of starting therapy but do not affect the underlying disease. Propanolol is used customarily but other non-selective beta blockers are equally useful; nadolol and atenolol require only daily administration and may increase compliance. If initiated, beta blockers should be continued until the patient is rendered euthyroid by other means of treatment
in cases of thyroiditis or in those with mild toxic nodular hyperthyroidism treated with radioiodine, beta blockers may be the only treatment required
beta blockers are contra-indicated in patients with asthma should be used with caution in patients with heart failure
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