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Have the Epstein Barr virus with hypertension. Took Propranolol. Started to have fibromyalgia. Treatment?

Aug 2012
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Practicing since : 1999
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I have the Epstein Barr virus. My blood work also shows I have hypertension. This has only been the case since I have had the virus. My pulse has been 84-100, I sometimes get hot, my hand shakes when I write. Otherwise I am generally cold and tired because I have been anemic and take iron for. My iron levels are normal now since taking supplement since September, except iron stores still needs to be built up.
In addition, I am on 50,000 units of vita d every week and I am know up to 54.
Also, since I have had the virus, my neck has been sore, and sometimes affects my ears, though it is feeling a lot better since the virus started..
I took one dose of Propranolol, 20mg last night for the first time. This morning I had a diarrhea explosion, solid fecal matter with bright yellow liquid that is not urine. Otherwise, no other side effect that I am aware of.
The medicine really didn't slow down my pulse much, which is the only reason I was on it. I still didn't sleep well either, though I am always fatigued from the virus.
Also worth mentioning...
I started to have fibromyalgia in fall of 2009 because of high stress level from being rear ended in a car accident in August 09. The pain is lessened when I limit my dairy and gluten intake.
I had my gallbladder removed in 2010, lingual hernia repaired 2003, and tonsils removed in 1974.
I am 42 years young, 5 foot 8 inches and 168 pounds, which is 15 more pounds in the past 12 months.
What do you recommend ?
Posted Fri, 29 Mar 2013 in Infections
Answered by Dr. Madhuri Patil 13 hours later
Hi there.

From Endocrinology point of view, the following answer is dealing with your problem of weight gain. For Anemia and EB virus questions, it's better to forward your query to XXXXXXX Medicine doctor.

For acute weight gain get your TSH, AM Cortisol, FT4, Lipid Profile, LFTs, Fasting and Post prandial Sugar, HbA1c tests done and please get back.

If the tests are normal then it indicates your weight gain is purely nutritional and then you need to work on diet and physical activity part. Watch the food you are eating. Make a note of food items you consume all through the day and also the physical activity schedules.
Reduce your calories by 25% to start with and work out for 30 to 45 minutes a day. It should be moderate intensity exercise like walking/ jogging/ cycling.
Please get back for clarification if any. Take care.

Above answer was peer-reviewed by
Follow-up: Have the Epstein Barr virus with hypertension. Took Propranolol. Started to have fibromyalgia. Treatment? 17 hours later
I'm sorry, but I realized why you are not saying anything about my thyroid. I don't have hypertension.
I have hyperthyroid and my last blood pressure reading was was 100 over 60.
Now that you have the correct info, please analyze the full question history again.
Sorry for the mistake.
-all other blood work is normal.
Answered by Dr. Madhuri Patil 6 hours later
Oh ok.
Thank you for the clarification.
Now the symptoms- feeling warm, shaky, loose stools (unlikely due to Propranolol)- explain themselves that they are due to the low TSH. I want to know if you have already been evaluated further for this?
The evaluation includes- FT4, Anti TPO, Technetium's scan of thyroid.
Low TSH in the blood signifies two possibilities:
1.Thyroiditis- induced possibly due to EB virus- which temporarily shows low TSH, but weight gain and later leads to 'hypo' thyroidism in most of the patients.
2. proper hyperthyroidism- where you lose weight and not gain weight- and need long term treatment, say for 12 to 24 months.

Looking at your weight gain, I feel it is the second possibility. But a technitium's scan of thyroid will help you for final dignosis.

OR: If you have already undergone the above mentioned tests and diagnosed to have proper hyperthyroidism and started by your doctor on treatment with something called Carbimazole or Methimazole then you tend to gain weight.

Now please see an Endocrinologist in case you have not evaluated your hyperthyroidism and get back to me for further. YOU DO NOT NEED PROPRANOLOL AT THIS STAGE WHEN YOUR PULSE IS NOT BEYOND 100. no need to continue it. Take care.
Above answer was peer-reviewed by
Follow-up: Have the Epstein Barr virus with hypertension. Took Propranolol. Started to have fibromyalgia. Treatment? 43 hours later

The Endocrinologist recommended the thyroid uptake scan. I am having a problem with the scheduling, however. The doctor didn't tell me it is a 2 day test.
With my schedule, I don't think I will be able to go on the low iodine diet and have the testing until 4 weeks down the line.
I am not too concerned about it though, because my pulse has returned to normal and my energy has also increased.
I will definitely have the test done and the blood work. Just not this month.

What are your feelings about having to delay the scan for a month?
Answered by Dr. Madhuri Patil 4 hours later
Hello again.

You being 42 years old and showing typical signs of thyroiditis, and not typical hyperthyroidism, even I do not insist for the scan in emergency. But if you get the symptoms of palpitations, feeling warm, sweating palms, losing weight again then you should not wait for the test.
The iodine scan has its drawbacks of keeping yourself with low iodine diet etc, but technetium's scan is just about 45 minutes single day procedure and almost with no pre-requisites. You may ask your doctor if he/ she can prescribe pertechnate scan instead of iodine scan.
If no scan is done, please repeat your blood test for TSH, FT4 and Anti TPO after about 8 weeks. You might see the TSH either normalised or even gone up in 'hypothyroidism' range if yours is a real case of thyroiditis. Please get back with those reports following 8 weeks.
Take care.
Above answer was peer-reviewed by
Follow-up: Have the Epstein Barr virus with hypertension. Took Propranolol. Started to have fibromyalgia. Treatment? 9 hours later
Thank you very much for your guidance!
Answered by Dr. Madhuri Patil 3 minutes later
You are welcome. Take care.
Above answer was peer-reviewed by
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