Beta blocker can be prescribed to soothe performance anxiety
Q: My doctor prescribed metoprolol for my stage fright. I am an author and have terrible nerves and an embarrassing shaky voice when doing a reading. I wanted to share my experience with others who may also have stage fright. A:
The beta blocker metoprolol (Lopressor, Toprol XL) has approval from the Food and Drug Administration for treating high blood pressure, angina pectoris and heart failure. Doctors sometimes prescribe beta blockers off-label for performance anxiety. These medications slow down the heart rate, which can help calm an overactive cardiovascular reaction.
Not everyone can tolerate beta blockers, though. People with asthma or complicated heart problems may experience dangerous complications.
Q: After reading an article in The New York Times, I asked my dermatologist about low-dose oral minoxidil to reverse hair loss. My hair has slowly thinned since my 50s.
I started with ¼ pill (monitoring my blood pressure daily). After four months, I upped it to ½ pill. I’ve had no side effects, and my hair is thicker. It’s still not as thick as when I was young, though. After talking to my dermatologist, I’m increasing the dose to ¾ pill, and I’ll watch for side effects.
Low-dose minoxidil is working for me, but it might not be for everyone. I decided to go slowly, as this is a regimen that you have to continue for life. If you stop, you lose the hair you’ve grown.
A: Minoxidil is better known as a topical medicine under the brand name
Rogaine. It was first developed as a pill to treat high blood pressure. That dose was 10 to 40 milligrams daily, which can produce serious side effects.
Some dermatologists have been experimenting with low-dose oral minoxidil (up to 5 milligrams). As long as your dermatologist is monitoring your progress, this could be an interesting option.
Q: Are there any new treatments for me? Reactive hypoglycemia has been an issue for five decades. It’s getting worse as I age.
I monitor what and when I eat closely. My diet is low in carbohydrate (45-60 grams/day), and I keep a low-sugar protein drink available at night. I pay for a continuous glucose monitor out of pocket. This has been a lifesaver since I have low blood sugar events several nights a month or sometimes shortly after getting up. Even when my diet is clean, I can have a spate of three to six alarms for a few nights in a row.
I haven’t had much luck with dietitians or endocrinologists. Most had never treated someone with RH since it’s rare. Is there any information to make life easier besides watching what I eat, which was my
last dietitian’s suggestion? A:
Reactive hypoglycemia, or RH, happens when blood sugar drops below normal levels (70 mg/dl) two to four hours after eating. It can sometimes be triggered by exercise or a meal that is high in carbs, especially sugar.
Symptoms may include lightheadedness, brain fog, dizziness, weakness, fatigue, sweating, rapid pulse, nausea and anxiety. Doctors do not know what causes this condition, though they suspect that excess insulin production may contribute. Have your physician check for adrenal gland or pancreatic disorders.
Nocturnal hypoglycemia occurs when blood sugar drops at night. Wearing a continuous glucose monitor is an excellent strategy because it will alert you to both high or low blood glucose levels. Avoid alcohol in the evening as well as exercise. Do not skip supper. Eating a healthy snack before bed may help. Keeping a high-protein drink handy also makes sense.