Since many of the signs and symptoms of hyperthyroidism reflect increased cellular sensitivity to adrenergic stimulation, β -adrenergic antagonist, such as propranolol, can be used adjunctively. During the acute stage, B—blockers are extremely helpful.
Propranolol (given alone) often aboishes or controls tachycardia, tremors,hypertension, A.F. and excess sweating. may be used to inhibit the sympathetic nervous system symptoms such as tachycardia until antithyroid treatments start to take effect.
It decreases peripheral conversion of T4 to T3 (active form)
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It is gradually withdrawn if serum thyroxin returns to normal level.
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If propranolol is contraindicated you can give diltiazem to control tachycardia (other CCBs may not be effective).