low resting HR - how to deal with symptoms

[eyestotheleft]

I have a low RHR (around 45), which lowers even during phases of my menstrual cycle (down to 35-37bpm). I have had an ECG which confirmed the low RHR. I wouldn't be bothered by it, but when my RHR lowers I experience dizziness, depression, brain fog and significant fatigue. I have been to the GP repeatedly - I'm on a waiting list for a 24 hour ECG, but their general view is this isn't a problem and have no advice to offer.

I'm posting in the hope that someone else here is / has experienced this and can help with managing symptoms. For example when my HR is low should I deliberately try and increase it (through exercise) to improve how I feel? are there any foods / anything else I can try?

At the moment, I am going through 3-4 days a month feeling absolutely dreadful and struggling to move with fatigue and dizziness so any help gratefully received. I have a one year old..so it makes life very hard!

Thank you for reading.

specific advice would depend on what the ECG shows aside from the rate, what your BP is, any other examination findings/investigation. Best bet if you’re really going into the 30s/ having symptoms is to present to ED.

What medications were recommended to you and which ones have you tried?

Been there. It actually wasn't the low rhr that was the issue causing it but the perimenopause that impacted on both the the and symptoms.

The only remedy is the same than what is advised for high rhr. Give up all caffeine, drink 2-3 litres of water a day.

I have similar symptoms - heart rate sitting at around 40 - 45bpm, which triggers endless warnings from my watch! I ended up having an ECG, the nurse thought there was something wrong with the machine so redid the test, and then called the doctor in, was then sent straight to hospital! Spent 4 days having tests, heart scan, some kind of radioactive test thing, adrenal gland tests, all clear and ok. I really appreciated the action they took and taking time to check it out.

So anyway - no change in symptoms. When I'm going through a bad phase I snore really badly (not overweight). CBD oil seems to make it worse but not sure if there's any scientific link.

And I am menopausal too. My mum was the same so maybe hereditary.

Thanks all. @lljkk haven't been recommended or tried any medications - I wasn't aware there was any for low RHR.

but more generally...seems like maybe it is hormone related? I don't think I'm perimenopause yet but its not beyond the realms of possibility. I will go back to the GP..and tell them again (I do think they just see me as a low risk of heart attack/disease and so tell me to bog off). It really freaks me out - at some points I feel like my heart is just going to stop beating it's going so slowly.

Kind of reassuring to know it's not just me @Sockbogies @vivainsomnia so thank you for sharing!

Push for having your thyroid checked. This can cause low BP.

Get your cortisol levels checked (needs to be taken first thing / blood test). Google pots and Addison’s disease / adrenal insufficiency.

The underlying cause needs to be diagnosed & then appropriate medications discussed. You've had a pretty sophisticated test (ECG). Was there no discussion of cause, monitoring or treatment after the ECG? Who told you about your ECG results?

I have a low heart rate too. My GP has also said it’s no big deal. I also feel lightheaded at times and have low energy, especially evenings. I’m think there’s probably something not quite right, but it’s something that GP’s/ doctors don’t know about. Maybe to do with low blood volume? I exercise regularly, that helps. I was very slim, I put on weight and I think that helped. I also think that I’m a bit better since starting HRT.

I'm having the same issues now, OP. Doc, ambos, cardiology nurse say I need a pacemaker. Every time I go to ED, the stress makes it rise to 50+ (from 32-36). They've done x-rays and blood tests, all normal, except very low body temp. DH rented an ECG machine, which shows how low my HR goes at home. Sent tracings to doc, who sent on to hospital cardiology. I now have an appointment for Holter monitor and echocardiogram. Maybe worth a try? I've had ongoing Afib for years, and bradycardia too, but much worse since having covid. What put the wind up me was the doc giving me a hug, saying "I don't want you to die!"

Oh, meant to add...make sure you eat regularly. I've noticed that my HR is much lower around 9.30 am. I never eat breakfast, but have taken to having a piece of wholemeal toast and manuka honey at around 10.00, and notice that it helps a little. Keep a track of your bradycardia with particular attention to its going progressively lower. If you get breathless and faint with exercise, then sit down. When my HR is 36, I can't walk very far at all, feel breathless and weak, and break out in a sweat.

Thanks all. @lljkk I had an ECG at the hospital - I said to the nurses, this is silly I had just ran at the hospital and walked up four flights of stairs, so obviously my heart rate would be high. anyway. It came back at 45. The Gp said it was in the range of normal - I think they see that I exercise (which I do) and say that's the reason. But I am in no way a pro athlete and my HR should not be this low!

I'm waiting for a 24 hour ECG. But will contact the GP again. to be honest, I'm convinced this is something hormonal / endocrine related. It fluctuates significantly with my menstrual cycle. Thank you @Afterfire @RainbowsMoonbeams - i will look into these. My thyroid levels have been repeatedly checked and apparently fine - although all my symptoms match underactive thyroid.

@pollyglot @Mustardfan thank you for sharing your experiences. Really does make me feel slightly less mad with this!

Why did you have ECG at hospital, who was trying to assess what?

I had an ECG because I had repeatedly claimed about low RHR so this was to test / look at that. However the ECG was just a 5 minute one - I repeatedly said it needs to be a 24 hour ECG to capture the low RHR. I'm on the waiting list for this.

I was going to suggest Thyroid, like a pp said. Especially as you say you tick some hypothyroid boxes.

thyroiduk.org/if-you-are-undiagnosed/hypothyroid-signs-and-symptoms/

'Fine' thyroid results from the GP, often don't mean fine at all. Make sure you check your actual figures on the NHS app or Patient Access etc. Pop them on the forum on Thyroid UK if you're not sure.

thyroiduk.org/thyroid-function-tests/

And/or take a private blood test, one that will actually test T3, T4 & antibodies. All my test results were 'fine' but they were only looking at TSH.

Discount codes here
thyroiduk.org/help-and-support/private-thyroid-tests-in-the-uk/

My results were NHS 'fine' but I actually had Hashimotos (high antibodies) & receiving thyroid treatment now is helping all my symptoms.

Good luck!