Low pulse, tiredness

Patient

Q: I'm 55 in a good overall health condition. All my life I have been doing sports like swimming, tennis, weight room. Recently, I start feeling that I don't have enough energy, have tiredness after doing sport. Need at least one day with no sports to feel good again. I was swimming in my childhood 10 years professionally and 9 months ago started to swim and participate in masters swimming events again. I'm practicing quite intense 3 times a week. In between days with swimming, I'm playing tennis.
Is that, perhaps, too much in my age? I start to worry.

Perhaps, I feel tired and recover slower, because I have very low pulse rate? Just measured my blood pressure. It was perfect - 120/80, but pulse only 45...

Just read in Internet:" A heart rate of less than 60 beats per minute (BPM) in adults is called bradycardia. What's too slow for you may depend on your age and physical condition. Physically active adults often have a resting heart rate slower than 60 BPM but it doesn't cause problems."

Is my pulse rate too low or it is OK with my life long sports activities? Do I feel lack of energy because of low pulse rate? How to get energy? I'm eating healthy products, sleeping at least 8 hours.

Symptoms:  Low pulse rate at perfect blood pressure. Lack of energy. Tiredness. Slow recovery after sports.
Doctor

A:   Hi.
Thanks for your query and an elucidate history.
Read and understood your history well.
To recapitulate important points: Male/55 - sports all life - recently feeling low energy and tiredness after doing sports - thinking of low pulse rate as a reason in spite of good BP - Read internet about bradycardia - wants to know more -

Your queries:
Is that, perhaps, too much in my age? (9 months ago started to swim and participate in masters swimming events again. I'm practicing quite intense 3 times a week. In between days with swimming, I'm playing tennis. )
> 9 months is a long time to have a practice, intense - thrice a week. in between playing tennis.
Both these activities are strenuous and need a great stamina. It is possible that the intensity and duration of swimming and playing tennis may be in fact more than the stamina one has at the age of 55.
The Duration and the intensity be reduced and see the effect; it is possible to titrate your timing and intensity and to see the effects.

Is my pulse rate too low or it is OK with my life long sports activities?
> I think that your heart rate may be normal with the history you have provided of long sports life. The most important point to be noted is your heart rate and blood pressure during or immediately after the sports activity that you are doing to know the readings on exertion. That is the reason I would advise you to undergo some tests as follows:
EKG, stress test and echo-cardiography as these basic investigations will help us to know the exact position of the cardiac/circulatory system to decide whether the pulse rate of 45 is normal for you, supports your heart and the body well or not.

Do I feel lack of energy because of low pulse rate?
> as explained above, it is not necessary that the low pulse rate of 45 (one reading that you have noted)
is the sole reason for lac of energy. This may not be applicable to you as you would have developed other symptoms of breathless on exertion, palpitation, spells of fainting or so. Since you are already involved into such sports activities that you have noted, it would not have been possible for you at all.

How to get energy? I'm eating healthy products, sleeping at least 8 hours.
With the limited knowledge we have at the moment, just reducing the duration and intensity of the activities you are doing we can see the changes.

I would like to know you pulse rate and the blood pressure at the moment, after doing some exercises like climbing the stairs or so and after the swimming/ game of tennis.

Please give feedback about any investigations you have done till now, any medical problems like diabetes or allergies or so.

Please tell me the about what you are doing at the moment and the pulse and blood pressure at the moment.

Please feel free to give more feedback, ask further queries if you need to or if you feel that there is a gap of communication.(for any points I might have missed.)

I shall be happy to assist you further.

Comments / Follow Ups

Patient: As I said, I just measured my blood pressure and pulse 3 times. About 120/80 all 3 times, but pulse 44, 45, 47. I have no diabetes or allergies. I just did EKG, but do not have a copy here at home. I will get one from my physician later in October and send to you along with velo-energometric test, which I will have on October 14th. Hope that it is possible to come back here and talk to you in 1 months?Meanwhile, I'm actively practicing for European Masters Games, which takes place in the beginning of October. That is why I worry about my feelings and about how to prepare for the games better. I hope that you are right that I just have to reduce intensity and frequency of sport. That's too much. I remember that I had a lot of tennis about 2-3 years ago, but this year I added intensive swimming trainings... Actually, I thought about it myself. I will reduce, cause only 1 week is left till the Games and I have to reduce intensity of trainings anyway to be in the best shape October 1. Thanks!
Doctor: Oh, this is great. All the best for your European Masters Games.
With the absolutely normal blood pressure the readings of 44, 45, 47 may be just physiological (as adjusted by the body and heart) for you, otherwise you would not have been in the position to have both the strenuous games.
Adjust to the capacity. I mean as we discussed and hope you get the best results.
Also the stress and anxiety and all the daily chores of life are different at the age of 55 one usually copes with, but may not always.
Certainly you can talk o me even after one month and if required can give a reference Q ID of 308004.
I shall be happy to assist you the most.

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