Concerns About Morning Heart Rate Drops
A 30-year-old female, previously a smoker and abstaining from drugs and alcohol, seeks advice about a troubling situation regarding her heart rate. She has a history of various health conditions, including Hypermobile Type Ehlers-Danlos Syndrome, suspected Postural Orthostatic Tachycardia Syndrome (POTS), tachycardia, fibromyalgia, venous insufficiency, deep vein thrombosis (DVT), and superficial clotting, but no genetic clotting disorders have been identified. Currently, her medication regimen consists of: - In the morning: Metoprolol 12.5mg, Vyvanse 30mg, and Eliquis 5mg. - Midday and evening: Recently initiated low-dose Naltrexone, currently at 4.5mg. - At bedtime: Clonazepam 1mg and another dose of Eliquis 5mg. Since beginning the low-dose Naltrexone, she has experienced significant drops in her heart rate during the morning hours, sometimes falling to the low 50s and even the 40s. These episodes only occur shortly after waking, around 7-9am, with the most recent drop reported at 9am, where her heart rate plummeted to 35 beats per minute prior to taking her morning Metoprolol. During these episodes, she has experienced fleeting face tingling that dissipates within a few minutes. Throughout the remainder of the day, her heart rate fluctuates between 55 and 130 beats per minute, with these morning drops being a notable exception. She is grappling with whether this alarming drop in heart rate warrants a visit to the emergency room. Although she suspects this may seem trivial to some, her past experiences at the hospital have left her feeling hesitant, as her conditions are sometimes not taken seriously. She has attempted to reach her primary care physician for guidance but has not yet received a response. According to her pain management doctor, the Naltrexone is not likely to be the cause of her heart rate issues. With her complex medical history and the distressing symptoms she is experiencing, she is seeking advice on whether an emergency room visit is needed for further evaluation of her heart rate concerns, despite her reservations about being dismissed by medical professionals again.
Answers (1)
8/14/2025, 5:50:56 PM
OpenHealth AI
Experiencing significant drops in heart rate, especially to the 40s or 30s, can be concerning, particularly given your complex medical background. It's important to approach this situation carefully but also to validate your feelings regarding your health.
Explanation:
-
Understanding Heart Rate Drops: A heart rate that falls too low, especially into the 30s, is known as bradycardia. This can happen for various reasons, including medication effects (such as Metoprolol), autonomic nervous system issues (common in POTS and Ehlers-Danlos), or other underlying health conditions.
-
Symptoms to Observe: The tingling you are experiencing may also suggest something related to how your body is responding to these fluctuations. It’s crucial to monitor these symptoms carefully.
Next Steps:
-
Immediate Monitoring:
- Keep a detailed log of your morning heart rates, the times they drop, and any accompanying symptoms (like the tingling you mentioned). This information will be extremely helpful for healthcare providers when you are able to consult them.
-
Hydration and Movement:
- Since you have suspected POTS, staying well-hydrated can help manage blood flow and heart rate. Try to increase your fluid and salt intake (if not contraindicated).
-
Review of Medications:
- Consider the timings of your medications, especially Metoprolol and the recently added low-dose Naltrexone. While your pain management doctor suggested Naltrexone is unlikely the cause, it would be useful to discuss the interactions between your medications when you get a chance.
-
Seek Prompt Care if Symptoms Worsen:
- If you continue to experience heart rates in the 30s or any new severe symptoms arise (like fainting, severe dizziness, or significant changes in your overall condition), it would be prudent to visit the emergency room or a healthcare provider. Trust your instincts on this one; you know your body best.
-
Follow-Up with Healthcare Providers:
- Pursue contacting your primary care physician or consider seeking urgent care if you cannot reach them. Explain clearly the drops in heart rate and your experience, including how this is affecting your quality of life.
Remember, your health concerns are valid, and you deserve a thorough evaluation of your symptoms. The logs you keep and your ability to articulate your experience can help you receive better support and understanding from healthcare professionals. Please reach out for help when needed.
Related Questions
Experiencing Unexplained Skin Sensations
I am a 32-year-old female with a history of ADHD and Sleep Apnea. My current medications include Adderall XR at 30mg, Zyrtec at 10mg, and Wegovy at 2.4mg. Recently, I’ve started experiencing unexpected burning sensations on various parts of my body. This discomfort has appeared on my upper left arm, around the middle area of my right arm, my left thigh, and even my right pinky finger. I haven't been exposed to sunlight, haven't touched any hot surfaces, and there haven't been any changes to my skincare routine or laundry products. I'm puzzled about what might be triggering these sensations and would appreciate any insights on how to alleviate them. Additionally, it’s worth mentioning that I sometimes feel a tingling sensation in my face, which lasts around 30 minutes. This peculiar feeling begins at my upper lip, presents a cold sensation, and then gradually moves toward my right eye. This issue has been intermittent for the past few months, while the burning sensations have just surfaced this week. Any thoughts?
Foot and Ankle Misalignment Concern [19M]
Greetings, everyone. Approximately a year ago, after completing a 7-kilometer run, I began experiencing severe discomfort in my feet. By the end of the day, my left leg felt completely normal, yet my right leg continued to ache, causing me to limp for nearly three weeks. Eventually, I opted for orthopedic insoles to help manage the pain. A month or two later, I happened to observe that my right foot appeared to be angled in relation to my left. When I aligned my knees, the left foot remained straight while the right foot was positioned outward at an angle of about 40 degrees. Notably, when my feet are straightened, my right knee tends to curve inward. Running more than a few steps becomes extremely painful for my right leg. Additionally, while cycling, my knee often strikes my bike due to its inward tilt while my foot is positioned correctly on the pedal. Can anyone identify what this condition might be called? Are there any recommended actions I should take or specific medical professionals I should consult?
Recent Blood Test Outcomes and Health Updates
I received my blood test results today, but the doctor informed me that it might take some time for them to be thoroughly assessed. The blood analysis revealed: * Elevated levels of: * Eosinophils - 6.6 (showing a steady rise since 2019) * Bilirubin - 1.4 * Decreased levels of: * Vitamin D - 19.9 Additionally, I've been encountering considerable hair thinning, having lost approximately half of my hair.
Concerning Edible Aftermath
Greetings. I’m a 17-year-old male, weighing 121 pounds, and I recently tried an edible for the first time. The amount I consumed was uncertain, but I suspect it was between 80 and 500 milligrams. Now, nearly 72 hours later, I’m still experiencing significant cognitive cloudiness and a sensation akin to my head spinning. This ongoing issue has me worried. What could be happening, and what steps should I take next?
Concerns About My Daughter’s Eye Bump
My daughter, who is 16 months old, has been dealing with a bump on her eye for roughly five weeks now. Initially, it seemed minor, but over the past week, it has progressively worsened. The area has become notably red and swollen. After noticing these changes, I took her to a local children’s hospital, where the physician diagnosed it as a chalazion, confirming it was not harmful and stating it wasn’t causing her any discomfort. Nevertheless, due to my worries about a potential infection, the doctor prescribed amoxicillin. Unfortunately, my daughter had an adverse reaction and began vomiting, which led her pediatrician to change her medication to cephalexin instead. We have also been referred to an ophthalmologist, but I was informed that the wait time could be several months. I'm reaching out to see if anyone has any advice, suggestions, or alternative options available. Although she hasn't had any fevers, her irritability has increased significantly over the past week, raising my concerns about her experiencing any pain. Lately, I also noticed that the skin in the affected area has started to peel. Any insights would be greatly appreciated.