What's causing my heart rate to drop? DR MARTIN SCURR answers your health questions

I am 75 and extremely fit — I enjoy cycling, weights, spinning and walking. My resting heart rate used to average around 46-48 bpm: however, since my third Covid vaccine it has dropped to 39-43bpm. The same happened to my wife and youngest son (aged 40). My GP says she is not aware of any such symptoms from the vaccine.

Paul Mackintosh, Darlington.

Having a low resting heart rate — classed as anything under 60 bpm (beats per minute) — is not necessarily a bad thing and can be a sign of physical fitness.

A low heart rate, known as sinus bradycardia, is a natural phenomenon in some people and is a sign that the impulses coming from the sinoatrial node (the pace-making part of the heart) are lower than the normal range of 60 to 100 beats per minute.

However, other factors can have an impact. Your resting heart rate will drop with age — and this may be contributing in your case.

A low heart rate is not usually considered a medical problem unless accompanied by symptoms such as fainting, which can occur if your heart rate is too low to pump adequate amounts of blood around the body.

Paul Makintosh, from Darlington, writes: ‘My resting heart rate used to average around 46-48 bpm: however, since my third Covid vaccine it has dropped to 39-43bpm’

I had a patient with a medical history similar to yours who I referred for an annual ECG — a test to check the heart’s rhythm and electrical activity. Each year his resting heart rate became lower until, eventually, it reached 32 bpm and I referred him to a cardiologist, who fitted a pacemaker to prevent his heart rate reducing further. I’m happy to report this never happened.

As to whether the drop in your resting heart rate could be related to Covid vaccination, I’ve checked the medical literature and there’s no mention of bradycardia as a complication. I’ve also spoken with colleagues and there is some evidence that Covid infection is associated with changes to the nervous system that controls heart rate.

While the cause in your family’s case could be coincidence, I think it’s worth the three of you discussing with your GP an annual ECG to check your heart rate.

I’ve been waiting two years now for an operation to straighten my manhood. I’m told it could be another two years for the procedure. My wife is understanding but the curvature of my penis makes sex impossible and the situation is affecting my mental health. Can you help?

Name and address supplied.

It can’t have been easy for you to write in about this distressing condition — but let me reassure you that you are far from alone.

IN MY VIEW… IT’S NOT JUST WHAT YOU EAT —WHEN MATTERS TOO

I’m always on the lookout for new advice for patients trying to lose weight, so I was fascinated by recent research on time-restricted eating.

Published in JAMA International Medicine, this showed that when obese adults ate only between 7am and 3pm, they lost more weight compared with those who ate the same amount of food but spread over the whole day.

Our body’s circadian rhythms affect so many elements of our health. I recall learning as a medical student about how output of the hormone cortisol — known as the stress hormone, it also keeps us feeling alert — is at its lowest at 4am, which is why people are more likely to die in the darkest hour before dawn, when feeling weak through low cortisol (levels then climb rapidly).

It seems there’s also a natural rhythm for metabolism. So for those trying to lose weight, the maxim must be that it’s not only what you eat but when you eat it that counts.

Around 5 per cent of men from middle-age onwards are affected by this. It not only makes sex difficult but it can be painful, too.

Your condition, called Peyronie’s disease, is where scar tissue forms in the fibrous sheath that covers the spongey erectile tissue in the centre of the penis.

The scar tissue tugs at the surrounding area, causing the penis to develop a pronounced curve during an erection.

Understandably, this can have a huge impact. One study found that 81 per cent of men affected reported emotional difficulties, with 54 per cent suffering relationship problems.

One treatment option is a vacuum device that can help straighten the penis. Another is an injection of the enzyme collagenase, called Xiapex, which softens or completely gets rid of the scar tissue (although this isn’t available on the NHS).

For severe cases, surgery is the gold standard treatment.

This involves removing the scar tissue and implanting a device to straighten the penis.

Overall, the success rates of surgery are good: a study of 61 patients found 86 per cent were able to return to sexual activity.

The greater difficulty that I foresee is getting the surgery on the NHS. As the condition is neither cancer-related nor life-threatening, I fear you may face a considerable wait.

Depending upon your financial circumstances it might be worth investigating going private. Given your understandable distress, it is a tragedy for you and millions of other patients that, because of the current state of our NHS, paying for private care may be the easiest resolution for you.

Write to Dr Scurr

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail. co.uk — include your contact details. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context and always consult your own GP with any health worries.

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What’s causing my heart rate to drop? DR MARTIN SCURR answers your health questions

IN MY VIEW… IT’S NOT JUST WHAT YOU EAT —WHEN MATTERS TOO

Write to Dr Scurr