Snippy doctor comment (resting heart rate question)
MzLazyBones
Posts: 63 Member
I’m one of those frustrating patients for my doctor. I’m 5’9” and about 277-277.5lbs, depending on which day I look at the scale. My doctor tests me for high blood pressure and pre-diabetes every visit (I don’t go often). I’m in danger of neither, and for that I feel fortunate. My blood pressure is that of an athlete or child. This isn’t to sound braggy, this is for context.
My doctor, apparently mad that I don’t have these things she feels I should have because I’m obese, she told me that a low resting heart rate meant I couldn't eat as much energy. She said it in such a snide way that I've put in for a new doctor, someone who doesn't suffer from a dislike of heavy people would be a nice change of pace.
But could I, because my heart beats slower than someone else, require less energy? I know the heart is a muscle, but I have good conditioning because I climb a lot of stairs, use a stationary bike regularly, and I work out my legs a lot (especially since I was injured and am recovering). So, how much less energy do I really need? Should I worry about this?
My doctor, apparently mad that I don’t have these things she feels I should have because I’m obese, she told me that a low resting heart rate meant I couldn't eat as much energy. She said it in such a snide way that I've put in for a new doctor, someone who doesn't suffer from a dislike of heavy people would be a nice change of pace.
But could I, because my heart beats slower than someone else, require less energy? I know the heart is a muscle, but I have good conditioning because I climb a lot of stairs, use a stationary bike regularly, and I work out my legs a lot (especially since I was injured and am recovering). So, how much less energy do I really need? Should I worry about this?
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I support you to find a doctor who acknowledges your good health markers. Obesity is not always caused by or the cause of bad health.0
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I haven't seen your previous posts... My H is your height, but has lost around 22lbs, and is now at around 194lbs.... are you looking to lose weight, or just maintain good health?
My daughter is 'big' (she has also called herself fat, but is keen to do the LCHF to lose weight) but is also extremely healthy, with all tests normal and sound.
So what is your aim?1 -
@Replies - It's tough finding health professionals that don't look at you and assume you're diabetic, arthritic, in terrible shape, and have high blood pressure. Hope I can.
@AlexandraCarlyle I've only been active in the group a few days. My goal is to lose weight; I'd like to hit 150, but anything below 180 would be a big improvement (I have some great jeans I want to fit in again). Regardless of weight, I don't intend to give up my physical activity, ever. I love the endorphins.
I'm just wondering if 1530 calories is going to be low enough when combined with induction carbs (just started yesterday, before I was closer to 50-70carbs), or, if because my heart rate is low, I need to drop the calorie levels. So far, I've lost (averaging, it spikes and unspikes week to week) about a pound a week for a month and I haven't gone over my base calories even when I exercise (so if I burn 600 calories exercising, I don't eat any of them).0 -
First of all, I would discount what your Doctor tells you on the opinion of your heart rate, because it seems clear to you that she's basing her advice on a certain amount of personal frustration.
I suspect that when she tested your heart rate you hadn't exerted any great amount of energy, or had just finished a 10k run in 5 minutes - ! So in other words, her opinion was based on an already resting heart rate.
I would, in your shoes, consider discussing the matter with someone at a gym, or contact a dietician, to see what they say.... Don't base your concerns on the comments of one person alone, however qualified.
Especially if she was 'snippy', which is a dead give-away, isn't it?3 -
doesn't make sense to me... a lower heart rate is supposed to mean good cardiovascular health as long as you are feeling fine (edema, not able to move, fainting, etc would be a major cause of concern).
my go to guide for calories and macros is keto calculator..
https://keto-calculator.ankerl.com/
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I think it's a reliable Mantra for you @food_lover16 ... and yes, it's a great site, once I managed to get the hang of it. I am what's loosely known as a techno-doofus.....0
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I tend to have a lowish BP (usually 90 to 100/50 to 60) and an average to good heart rate (65-75). I lost very easily at about 1500 kcals, and taking meds for hypothyroidism. I had about 40 lbs to lose, at 5'8" and 40 something.
I'm not sure what your doctor was on about. A lower heart rate is generally good. It indicates pumping efficiency, as I understand it. As long as it rises well during exercise you are fine. There might be a slight difference in metabolism for someone with a slower heart rate but that seems to be majoring in the minors.4 -
@MzLazyBones - First check out this thread and the link in it. It is how I found my current doctor after firing both my PCP and endo.
http://community.myfitnesspal.com/en/discussion/10478334/online-list-of-low-carb-doctors#latest
Second, define "low" resting HR. I am in maintenance now with a resting heart rate (according to my FitBit) of between 49 and 55, although it drops into the 40's every night at some point. I think the lowest I have seen is 43. I say that because, as a 6'1" 185 lb 46 yo man who is active, I am still able to consume/burn well over 3000 calories a day, so the low HR doesn't seem to affect me that way.
The way I understand it is the heart rate is lower because it is pumping more efficiently. Basically, it is working more like the super soaker than the little squirter water gun. The muscle is stronger and therefore able to pump the same volume of blood in fewer contractions. I don't see how that would negatively impact your TDEE.
As for the pre-diabetes part, be careful. I very much doubt your doc is testing properly to really know any risk here. He is probably only testing blood glucose. Prior to that being elevated, your fasting insulin will increase. Very few docs will test this. This happens first and can take decades for your cells to become insulin resistant enough to cause the elevated blood glucose to move you to pre-diabetes then to T2.
If you find a doctor on this list in the referenced link, s/he will almost certainly be familiar with and in favor of checking your insulin to see if you do actually have any risk. Dr. Joseph Kraft did an amazing study of over 15,000 patients showing how the elevated insulin is actually the first sign of pre-diabetes even while BG remains "normal."3 -
1530 cal/day should be fine for weight loss, my per day average is 1625 and I'm the same height as you and have been bouncing between 145-150 lbs...my heart rate is usually around 60 when I go to donate blood, not sure if that qualifies as totally resting since I usually have to walk around the room, but nothing strenuous in terms of activity...0
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I don’t like my doctor, no secret, I just worry about things like this (I'm a worrier, it's what I do). My husband, who’s fairly laid back, doesn’t like my doctor, either—she’s made comments in the past about my weight that were more jabs than helpful. “You’d recover faster from your knee injury if you were half your size”, to which my husband said “No *kitten*, really?” then asked her to snap her fingers and make it so, otherwise it would take time.
I guess I should have swapped doctors then, but I’d just had a serious injury, and it felt like a lot of effort to find someone new when I could barely walk and she was my link to not only refilling my prescriptions (which was SO important at the time, I was in bad shape!) and the physical therapy I was starting. I’ll take a look at that list, no excuse now that I’m at a gym for my physical therapy and can get around pretty well again.
BTW, for those asking, my resting (sitting down, watching tv etc) BPM is between 55 and 61 (I know 60 is the lower end of normal), and yes it definitely goes up when I’m working out. I just sat down (I was making dinner in the kitchen) and its 57BPM right now.
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Just checked the list, none even in my country. There's one in Sweden and one in Germany, both several hours away (one way) by train.0
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MzLazyBones wrote: »Just checked the list, none even in my country. There's one in Sweden and one in Germany, both several hours away (one way) by train.
Sorry. Didn't know what country you were in. Good luck.1 -
I read conflicting information regarding nearly everything I research and whether or not a slower heart rate results slower metabolism is no different. Conflicting information. Both sides can be equally convincing.
Regardless of what actual truth might be, I'm inclined to say if you are satisfied with your current rate of loss, keep on with your 1530 average daily calories and good for you for exercising for your overall health/rehab.0 -
Just to play devils advocate a little. Not because I disagree at all just to throw out a perspective that's probably driving your doctors assumptions that you'll end up testing negatively eventually.
The 2015 statistics from the CDC show that 1 out of 3 people are pre diabetic and 9 out of 10 of them don't know it. These are the people with normal fasting blood sugars and A1C's because even though their cells are in the early stages of insulin resistance, the pancreas is able to keep up with the increased demand. At this point, all tests show nothing negative but weight begins to pile on especially in the abdomen.
So having good blood work doesn't actually clear you of being hyperinsulinemic. They never bother to actually test fasting insulin which is what could actually catch it early on.
I always though a low resting heart rate was a good sign also. But I do know that one reason people abuse Adderall is for weight loss. And it raises your heart rate.
Even now that I've dropped my dosage to half what I used to take, I rarely see a heart rate below 80. It takes hardly any effort at all for me to reach what's considered the aerobic heart rate level for my age. Just a brisk walk can maintain 140 easily. I don't actually know if that's one reason it is often used for weight loss or if it's the appetite suppression that often comes with it. For most people taking it long term, the appetite suppression is only temporary though.
Anyway, just food for thought.3 -
I always though a low resting heart rate was a good sign also. But I do know that one reason people abuse Adderall is for weight loss. And it raises your heart rate.
Considering one of the medications offered by "weight management clinics" is an amphetamine (the same class as Adderall), because of its appetite suppressant effects, I doubt the reason for weight loss is the heart rate.MzLazyBones wrote: »I’m one of those frustrating patients for my doctor. I’m 5’9” and about 277-277.5lbs, depending on which day I look at the scale. My doctor tests me for high blood pressure and pre-diabetes every visit (I don’t go often). I’m in danger of neither, and for that I feel fortunate. My blood pressure is that of an athlete or child. This isn’t to sound braggy, this is for context.
My doctor, apparently mad that I don’t have these things she feels I should have because I’m obese, she told me that a low resting heart rate meant I couldn't eat as much energy. She said it in such a snide way that I've put in for a new doctor, someone who doesn't suffer from a dislike of heavy people would be a nice change of pace.
But could I, because my heart beats slower than someone else, require less energy? I know the heart is a muscle, but I have good conditioning because I climb a lot of stairs, use a stationary bike regularly, and I work out my legs a lot (especially since I was injured and am recovering). So, how much less energy do I really need? Should I worry about this?
If you see that doctor again, challenge that statement by a request for a Medgem test. It's a device that measures your resting metabolic rate based on the carbon dioxide amount you breathe out.
"Let's test your hypothesis, doc, and measure my RMR!"3 -
I'm sorry that you are dealing with such a snippy doctor, and I can understand why you are frustrated. Have you ever had your thyroid levels checked? A low heart rate is a very common symptom of hypothyroidism as are weight gain and difficulty losing weight. Your low heart rate and relatively low weekly weight loss (given your current weight) could point to a thyroid problem. These were among my first symptoms. Low energy level is another symptom, which you don't have. Other symptoms include needing extra sleep, dry skin, loss of hair in the outer third of the eyebrows and thinning hair on the head, and many more. You may want to discuss getting comprehensive thyroid testing with your current or preferably a new doctor.3
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Can I ask how old you are? I'm assuming young adult 20-40? If you are not a frail elderly person then a low resting heart rate is rarely a problem. Athletes typically have low resting heart rates. If means your heart beats strong and efficiently. If a person's heart contractions are not very strong it will pump faster in order to maintain circulation. If the heart contracts stronger then if can do so fewer times and still obtain adequate blood circulation. With your physical activity and excess weight (which is essentially weight training) your heart has become strong and efficient.
Good luck in your search for a doctor with some bedside manner.0 -
I'm 35, not quite old but some days I feel pretty darn frail (I tore my ACL and a week ago I sprained my wrist)
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what is your blood pressure and heart rate?
I have a low heart rate. When I'm in shape running, fasted and rested it is around 42-45 beats/min (I'm 55). If I eat something, it immediately goes to around 55 beats/min. I've timed it at 38 beats /min in the last year a few times (I have an app on my phone that uses the camera light to read my pulse by putting my finger over the light).
In college as a young guy who ran a lot it was normally 41-42 rested and I could get it down to 36-39 if I really relaxed.
My dad had a minor stroke due to slow pulse rate (high 20's) so too low is not good.
I have freaked out a couple of doctors.0 -
My whole family has lower RHR - my normal has always been 60 avg which is fairly slow for a woman and a BP of 110/60. Get the full on thyroid panel and fasting insulin tests once you get a new physician. That will let you know if you need to be concerned about the RHR.1
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@blambo61, I don't have a blood pressure cuff on hand, but yesterday my BPM was 57 after I sat down, having been in the kitchen cooking. Right now, it's at 53 BPM (just woke up, haven't eaten yet). Think I may have something little and go back to bed, 4 hours of sleep just doesn't cut it.0
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some information about heartrate
actually there are two types: normal(low)-pulser and high-pulser
as you can see in my avatar, i am a high-pulser. my max puls is 208 (picture was taken after a MTB-marathon from a Garmin device, and correspond with my Polar-watch)
while the morning BPM varies wide, there exists no "aerobic heart rate level for some age"
so, if you reach very easy 140 or even 150, you might be a high-pulser
for normal-pulser, 140 BPM is already some "work"
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Freischuetz wrote: »some information about heartrate
actually there are two types: normal(low)-pulser and high-pulser
as you can see in my avatar, i am a high-pulser. my max puls is 208 (picture was taken after a MTB-marathon from a Garmin device, and correspond with my Polar-watch)
while the morning BPM varies wide, there exists no "aerobic heart rate level for some age"
so, if you reach very easy 140 or even 150, you might be a high-pulser
for normal-pulser, 140 BPM is already some "work"
Idk. I just know the machines at the gym have target heart rates based on age for aerobic or fat burning and I know your basically supposed to be working pretty hard to maintain in the "aerobic" range. But I don't even get to a slow jog ... so that's what I was referencing.1 -
MzLazyBones wrote: »I don’t like my doctor, no secret, I just worry about things like this (I'm a worrier, it's what I do). My husband, who’s fairly laid back, doesn’t like my doctor, either—she’s made comments in the past about my weight that were more jabs than helpful. “You’d recover faster from your knee injury if you were half your size”, to which my husband said “No *kitten*, really?” then asked her to snap her fingers and make it so, otherwise it would take time.
I guess I should have swapped doctors then, but I’d just had a serious injury, and it felt like a lot of effort to find someone new when I could barely walk and she was my link to not only refilling my prescriptions (which was SO important at the time, I was in bad shape!) and the physical therapy I was starting. I’ll take a look at that list, no excuse now that I’m at a gym for my physical therapy and can get around pretty well again.
BTW, for those asking, my resting (sitting down, watching tv etc) BPM is between 55 and 61 (I know 60 is the lower end of normal), and yes it definitely goes up when I’m working out. I just sat down (I was making dinner in the kitchen) and its 57BPM right now.
Those numbers are very close to mine, I am shorter, older, live at altitude (CO Front Range area), and while I walk daily, I am far from super fit cardio status. My dr. thinks my resting heart rate is fine, and has never mentioned it effecting my calorie burn. Not sure where your dr. came up with that one.
I hope you find a good dr. if none near you are on the list posted above, look for someone who treats epilepsy. At least they will be well aware of keto dieting.
Good luck on finding a good one.0 -
I'd say I support your choice to look for a new doctor as well. I think doctors have to recommend that we lose weight if we are obese. I think they'd be negligent not too, however, they also need to look at the way you as the patient presents. Your labs are great, you are active, vitals are great. I have to say, I was in the same boat up until a year ago. I think living an active lifestyle does so much for our health. (I'm living proof, a year ago, my A1C was 5, my LDL was less that 100, my bp was great, then I had a stroke after an intense work out due to a congenital malformation in my brain the work out spiked my bp and cause a bleed. I had to give up the activity and within 3 months my labs started to look bad. Now, please take into consideration that I have PCOS and have insulin resistance.) The point of my post is to say that my doctor and I always attributed my activity level to my good health and we discussed my labs and activity at every physical to keep on the right track. You absolutely have to have a doctor you are comfortable with and supports you but still educates you about the risks of obesity. Good luck with your search.6
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@kristelrn, a pearl of wisdom. Welcome!1
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I once had an endocrinologist who told me that he couldn't help me with my thyroid health until I stopped being fat, that it wouldn't ever make a dent. And he said it in quite a spiteful/blame the patient way. Needless to say, I fired him.
And it's sad, because I took part of what he said to heart and actually stopped the thyroid meds I hadn't realized were helping behind the scenes... I should have realized if he was a moron enough to get it backwards within his own darned specialty!!!! that he would never be able to help me, and was probably "backwards" about more than just that one thing.
You've gotten some incredible advice above. I just wanted to pop in and let you know some doctors are just judgmental because they truly don't understand the causes of underlying health issues. Just listen to Dr. Attia's TED Talk if you wonder about that...I may not agree with all of his conclusions, but even doctors who think they KNOW...can be wrong.
https://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes
"As a young surgeon, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she needed a foot amputation. But years later, Attia received an unpleasant medical surprise that led him to wonder: is our understanding of diabetes right? Could the precursors to diabetes cause obesity, and not the other way around? A look at how assumptions may be leading us to wage the wrong medical war."2 -
True story: I went to my local practice and saw a new Doctor, a lady from Denmark. She is, shall we say, well-rounded and 'Rubenesque'. I spoke to her about weight-loss and we discussed white/yellow fat cells (so she knows what she's talking about) and then she told me, "You know, when I arrived here, I said to my Husband, 'darling, I really need to lose a bit of extra weight, you know, if I'm going to set a good example, and advise my patients...' and then, I took a look around the town and thought to myself, 'you know, I'm actually not that bad'....!"
I like my Doctor, she's great fun!
ETA: The region I live in is not particularly affluent; we have a sadly high proportion of low wage earners, and of course, as with many other locations, the salary is never commensurate with the ACCL*. So they thrive on crap-laden foods. Which are of course, high-carb, cheap and plentiful.....
(ACCL = Actual Current Cost of Living)0 -
I was once told that without other risk factors, my weight was irrelevant. My reaction was to say that the doctor had just shot down my last motivation to lose weight.1
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I have a closet full of motivation (clothes I'm hanging onto like a hoarder), also women who are trying to conceive have a much easier time doing so if they're at a healthy weight (according to my OBGYN). So there's that. Motivation is not my problem, it's a combination of willpower and breaking seriously bad habits, like using food as therapy.1
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