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What causes tiredness, fatigue and slow heart beat?

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Practicing since : 2001
Answered : 1663 Questions
I have a slow heart beat which began in 2013 also have sleep apnea and HBP. I was examined by a cardiologist
who ordered every test in the book He said some ppl just have a slow heart beat. I'm a 69 y/o XXXXXXX XXXXXXX male. I have a tumor on my pituitary gland, elevated prolactin and reflux in my left ankle, diabetes type II last 3 A1c=4.1. I have no energy and am fatigued most of the time.
Posted Tue, 12 Aug 2014 in Brain and Spine
Answered by Dr. Shehzad Topiwala 10 hours later
Brief Answer:

Detailed Answer:
Sorry to learn about your symptoms.

Your complaints are of significant concern to me.

Kindly do not ignore these and see an Endocrinologist in person at the soonest opportunity.

I dont mean to cause panic, but you should seek immediate care to make sure you do not have life threatening endocrine problems, such as adrenal insufficiency.

This can occur with pituitary tumors.

When I see someone who comes to me with such complaints, i immediately refer them to the ER. There the ER physician stabilizes their vital signs while I give my inputs on the work up. Some examples of tests that I order are :

Free T4
8 am cortisol
Salivary cortisol
Total testosterone
Free testosterone

Many of your symptoms can be potentially explained by pituitary conditions. For example a slow pulse can be caused by 'Secondary hypothyroidism' meaning an under active thyroid due to lack of pituitary signal to the thyroid gland. This can cause fatigue and many other symptoms too. Further, extreme lack of energy can very be a classic manifestation of low adrenal hormones. this can also occur when the pituitary signal to the adrenal glands is reduced.

Please seek specialized endocrine care promptly
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