<s>[INST] i have a very low heart rate of 44 to 42 bpm.for last six months i am being treated for iron deficiency anemia . i have been working out regularly for last 3 years for 1 hour daily morn n eve, aerobics and step aerobics.off late when my heart rate drops below 45 i have sudden fatigue ,body seema tired whole day head remains heavy. [/INST] DEAR KIRSTEN, HI I AM Chat Doctor. . I WOULD LIKE TO HELP YOU.  CONSIDERING THAT YOU HAVE BEEN EXERCISING REGULARLY SINCE 3 YEARS IT IS QUITE NORMAL TO HAVE SUCH A LOW HEART RATE.THE HEART MUSCLES IN SPORTSMEN BECOME SO EFFICIENT THAT IT CAN PUMP ENOUGH BLOOD IN FEWER STROKES HENCE THE BRADYCARDIA(HEART RATE LESS THAN 60).  THE MOST PROBABLE CAUSE OF YOUR TIREDNESS, FATIGUE AND HEAVY HEADDRESS WOULD BE ANEMIA.SIX MONTHS PERIOD IS GENERALLY SUFFICIENT FOR CORRECTION OF ANEMIA IF YOU WERE COMPLIANT. YOU CAN CONFIRM THE REASON FOR YOUR ANEMIA STILL PERSISTING BY GETTING A PERIPHERAL BLOOD SMEAR FOR TYPE OF ANEMIA AND ALSO GET AN ANEMIA PROFILE DONE(IF NOT DONE ALREADY).YOU MAY BE REQUIRING A FOLIC ACID OR VITAMIN B12 SUPPLEMENTATION AS WELKIN ANEMIA BLOOD IS NOT CAPABLE OF CARRYING ENOUGH OXYGEN TO BRAIN AND OTHER PART OF BODY AND THAT MAY BE THE REASON FOR YOUR EASY NAVIGABILITY AND TIREDNESS.  SO YOU WILL BE BACK IN GOOD SHAPE WHEN YOU GET RID OF YOUR ANEMIA.PLEASE MAKE SURE YOU UNDERSTAND WHY YOU BECAME ANEMIC IN THE FIRST PLACE SO THAT IT DOESN'T HAPPEN AGAIN.SO KEEP EXERCISING AND EATING WELL.....BYE </s>