<s>[INST] I am a 52 yer old female and my pulse on waking up is 54-56/min  then resting pusle is 64/min and respiis 20/min. Is this normal? Feel very tireddo keep feeling vey anxious  having butterfleis in my stomach fro timeto time for about 2 weeks now waht can I do about this? [/INST] Hello It's very common to have pulse in between 50 -60, rather it's a sign of healthy heart as all athletes who do intense training have a lower heart rate. Now in your case, it may be a natural phenomenon which is good, but as you are feeling tired I would suggest that you rule out secondary causes of lower pulse, most common being hypothyroidism (less working of thyroid gland) by doing S. TSH.  Also, a baseline ECG to rule out any conduction abnormality of heart would be recommended.  This two simple test with give us a better picture and will help relieve your anxiety.  Regards Chat Doctor.  </s>