I have a low heartbeat. I exercise regularly and this has never happened before… should I be worried? DR ELLIE reveals what’s going on – and the troubling link to alcohol

Lately my Apple Watch has been waking me up with an alert that my heart rate is below 40 beats per minute. Should I be worried? I’m a 75-year-old man who exercises, and my only downside is that I drink a few bottles of wine a week.

Smartwatches are known to be unreliable during sleep. However, excessive alcohol consumption can also be the cause of a low pulse.

These devices can be useful for providing useful health data, including your daily step count, and sometimes detecting serious problems such as atrial fibrillation, a heart rhythm problem.

However, these are not medical devices, which means they do not always provide accurate results. I also wouldn’t recommend sleeping with someone.

This is because heartbeats can fluctuate throughout the night. The average heart rate is about 60 to 90 beats per minute, but it is normal for it to drop to 40 beats per minute during sleep. This may be alarming for a smartwatch, which typically sends a health alert to the user, but it’s not unusual.

A low heart rate is generally only a problem if it occurs during the day and causes dizziness, fatigue, fainting, and/or shortness of breath. This is called bradycardia and can occur after a heart attack, due to thyroid disease, or sleep apnea (a condition in which breathing is blocked during the night).

In some cases, excessive drinking can also be triggered because alcohol can damage the heart in severe cases. The NHS recommends consuming no more than 14 units (about one and a half bottles of wine) per week. Consuming more than one bottle per week will increase the risk of heart problems as well as other problems such as liver disease and cancer.

Anyone concerned about their heart rate should speak to their GP, who can arrange for 24-hour pulse monitoring via a portable device.

My prostate is enlarged and is causing me problems when going to the toilet. What can I do that doesn’t require surgery?

It is very common for prostate enlargement to be treated without surgery. There are various medications that can help relieve symptoms.

Prostate enlargement is a common problem among men aged 50 and over. Over time, the prostate naturally enlarges and can eventually lead to urinary problems such as weak stream, urgency, starting and stopping, difficulty expelling urine, urinating too frequently, and feeling like you haven’t fully emptied your bladder. Patients may also begin to pass water several times during the night, which can disrupt sleep.

Anyone experiencing these symptoms should contact their GP as cancer must be excluded. However, in most cases, this is due to prostate enlargement.

Alpha blockers are often prescribed. These tablets, like tamsulosin, reduce some of the more annoying problems.

Another possibility is a tablet called finasteride, which can help reduce the size of the prostate. However, it is not suitable for everyone and can lead to erectile dysfunction. It may also take six months to work.

Only in cases where medication does not work or side effects are severe (for example, when patients cannot go to the toilet at all), surgery may be considered.

The procedure, called transurethral resection of the prostate, or TURP, involves inserting a surgical instrument through the penis and cutting off excess tissue. It is usually done under general anesthesia and requires a hospital stay of at least one night. It is highly effective and complications are rare.

I have painful diverticulitis. I experience these attacks that can last for hours, but I was told that it was not an emergency that required surgery. What should I do?

Diverticulitis is where tiny pouches develop in the intestinal wall. These pockets can become inflamed and even infected, leading to stomach aches, nausea, fatigue, and bleeding from the back.

It’s thought to be linked to a low-fiber diet, so what you eat is crucial in combating painful symptoms. Nearly nine in ten Britons don’t get enough fibre, which is why diverticulitis is becoming increasingly common; especially among those over 50. Smokers and those who are obese are also at greater risk.

Surgery may be necessary in severe cases, but this may only be recommended if patients are regularly hospitalized for serious infections. Antibiotics are also offered, but they cannot treat the underlying problem.

Instead, most diverticulitis patients need to increase their fiber intake. Fiber is found in nuts, seeds, whole grains, oats and root vegetables. It can also be taken as a supplement.

However, increasing fiber consumption should be done gradually. This is because a sudden increase can lead to bloating and wind; both of these can exacerbate diverticulitis. For this reason, general practitioners generally recommend not increasing fiber intake during a flare-up.

Patients should also drink more water, lose weight, quit smoking and avoid red meat. Regular exercise can also help.

HRT is not the only answer…

Research from the University of Cambridge this week showed that menopause is linked to a decline in gray matter in key brain regions that influence mood and reaction times. I found this interesting given the backlash from campaigners about antidepressants during menopause; it’s something I’ve never fully understood other than as a sign of the persistent stigma associated with mental health issues.

Anxiety and depression can certainly be features of menopause. And both US and British regulators recommend antidepressants as a treatment for this aspect of transition. This is not nonsense; evidence-based medicine. I’m a fan of HRT when women need it and it changes the lives of many. But these data should put an end to broader claims that HRT prevents aging, protects against dementia, or is the only treatment a menopausal woman may need.

There are countless celebrity examples, such as 67-year-old Sharon Stone, who look gorgeous for their age, but I have patients who look and appear both younger and older than they are.

Are you super old like Sharon Stone?

Are you uncomfortable with getting older? I’m not particularly about wrinkles and gray hair.

But I want to stay healthy for as long as possible, so I’m interested in the different rates at which aging affects people. Of course, there are countless celebrity examples, from A-listers Sharon Stone (67) to Jane Fonda (88) who look gorgeous for their age. I was stunned to learn that Wicked star Jeff Goldblum was 73 years old. But I have patients who look both younger and older than they actually are.

Much of the talk about biological aging is frankly health fiction. But there must be an explanation why some people actually age so slowly. I suspect it’s all in our genes. I want to know what readers think. Do you look much younger? Write to let me know.

Have a question? For Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk