Energy level- What steps next

[JR1952]

At age 50 passed all physicals just fine. I had repeated ear infections with vertigo at age 53 and had a 2nd echo cardiogram after which I was told I had LVH, and put on a Beta Blocker and then an ACE inhibitor. In the doctors offices I often have HBP, but at home the reading are lower. (I am now 56 YO, 208 Pound at 6'-4")

The Doctors must not have been reading my charts to well since I have had a slow heart (Bradycardia) diagnosed in my 20's. (Resting heart rate at 38) The Doctor had me set up with a holter monitor which confirmed that my BP was normal, and since I have given up caffeine I now have many reading like 100/61 and 95/67. Caffeine seams to cause my BP to increase very easy, so I try to avoid it as much as possible)

(I am on 5 MG Enalapril) Also in the last few years I have been diagnosed with Hypothyroidism and I am on 50 MCG Levothryroxin.

I am now age 56 and my energy levels fluctuate greatly, I have noticed I feel fatigued after eating so I have been eating smaller portions and feeling better latter in the evening. (Been up and down with energy after eating the last few years, the Doctor tells me this is not unusual)

Also my last two blood tests my  creatine Blood work is at 1.5 MG (Up slightly over what lab says is high)

Should I go in and get rechecked for Thyroid or is there another test to check for other issues?
On the LVH, since trying to give up caffeine my BP seams to have dropped off to a lower level but so has my energy. Is having a Heart Check-up up at the Mayo Clinic worth while to consider? (Coffee seams to have speed me up to much)
Any other ideas to consider, I walk 1 mile a day and try to work out several time a week, eat more fish, less red meat)

Thanks

[grendslori]

A few things come to mind for me. If you have LVH and the heart is enlarged it may be pressing on the stomach to the degree that you can't eat as much. The Holter, as far as I'm aware doesn't take blood pressures, it only takes a history of the heart beats. How was it taking your BP? If your heart rates are in the high 30s, you need to have a pacemaker. The heart can actually stop beating with heart rates in the 30s! Why haven't you had a pacemaker inserted? Low heart rates as well as HCM (LVH) can also cause fatigue. Go to the Mayo Clinic if you can (I don't know where you live) or another major facility that deals with HCM issues and be evaluated by someone who uinderstands this disease. HCM patients usually do better on Calcium Channel Blockers as opposed to Beta Blockers, which makes me kind of wonder if your doctor realizes that.(We've been there, dealt with this disease for years with our daughter, who finally had a transplant. She was one of the worst cases seen in this country) Get to the Mayo clinic if you can.  

[JR1952]

The holter monitor did take BP readings about every 15 minutes for 24 hours. BP readings ran from 106-159 mean Systolic was 124 and the mean Diastolic 78, min HR was 40 and the Max was 90 avg HR was 59 (Over 24 HR)
I can exercise without any discomfort, it is just that it seams that the last few years the body is not getting any breaks, every time I get tested I come up with another issue. The energy levels over the course of a week is all over from being just fine to just dragging.  
When I work out on an elliptical I can get my HR up to 130 (12-15 minutes workout)
I agree with the DR starting with Beta Blockers assuming my BP was out of control and needing multiple medication, so far I have done more with quitting caffeine. (My energy level was better with caffeine, but cause very high BP reading)

[grendslori]

JR a heart rate of 130 after 12-15 minutes of work-out is not normal. The reason you are dragging is because your heart rate isn't keeping up with the demands you are putting on it. HCM is a form of diastolic heart failure. The walls are stiff and that causes the heart muscle to not be able to relax and fill with blood. You asked about a re-check at the Mayo Clinic, go if you can, it would certainly be worth your while.