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Hello and welcome to JA. Dr Saleem here. Will be answering you shortly
Sorry to hear that. So when was the last time you got your thyroid levels checked ? Optimal levels are assessed with TSH levels and not T3 n T4 only so i would like to know if all three were checked or not. You should get an EKG done. If you think the slow heart is causing you symptoms like lightheadedness, near fainting or blackout spells then its better to get Holters monitoring of your heart done under care of a cardiologist. Its also important to know whether you are taking any beta blockers or other medications to control your heart rate ? If yes then the dose needs to be reduced.
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Well if everything came back normal then its just sinus bradycardia , we dont need to treat it unless its causing you symptoms. If symptomatic then cardiac pacemaker can be inserted.
The cause is difficult to be ascertain but its due to slowing of the SA node in heart.
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Well although all these causes can lead to low energy and easy fatiguability but slow heart rate isnt quite explained by these. You should get your electrolytes done including calcium, magnesium , sodium and potassium to see if there is any abnormality there. Imbalance in these electrolytes can lead to a slow heart and weakness subsequently. I am pretty sure you must have had baseline tests like complete blood count to see hemoglobin ( rule out anemia), liver function tests to rule out any liver related malfunction and kidney function tests. If your CBC is suggestive of any mineral or vitamin deficiency e.g iron or B12 deficiency then further specific tests can be done.
Autoimmune conditions like thyroid and addison's can co-exist and go side by side so the probability of addisons cant be ruled out if you are having persistent symptoms of lethargy / weakness.
Serum electrolytes and serum cortisol levels would help find out if there is anything wrong with your adrenals ( for addisons).
Hope it answered your query.