I have a very high variability in my heart rate and am wondering if these numbers strike anyone as concerning. I'd also like this considered with my other issues in mind.

Resting, I'm often around 50-55bpm, 60 if I'm lucky. When I exercise, I go on a treadmill and do a very brisk walk for 157bpm. If I'm sitting with also friend drinking, smoking, talking enthusiastically, it's around 80. After orgasm, it goes down to 43-45bpm and each beat is extremely big, with the rate remaining low for a while. I occasionally have palpitations, and went through a phase a few years ago of having palpitations almost every day. The ECG back then showed nothing but normal sinus arrhythmia, and eventually the palpitations became rarer. I do also have the variation in heart rate according to my breathing, which I'm told is a healthy sign, at least.

I have no diagnosed health issues or allergies as yet, but frequently have fatigue and consequent sleep cycle issues. I also have a red, dry rash on my upper arms that spreads in round, hot blotches all over my upper back and worsens on the arms when I leave the shower. For the rest of the day, the skin there is just dry and itchy, and the red is a bit faded. It doesn't break or go pussy/crusty or anything; simply dry. I have also recently started to develop urticaria/hives on my left arm over seemingly nothing I can relate to each occasion. Most annoying is probably how itchy my head is. I don't have dandruff and don't shampoo or wash my hair too much, but my scalp can become so unbearably itchy that I've gotten out of bed at 3am to stand under a cold shower for relief before. Current moisturisers, washes, and conditioners marketed at sensitive or itchy skin have done absolutely nothing for body or scalp.

I have an apparently "meaningless" but statistically significant positive for ANA and ENA antibodies. Autoimmune issues run riot in my family (mum in particular with many different autoimmune diseases affecting pretty much every aspect of her biology), so I am concerned about this possibility.

The potential for sleep disorder or autoimmune disease is largely being ignored by doctors, despite my persistence and consequent referral to specialists, so I feel like I'll be dismissed if I try to ask about any other symptoms such as my low heart rate or skin. I really would just like someone to look at the whole picture and tell me if anything in particular is of great concern.

I'm a 25yo female, and around 100-105kg (with height of around 5'8/9'). I haven't done regular cardio due to my fatigue for a few years, and I do smoke, so I know my BPM can't be attributed to being a marathon runner or anything particularly healthy.