Heart rate on Reta

[wonttellyou]

Can confirm. Resting HR is at 77 even at night.

 

[maven8518]

I'm on two low dose Metoprolol and Lisinipril from when I was in the hospital 3.5 years ago. A bad case of double Pneumonia put my heart in afib. It's never come back since and my cardiologist wants me to stay on it. I was just there two weeks ago for my yearly check up, and all good on everything and the EKG. They don't bother me at all. I'm on Reta since the first of the year.

Ya im on daily low dose meto as well. No afib repeats since starting the meds a year ago. I was on another med for 6 months but at my checkup I asked if I could come off one or both and so dropped to just the meto.

 

[Zephy]

Low & slow: currently on 1mg per week split-dosed. My RHR increased up to 10 points.

I am taking apixaban (clotting related) and combined with the increase making this my only concern on Reta. I can confirm the sensitivity to caffeine - had a decaf earlier and can feel the increase in HR.

Something curious I found: I don’t notice an increase after dosing, but the day before the next one - I dose Monday and Friday.

 

[5byfive]

I have observed increase in both resting HR and Max

———————————————————

Heart Rate Concerns — Resolved

Initial concern about 208 bpm at age 53 was systematically explained:

• Age-predicted max HR formula (220 - age) gives 167 bpm for a 53-year-old — making 208 appear alarming on the surface

• Retatrutide (GLP-1 agonist) has caused a uniform +15-20 bpm shift across your entire HR range

• Resting HR moved from 51 → 67 bpm

• Observed max moved from 185 → 208 bpm

I'm your age and in execllent shape and if my heart rate did that, I would throw my stash in the garbage. My RHR has gone up from 50 to 57 and I'm not happy about it. My maxHR has been stable. That's on low dose Tirz (5mg). 208 max HR is definitely alarming and so is that big a jump in resting HR. Systematically explained is not the same as not an issue. Everyone has their own risk tolerance and maybe your doctor clears it as ok, but I know I wouldn't be ok with it.

 

[Cannonball72]

I'm your age and in execllent shape and if my heart rate did that, I would throw my stash in the garbage. My RHR has gone up from 50 to 57 and I'm not happy about it. My maxHR has been stable. That's on low dose Tirz (5mg). 208 max HR is definitely alarming and so is that big a jump in resting HR. Systematically explained is not the same as not an issue. Everyone has their own risk tolerance and maybe your doctor clears it as ok, but I know I wouldn't be ok with it.

I honestly didn’t trust the watch, I wear a Garmin, had an update 3 days ago. Last two rides, my numbers are all back to normal.

If I had actually felt like my heart was working like that, l would have stopped on the spot. But I didn’t feel that kind of stress at all.

Last two rides, relatively similar efforts, Max HR back to a normal 178. And at 178 I was feeling it.

 

[Cannonball72]

I have observed increase in both resting HR and Max HR while on Retatrutide. The interesting thing is that I do not feel it at all, either during activity or afterwards.

I did a 25 mile mtb ride yesterday, max HR hit 208 (I am 53). Not having a cardiologist on speed dial, I went to Claude, uploaded my ride details and asked it to pinpoint concern as this was the 3rd time seeing numbers like this since I started taking Reta.

I then entered details about my peps and other meds.

This is what it kicked out.

And yes, I do plan to speak with my Dr.

———————————————————

Heart Rate Concerns — Resolved

Initial concern about 208 bpm at age 53 was systematically explained:

• Age-predicted max HR formula (220 - age) gives 167 bpm for a 53-year-old — making 208 appear alarming on the surface

• Retatrutide (GLP-1 agonist) has caused a uniform +15-20 bpm shift across your entire HR range

• Resting HR moved from 51 → 67 bpm

• Observed max moved from 185 → 208 bpm

• The shift is proportional and consistent — a pathological cause would be erratic, not uniform

• Cialis (vasodilator) likely contributes modestly by lowering blood pressure during exertion, causing compensatory HR elevation

• Feeling completely normal during and 3 hours post-ride essentially rules out an acute cardiac event

• Action item: Inform your prescribing doctor of the +16 bpm resting HR rise to ensure it’s stable and the medication combination is appropriately monitored

A 16 bpm rise in resting HR and a 23 bpm rise in max HR since starting the medications is remarkably consistent. It’s essentially a uniform upward shift across your entire HR range — exactly what you’d expect from GLP-1 receptor agonist effects rather than anything pathological. If it were a cardiac problem you’d expect an erratic, unpredictable pattern — not a clean, proportional shift.

An update on this post.

12 weeks on Retatrutide, my RHR is seemkng to return to normal, recorded 56 today, close to my pre-Reta norm of 51-53.

The max HR anomaly that had me concerned seems to have been either a blip or device anomaly. My Garmin recently had a software update and on similar mtb ride/effort, I was back in my normal max HR range at 178.

Net: RHR is returning back to pre-Reta baseline, this is exactly in-line with what studies had suggested. I am writing off the max HR reading as either an anomaly (I never felt overtaxed) or device reading issue.

 

[Retarage]

Can confirm. Resting HR is at 77 even at night.

What dose are you at? My sleeping hr was up to 82 the night after I titrated up to 4mg. It is around 79 now 3 nights after but sill up 10-12 from pre rets.

 

[wonttellyou]

What dose are you at? My sleeping hr was up to 82 the night after I titrated up to 4mg. It is around 79 now 3 nights after but sill up 10-12 from pre rets.

8 mg currently .. and it is 88, not 77

 

[wulf00777]

With a heart condition why take Reta? Tirz has nearly the same benefits without the increase heart rate pressure. Curious why you decided reta was worth it over tirz.

Lots of warnings out there regarding Reta and tachycardia and arrhythmia. Be careful.

 

[Cannonball72]

Emerging theory I have on Reta is that people experiencing elevated HR should consider titrating down to a lower dose.

With Reta, conventional wisdom was that The glucagon component kicks in at 4mg/wk.

Given the glucagon effect on HR, I think we are seeing glucagon effect kicking in at lower than 4mg. If not, there would be no reason for elevated HR below 4mg.

I noticed effect on my HR starting at 3mg/wk. I did not realize it was probably the Reta, because like an idiot, I had a strong bias to listen to the literature vs. listening to what my body was signaling. I continued to work my way to 4mg in pursuit of the glucagon effect.

I strongly believe in minimum effective dose. I am now working my way back down, will see what happens at 3mg, and if I experience my appetite spiking, I’ll stack with low dose tirz and monitor that until I hit a sweet spot.

 

[woundcarping]

Emerging theory I have on Reta is that people experiencing elevated HR should consider titrating down to a lower dose.

Based on what reasoning?

With Reta, conventional wisdom was that The glucagon component kicks in at 4mg/wk.

Again, based on what?

Given the glucagon effect on HR, I think we are seeing glucagon effect kicking in at lower than 4mg. If not, there would be no reason for elevated HR below 4mg.

GLP affects RHR on its own, or with GIP, as shown with Sema and Tirz. The thought that Reta's GLP/GIP agonism wouldn't affect heart rate at lower doses is curious. Sema and Tirz increased RHR 2-4bpm. 16 weeks on Reta and my RHR seemingly has peaked and is dropping, currently (last two weeks average) ~4-6bpm above my 5 year average.

I absolutely couldn't care less about my RHR being 6bpm faster while taking a large dose of Reta dropping ~2.5lb of FAT (not weight) per week.

I strongly believe in minimum effective dose. I am now working my way back down, will see what happens at 3mg, and if I experience my appetite spiking, I’ll stack with low dose tirz and monitor that until I hit a sweet spot.

If you're not going for GCGR signaling with Reta, why not take Tirz?

Low and slow could conceivably make sense for relatively trim people just wanting to cut weight. For people with elevated BMI and wanting to drop say 15%+ their weight, it makes less sense.

I want to drop 30-35% of my weight. Low and slow is not something that interests me based on trial data showing consistent plateau timing across the various doses. Tirz plateaus after a ~year while reta looks to plateau maybe around 18 months. I haven't seen research on people increasing their dose after that time based plateau and their weight changing appreciably either direction.

I have seen clear research that higher doses earlier have considerably higher long term weight loss potential than lower doses. Anecdotally and emerging research suggests cycling GLP drugs leads to a tolerance with reduced efficacy and reduced outcomes.

 

[Cannonball72]

Based on what reasoning?

Again, based on what?

GLP affects RHR on its own, or with GIP, as shown with Sema and Tirz. The thought that Reta's GLP/GIP agonism wouldn't affect heart rate at lower doses is curious. Sema and Tirz increased RHR 2-4bpm. 16 weeks on Reta and my RHR seemingly has peaked and is dropping, currently (last two weeks average) ~4-6bpm above my 5 year average.

I absolutely couldn't care less about my RHR being 6bpm faster while taking a large dose of Reta dropping ~2.5lb of FAT (not weight) per week.

If you're not going for GCGR signaling with Reta, why not take Tirz?

Low and slow could conceivably make sense for relatively trim people just wanting to cut weight. For people with elevated BMI and wanting to drop say 15%+ their weight, it makes less sense.

I want to drop 30-35% of my weight. Low and slow is not something that interests me based on trial data showing consistent plateau timing across the various doses. Tirz plateaus after a ~year while reta looks to plateau maybe around 18 months. I haven't seen research on people increasing their dose after that time based plateau and their weight changing appreciably either direction.

I have seen clear research that higher doses earlier have considerably higher long term weight loss potential than lower doses. Anecdotally and emerging research suggests cycling GLP drugs leads to a tolerance with reduced efficacy and reduced outcomes.

I am sharing my own hypothesis, based on my experience, as well as others. I have seen the same research, I have also seen testimonial that Reta is very individualistic.

I am going for glucagon effect, but in my case, and I think for many others, I don’t think we need to be at research level doses to achieve that outcome.

I exercise a lot, I collect a lot of data on that exercise. I had 20% to lose, i am half way there in 4 months. I yo-yo every year and this is faster more effortless progress than I have ever seen in my life.

At the same time, I have not only experienced a higher RHR, but a significantly higher max HR while under the stress of exercise. 208BPM for a 53/54 yr old man is not normal. I am extremely fit, I know my data, my norm is 181-185. This is not unique to me, it is well documented in forums and Reddit etc.

I am not discouraging a higher dose if you find it more effective than a lower dose. I am sure this is true. But for some, a lower dose can also be effective, and I think it’s important to find the minimum that works effectively, while minimizing less desirable side effects.

My general point is that the dose itself is not the measure to determine glucagon effect. We should be listening to the signals our bodies are sending. The Elevated HR on Reta is more extreme than other GLPs which is also very clear signal that glucagon effect is occurring.

 

[wonttellyou]

Shouldn't a beta blocker like Nebivolol, in combination with empagliflozin, help here

 

[Cannonball72]

Shouldn't a beta blocker like Nebivolol, in combination with empagliflozin, help here

I would not even consider.

When you can address a problem by dropping dosage and still get the effect you are looking for, that should be the chosen path.

The goal should always be minimum effective dose to achieve your goals.

More is not always better.

 

[wonttellyou]

Butt he Glucagon component is the one responsible for the heart rate increase. And that one kicks in at 4mg, which is basically month two of using Reta.

 

[BNLFL]

My HR this morning is 72 bpm, which is normal for me.

 

[Cannonball72]

Butt he Glucagon component is the one responsible for the heart rate increase. And that one kicks in at 4mg, which is basically month two of using Reta.

Again, my point is that perhaps 4mg is not needed to achieve glucagon effect and there are signals the body sends that force this assumption to be questioned.

Perhaps, it can be lower than 4mg, maybe not for all, but almost certainly for some.

This is a research compound, we are all learning as we go. No official dosage guidelines have been shared.

Don’t ignore what your body is saying, and don’t try to solve the adverse effect of one compound by layering in something different to block it. This is a wicked rabbit hole.

Start low, titrate up, find your sweet spot, settle in for a bit, assess and adjust.

For some, the adjustment may be up, for some it may be down, and for some, it may not be the right tool at all. All of these outcomes are OK.

 

[Cannonball72]

My HR this morning is 72 bpm, which is normal for me.

Prior to Reta, my RHR was 49-51, now it’s ~65, this is not the measure that I am too concerned about. The max HR is something that catches my attention tho. Especially when the same effort never got me higher than 181-185. IMO it’s not smart to ignore these signals.

 

[Notthatguy]

I heard of this before, currently on 6mg of reta. I dont know if it's a dud or not, but HR seems normal