Reta and Heart Rate

BNLFL said:

maven8518 said:

declan said:

maven8518 said:

I take medication for afib. Since starting reta, my resting heart rate has gone up, though it doesn't worry me. Haven't brought it up with my cardiologist lol
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If you already have a heart condition, what's the reasoning behind choosing Reta? Tirz delivers almost identical advantages and doesn't put that extra pressure on heart rate. I'm curious what made Reta seem like the better option compared to tirz.
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Could be I don't know any better, or perhaps it's because at 41 I still believe nothing can touch me. The rise hasn't struck me as something to worry about.
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Since being hospitalized 3.5 years ago, I've been taking 2 low-dose medications: Metoprolol and Lisinipril. Double Pneumonia, a severe case, triggered afib in my heart. It hasn't returned at any point, and my cardiologist advises I continue the medication. Two weeks back I had my annual exam, and the EKG plus everything else came back fine. These meds cause me no issues whatsoever. I began Reta at the start of the year.
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Yeah, I also take a low daily dose of meto. Since I began the meds a year ago, there haven't been any afib episodes again. I had been on a different medication for 6 months, but during my checkup I asked whether I could stop one or both, so I ended up only on the meto.
 
Low & slow: right now I’m splitting 1mg per week into separate doses. My RHR has climbed by as much as 10 points.

I’m on apixaban (clotting related), and when that is combined with the rise, it becomes my only worry while using Reta. Caffeine sensitivity is real for me too - I had a decaf earlier and I can feel my HR go up.

One odd thing I’ve noticed: I don’t get an increase right after dosing, but on the day before the next dose - my dosing days are Monday and Friday.
 
Cannonball72 said:

While taking Retatrutide, I've noticed my resting HR and Max HR have both gone up. What's odd is that I don't perceive it at all — not while I'm moving, not after.

Yesterday I went for a 25 mile mtb ride, and my max HR reached 208 (I'm 53). Since I don't have a cardiologist on speed dial, I turned to Claude: I uploaded the ride data and asked it to flag anything worrying, because this was the 3rd time I'd seen numbers in that range since starting Reta.

Then I put in the info about my peps and my other medications.

Here's what it came back with.

And yes, I do intend to talk to my Dr.

———————————————————

Heart Rate Concerns — Resolved

The original worry — 208 bpm at age 53 — got broken down step by step:

• The age-predicted max HR formula (220 - age) yields 167 bpm for someone who is 53 — so 208 looks scary at first glance

• Retatrutide (GLP-1 agonist) has produced a consistent +15-20 bpm shift throughout your whole HR range

• Resting HR went from 51 → 67 bpm

• Observed max went from 185 → 208 bpm

• The change is proportional and steady — a pathological cause would show up as erratic, not uniform

• Cialis (vasodilator) probably adds a small amount by bringing blood pressure down during exertion, which drives a compensatory HR increase

• Feeling entirely normal during the ride and 3 hours afterward basically rules out an acute cardiac event

• Action item: Tell your prescribing doctor about the +16 bpm resting HR increase so it can be confirmed stable and the medication combination can be monitored properly

Since starting the medications, a 16 bpm increase in resting HR and a 23 bpm increase in max HR is strikingly consistent. It amounts to a uniform upward shift across your whole HR range — precisely what GLP-1 receptor agonist effects would produce, rather than anything pathological. With a cardiac problem, you'd anticipate an erratic, unpredictable pattern — not a clean, proportional shift.
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I'm the same age as you and in great shape, and if my heart rate behaved like that, I'd toss my supply in the trash. My resting heart rate went from 50 up to 57, and that doesn't sit well with me. My max heart rate hasn't changed. This is with a low dose of Tirz (5mg). A max HR of 208 is absolutely concerning, and so is a jump that large in resting HR. Having a systematic explanation doesn't mean it isn't a problem. Risk tolerance varies from person to person, and perhaps your doctor says it's fine, but I know I wouldn't be comfortable with it.
 
5byfive said:

Cannonball72 said:

While taking Retatrutide, I've noticed my resting HR and Max HR have both gone up. What's odd is that I don't perceive it at all — not while I'm moving, not after.

Yesterday I went for a 25 mile mtb ride, and my max HR reached 208 (I'm 53). Since I don't have a cardiologist on speed dial, I turned to Claude: I uploaded the ride data and asked it to flag anything worrying, because this was the 3rd time I'd seen numbers in that range since starting Reta.

Then I put in the info about my peps and my other medications.

Here's what it came back with.

And yes, I do intend to talk to my Dr.

———————————————————

Heart Rate Concerns — Resolved

The original worry — 208 bpm at age 53 — got broken down step by step:

• The age-predicted max HR formula (220 - age) yields 167 bpm for someone who is 53 — so 208 looks scary at first glance

• Retatrutide (GLP-1 agonist) has produced a consistent +15-20 bpm shift throughout your whole HR range

• Resting HR went from 51 → 67 bpm

• Observed max went from 185 → 208 bpm

• The change is proportional and steady — a pathological cause would show up as erratic, not uniform

• Cialis (vasodilator) probably adds a small amount by bringing blood pressure down during exertion, which drives a compensatory HR increase

• Feeling entirely normal during the ride and 3 hours afterward basically rules out an acute cardiac event

• Action item: Tell your prescribing doctor about the +16 bpm resting HR increase so it can be confirmed stable and the medication combination can be monitored properly

Since starting the medications, a 16 bpm increase in resting HR and a 23 bpm increase in max HR is strikingly consistent. It amounts to a uniform upward shift across your whole HR range — precisely what GLP-1 receptor agonist effects would produce, rather than anything pathological. With a cardiac problem, you'd anticipate an erratic, unpredictable pattern — not a clean, proportional shift.
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I'm the same age as you and in great shape, and if my heart rate behaved like that, I'd toss my supply in the trash. My resting heart rate went from 50 up to 57, and that doesn't sit well with me. My max heart rate hasn't changed. This is with a low dose of Tirz (5mg). A max HR of 208 is absolutely concerning, and so is a jump that large in resting HR. Having a systematic explanation doesn't mean it isn't a problem. Risk tolerance varies from person to person, and perhaps your doctor says it's fine, but I know I wouldn't be comfortable with it.
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I wasn't really convinced the watch was accurate — it's a Garmin, and it got an update 3 days ago. Over my last two rides, everything has gone back to baseline.

Had I genuinely sensed my heart straining like that, I'd have quit right then. Yet I never experienced that sort of strain.

On the last two rides, with fairly comparable effort, my Max HR returned to a typical 178. And at 178, I could definitely feel it.
 
Cannonball72 said:

While taking Retatrutide, I've noticed my resting HR and Max HR have both gone up. What's odd is that I don't perceive it at all — not while I'm moving, not after.

Yesterday I went for a 25 mile mtb ride, and my max HR reached 208 (I'm 53). Since I don't have a cardiologist on speed dial, I turned to Claude: I uploaded the ride data and asked it to flag anything worrying, because this was the 3rd time I'd seen numbers in that range since starting Reta.

Then I put in the info about my peps and my other medications.

Here's what it came back with.

And yes, I do intend to talk to my Dr.

———————————————————

Heart Rate Concerns — Resolved

The original worry — 208 bpm at age 53 — got broken down step by step:

• The age-predicted max HR formula (220 - age) yields 167 bpm for someone who is 53 — so 208 looks scary at first glance

• Retatrutide (GLP-1 agonist) has produced a consistent +15-20 bpm shift throughout your whole HR range

• Resting HR went from 51 → 67 bpm

• Observed max went from 185 → 208 bpm

• The change is proportional and steady — a pathological cause would show up as erratic, not uniform

• Cialis (vasodilator) probably adds a small amount by bringing blood pressure down during exertion, which drives a compensatory HR increase

• Feeling entirely normal during the ride and 3 hours afterward basically rules out an acute cardiac event

• Action item: Tell your prescribing doctor about the +16 bpm resting HR increase so it can be confirmed stable and the medication combination can be monitored properly

Since starting the medications, a 16 bpm increase in resting HR and a 23 bpm increase in max HR is strikingly consistent. It amounts to a uniform upward shift across your whole HR range — precisely what GLP-1 receptor agonist effects would produce, rather than anything pathological. With a cardiac problem, you'd anticipate an erratic, unpredictable pattern — not a clean, proportional shift.
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Here's where things stand now.

After 12 weeks of Retatrutide, my resting heart rate appears to be settling back down. Today it came in at 56, which is pretty close to the 51-53 I used to see before starting Reta.

That strange max HR number that worried me looks like it was either a one-off or a glitch with my device. My Garmin got a software update not long ago, and on a comparable mountain bike ride at a similar effort level, my max HR was right back where it normally sits, at 178.

Bottom line: my RHR is drifting back toward my pre-Reta baseline, which lines up perfectly with what the studies had indicated. As for the max HR reading, I'm chalking it up to either an anomaly (I never actually felt overworked) or a problem with the device itself.
 
wonttellyou said:

I can back this up. Even during the night, my resting HR sits at 77.
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At what dose are you? The night after I increased to 4mg, my sleeping hr reached 82. Now, 3 nights later, it's about 79, yet still 10-12 higher than before rets.
 
Retarage said:

wonttellyou said:

I can back this up. Even during the night, my resting HR sits at 77.
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At what dose are you? The night after I increased to 4mg, my sleeping hr reached 82. Now, 3 nights later, it's about 79, yet still 10-12 higher than before rets.
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Right now I'm on 8 mg, and the reading is 88, not 77.
 
declan said:

maven8518 said:

I take medication for afib. Since starting reta, my resting heart rate has gone up, though it doesn't worry me. Haven't brought it up with my cardiologist lol
Click to expand...
If you already have a heart condition, what's the reasoning behind choosing Reta? Tirz delivers almost identical advantages and doesn't put that extra pressure on heart rate. I'm curious what made Reta seem like the better option compared to tirz.
Click to expand...
There are many cautions circulating about Reta, tachycardia, and arrhythmia. Stay cautious.
 
A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
 
Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

What's that conclusion drawn from?

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

Once more, what's it based on?

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

On its own or alongside GIP, GLP influences RHR — Sema and Tirz demonstrate this. It's odd to assume that Reta's GLP/GIP action at lower doses would leave heart rate untouched. Sema and Tirz raised RHR by 2-4bpm. After 16 weeks on Reta, my RHR appears to have topped out and is now falling; over the last two weeks it averages ~4-6bpm higher than my 5 year mean.

A 6bpm bump in RHR means nothing to me when a big Reta dose is stripping off roughly 2.5lb of FAT (not weight) each week.

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

If GCGR signaling isn't your goal with Reta, what's the point over Tirz?

For fairly lean folks who only want to trim some weight, low and slow might plausibly work. For those with elevated BMI aiming to shed, say, 15%+ of their body weight, it makes less sense.

My aim is to lose 30-35% of my weight. Trial data shows consistent plateau timing across doses, so low and slow doesn't appeal to me. Tirz plateaus after about a year, whereas reta seems to plateau around 18 months. I haven't come across research on people raising their dose after that time-based plateau and seeing their weight move meaningfully in either direction.

Research clearly shows higher doses taken earlier carry much greater long term weight loss potential than lower doses. Anecdotes and emerging research indicate that cycling GLP drugs produces tolerance, with lower efficacy and worse outcomes.
 
woundcarping said:

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

What's that conclusion drawn from?

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

Once more, what's it based on?

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

On its own or alongside GIP, GLP influences RHR — Sema and Tirz demonstrate this. It's odd to assume that Reta's GLP/GIP action at lower doses would leave heart rate untouched. Sema and Tirz raised RHR by 2-4bpm. After 16 weeks on Reta, my RHR appears to have topped out and is now falling; over the last two weeks it averages ~4-6bpm higher than my 5 year mean.

A 6bpm bump in RHR means nothing to me when a big Reta dose is stripping off roughly 2.5lb of FAT (not weight) each week.

Cannonball72 said:

A hypothesis I've been forming about Reta: if your heart rate climbs, dropping to a smaller dose may be worth trying.

Previously, the common assumption with Reta was that you needed 4mg/wk before the glucagon portion became active.

Since glucagon influences HR, my read is that this glucagon activity is showing up below the 4mg mark. Otherwise, there'd be nothing to explain a higher HR under 4mg.

For me, the HR change appeared once I reached 3mg/wk. I didn't connect it to the Reta at the time — foolishly, I let a strong preference for the literature override what my own body was telling me. So I kept escalating toward 4mg, chasing the glucagon effect.

Minimum effective dose matters a lot to me. Right now I'm stepping back down, I'll watch what 3mg does, and should my appetite surge, I'll add low dose tirz and track things until I land on a sweet spot.
Click to expand...

If GCGR signaling isn't your goal with Reta, what's the point over Tirz?

For fairly lean folks who only want to trim some weight, low and slow might plausibly work. For those with elevated BMI aiming to shed, say, 15%+ of their body weight, it makes less sense.

My aim is to lose 30-35% of my weight. Trial data shows consistent plateau timing across doses, so low and slow doesn't appeal to me. Tirz plateaus after about a year, whereas reta seems to plateau around 18 months. I haven't come across research on people raising their dose after that time-based plateau and seeing their weight move meaningfully in either direction.

Research clearly shows higher doses taken earlier carry much greater long term weight loss potential than lower doses. Anecdotes and emerging research indicate that cycling GLP drugs produces tolerance, with lower efficacy and worse outcomes.
Click to expand...
What I'm putting forward is my own theory, drawn from what I've gone through personally and what others have described. The same studies are on my radar too, and I've likewise come across accounts showing that how Reta hits each person varies a great deal.

My aim is the glucagon effect, but speaking for myself — and I suspect this holds for plenty of others — reaching research-level dosing doesn't strike me as necessary to get there.

Training is a big part of my life, and I log a huge amount of data around it. I had 20% to lose, and 4 months in I'm halfway. Every year I yo-yo, yet this is quicker and smoother than anything I've ever managed.

Alongside that, my RHR hasn't just gone up — my max HR during hard exercise has climbed a lot too. For a man of 53/54, 208BPM isn't normal. I'm very fit, I know my numbers, and 181-185 is my usual range. I'm not the only one seeing this; forums and Reddit etc. document it thoroughly.

If a higher dose works better for you than a lower one, I'm not telling you to avoid it. I'm sure that's often the case. Still, for certain people a lower dose does the job, and locating the smallest amount that works well — while keeping the unwanted effects down — strikes me as important.

Broadly, my point is this: the dose on its own doesn't tell you whether glucagon effect is happening. The signals our bodies give off are what we should be paying attention to. Reta raises HR more sharply than other GLPs, and that in itself is a strong signal that glucagon effect is underway.
 
wonttellyou said:

Wouldn't pairing a beta blocker such as Nebivolol together with empagliflozin be useful in this situation
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I wouldn't give it a second thought.

If lowering your dose still delivers the result you want while fixing the issue, then that's the route to take.

Minimum effective dose to reach your objectives ought to be the aim at all times.

A higher amount isn't necessarily an improvement.
 
The rise in heart rate comes from the glucagon part. That effect starts at 4mg, which is pretty much the second month on Reta.
 
wonttellyou said:

The rise in heart rate comes from the glucagon part. That effect starts at 4mg, which is pretty much the second month on Reta.
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My argument, once more, is this: achieving the glucagon effect may not require 4mg, and the body gives off signals that should make us doubt that assumption.

It's possible that a dose below 4mg is enough — not necessarily for everyone, but for some people it almost certainly is.

Since this is a research compound, everyone is figuring things out along the way. There are no official dosage guidelines that have been provided.

Pay attention to what your body is telling you, and don't attempt to counteract one compound's adverse effect by adding a different one to block it. That path is a wicked rabbit hole.

Begin at a low dose, titrate upward, locate your sweet spot, stay there for a while, then evaluate and make changes.

For certain people the change might be an increase, for others a decrease, and for some this may simply not be the right tool. Any of those results is fine.
 
BNLFL said:

This morning my heart rate came in at 72 bpm, and that falls within my usual range.
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Before starting Reta, my resting heart rate sat between 49-51. These days it's around 65. That number doesn't worry me much. What does get my attention is my max HR. The thing is, the same level of effort used to never push me past 181-185. In my opinion, brushing off these signals isn't a wise move.
 
I've come across this topic previously, and right now I'm taking 6mg of reta. Whether it's ineffective or not is unclear to me, but my heart rate appears to be within the usual range
 
I'm on 8mg and my resting heart rate is 90 bpm. Is that normal, should I lower it? I also use testosterone 250mg per week and I lift weights 4 days a week. I don't do much cardio. Should I?
 
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