Should I quit Reta due to resting heart rate rising by 20 bpm?

[koevet]

A recent post discussing Reta and heart rate made me see that I'm likely exposing myself to risks that aren't necessary.

About 4 months on Reta so far, and my current weekly amount is 5mg (taken as 2.5mg x 2). Over 10Kg has come off (22 lb), and I'm nearly at the weight I was aiming for (69 kg).

Tesamorelin is also part of my stack, and I've shed a huge amount of visceral fat. Reta genuinely delivers results.

But the negative side: my resting heart rate is up roughly 20 bpm.

A few screenshots from my Oura Ring app are below. The first one dates from a few days prior to starting Reta, while the second was captured yesterday.

Beyond the higher resting heart rate, a pronounced "heart racing" feeling has also been happening to me. I had a 24-hour Holter monitor fitted last week, and the results haven't come back yet.

My suspicion is that this jump in resting heart rate might be excessive. That said, the appetite-suppressing action of Reta is something I really value.

Has anyone else had a resting heart rate climb this dramatically?

If you were me, would you drop Reta entirely, reduce the dose (to 1 mg, say), or make the change to tirzepatide?

P.S. Some background: male, 53yo, 1.72 cm/5.6 feet, 69 kg, gym 3/4 times per week, cardio not a big part of it,

 

[5byfive]

Tirz would be my choice instead. A rise of 20 is simply excessive. Tirz raised mine by roughly 7-8, and I'm not pleased with that; 20 would be unbearable for me. Reta clearly puts more strain on the body, and your reaction appears particularly severe. Since you're close to your target, Tirz should work just as well for finishing the job and keeping you there. Switching looks like pure benefit with nothing to lose.

 

[woundcarping]

My initial reaction is to treat the data with caution and a healthy dose of skepticism, exactly as it's being shown.

Readiness is where your resting heart rate appears, and that's probably a better gauge than trying to eyeball a pair of daily charts.

Since I've got a longer track record with my Apple Watch, that's what I rely on for RHR tracking. The way Apple displays the data also appeals to me more, though I haven't combined Oura's numbers with the Watch's inside Apple Health.

 

[Jfrick11]

koevet said:

A recent post discussing Reta and heart rate made me see that I'm likely exposing myself to risks that aren't necessary.

About 4 months on Reta so far, and my current weekly amount is 5mg (taken as 2.5mg x 2). Over 10Kg has come off (22 lb), and I'm nearly at the weight I was aiming for (69 kg).

Tesamorelin is also part of my stack, and I've shed a huge amount of visceral fat. Reta genuinely delivers results.

But the negative side: my resting heart rate is up roughly 20 bpm.

A few screenshots from my Oura Ring app are below. The first one dates from a few days prior to starting Reta, while the second was captured yesterday.





View attachment 11406

View attachment 11407

Beyond the higher resting heart rate, a pronounced "heart racing" feeling has also been happening to me. I had a 24-hour Holter monitor fitted last week, and the results haven't come back yet.

My suspicion is that this jump in resting heart rate might be excessive. That said, the appetite-suppressing action of Reta is something I really value.

Has anyone else had a resting heart rate climb this dramatically?

If you were me, would you drop Reta entirely, reduce the dose (to 1 mg, say), or make the change to tirzepatide?

P.S. Some background: male, 53yo, 1.72 cm/5.6 feet, 69 kg, gym 3/4 times per week, cardio not a big part of it,

For me, the feeling of my heart racing is a bigger concern than whatever the reading says. When a higher resting heart rate comes with no other signs, that's one situation. But palpitations, a pounding heartbeat, skipped beats, chest discomfort, shortness of breath, dizziness, and similar symptoms make it a very different issue right away.

Since you're already close to your goal weight.... on a personal level, I'd at least think about lowering the dose, or even better, holding off until the Holter results are available.

If everything turns out fine, Tirzepatide tends to raise heart rate less than Reta, probably since it doesn't have glucagon agonism. You said you liked the suppression.... my guess is you'd find it even stronger on Tirz.

Should anything look wrong, I'd leave it to your doctor to judge whether even Tirz makes sense.

 

[DunningKruger]

Middle-aged athletic woman here, though my baseline cardio wouldn't give that away. My RHR was affected the same way.

How far from your target are you? For me, things began to settle down after I started lowering the dose.

An ECG plus a 24-hour Holter were done to look at rhythm problems, and neither showed anything abnormal. I asked about an echocardiogram for structural changes, but my PCP said no.

Since the heart tests were fine and my RHR is getting better, I'll keep tapering off during the coming weeks. Even so, should I ever need a GLP again down the road, Tirz would probably be my choice for this reason.

 

[BNLFL]

My resting heart rate climbed from 70-72 up to 76-80. These days, when I wake up, it sits at 72. During sleep, it lands somewhere between 53-62, varying by the day. That range works for me. I haven't noticed any strange rhythms or anything like that. As for blood pressure, it's been excellent, reading 117/70 over the past few mornings.

 

[jordekorn]

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

 

[BNLFL]

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Have you had a cardiology appointment recently? I'm not joking.

 

[JCO79]

Today I went through the phase 2 data from the Reta studies. It appears that minor arrhythmia issues occurred in 6% of the Reta group versus 3% of the placebo group, and that difference was statistically significant. On average, the heart rate increases reached their highest point at 24 weeks and then began to come down. If you were going into the 130s, you probably were not in normal rhythm. This could be atrial fibrillation or SVT. I agree that if this happens when you are off Reta, you should think about seeing a cardiologist.

 

[SeaGypsy]

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Reta gave me the same reaction. Even a short trip to the bathroom sent it soaring. A few times, while simply sitting in front of the TV, I'd get dizzy, look at my pulse, and see numbers in the 130/140s. I stopped Reta and switched back to Tirz. The problem hasn't come back since.

 

[swimmer]

Certain the retta is behind it? 2mg. My own heart rate climbs more than 10 bpm on Tessamorelin — dropping to 1mg was the only way I felt alright. And I'm not even on Reta.

 

[CMA Pooky]

SeaGypsy said:

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Reta gave me the same reaction. Even a short trip to the bathroom sent it soaring. A few times, while simply sitting in front of the TV, I'd get dizzy, look at my pulse, and see numbers in the 130/140s. I stopped Reta and switched back to Tirz. The problem hasn't come back since.

How much Reta were you taking, and at what dose did you restart Tirz? As I get nearer to my goal weight, I'm also thinking about moving from R to T after I hit that target, because Reta has pushed my resting heart rate higher.

 

[birdwhacker]

Could your health be signaling an issue? Do you take magnesium, potassium, omega 3, and trace minerals every day?

I have a heart condition of some sort — without magnesium, I get palpitations. It's been that way since roughly age 17. I also went hard on stimulants for years, coke and meth among them, and around 5 years back my resting heart rate sat near 90bpm for a stretch.

At 4.66mg per week, my resting rate is about 65bpm now — the lowest it's been in years. I really need more data, but I figure that's in the ballpark.

27 year old male, meh shape, went from 235 down to 210.

 

[SeaGypsy]

CMA Pooky said:

SeaGypsy said:

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Reta gave me the same reaction. Even a short trip to the bathroom sent it soaring. A few times, while simply sitting in front of the TV, I'd get dizzy, look at my pulse, and see numbers in the 130/140s. I stopped Reta and switched back to Tirz. The problem hasn't come back since.

How much Reta were you taking, and at what dose did you restart Tirz? As I get nearer to my goal weight, I'm also thinking about moving from R to T after I hit that target, because Reta has pushed my resting heart rate higher.

Reta was only at 2.5 for me. I switched to 3mg Tirz and began titrating upward. Currently I'm on 4mg Tirz

 

[jordekorn]

BNLFL said:

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Have you had a cardiology appointment recently? I'm not joking.

Nope, though getting some tests done would likely be wise. It doesn't concern me since my heart rate while walking is fine and my blood pressure is normal? My watch has never given a fib warning, and I took an afib test. (My mother in law owns some device from her doctor)

Still, this makes me wonder — I've never felt as drained as I do on Reta, and I've been low on magnesium naturally ever since menopause.

 

[lessthanhalf]

SeaGypsy said:

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

Reta gave me the same reaction. Even a short trip to the bathroom sent it soaring. A few times, while simply sitting in front of the TV, I'd get dizzy, look at my pulse, and see numbers in the 130/140s. I stopped Reta and switched back to Tirz. The problem hasn't come back since.

If the elevated heart rate persists for a long time, it may point to postural hypotension or postural tachycardia, particularly when lightheadedness is present. Blood pressure can be lowered by Reta itself, by weight loss, and by the fluid loss that accompanies losing weight; each of these can weaken the blood pressure response when you stand. Getting a blood pressure monitor is simple: take heart rate and blood pressure while seated, then while standing, and repeat every few minutes until things return to baseline or fail to do so. After that, consider seeing a doctor and bringing those written measurements for guidance. Similar problems could plausibly occur with tirz. It does not raise heart rate as directly, but postural blood pressure problems are certainly possible with it.

jordekorn said:

My scale includes a heart rate reading, so I stay at home, go from the couch or bedroom over to the scale, and weigh myself. Before Reta, my hr sat in the 80s. About a month into 1 mg Reta, it hit 133. My hr while walking normally climbed too, into the 98 to 110 range. I quit taking it, gave it a try a year ago, then again a month ago. The outcome was the same each time, and this last round may have been worse.

For me, using it looks risky. After two weeks off Reta, I'm back to an hr in the low 80s.

This too sounds like it could be postural hypotension or tachycardia, though less obviously so; walking normally improves venous return to the heart, so I would expect the walking heart rate to settle. Still, if you are obese or unfit, a walking heart rate can easily be that high. A resting heart rate that remained at 133 for a substantial period is definitely not normal. It is probably also worth obtaining a blood pressure measuring device and following the same steps described above. If you have lost a considerable amount of weight, that by itself can produce these issues even without reta. How old you are, whether you are obese, and other risk factors matter somewhat; the older you are and the more overweight, the more important it is to have it evaluated. Even so, a basic heart health checkup, ECG, lipids, blood sugar, and so on is not a bad idea. Tirz raises heart rate less than reta, so it might be the better choice.