Shall I get off Reta, rest bpm +20?

[koevet]

Recently a post about Reta and heart rate, made me realise that I am probably taking some unnecessary risks.
I have been on Reta for about 4 months, currently at 5mg a week (2.5mg x 2). I have lost more than 10Kg. (22 lb) and I am almost at my target weight (69 kg).
I am also stacking with Tesamorelin, and lost a ton of visceral fat. Reta really works.

Now for the downside: my resting heart rate has increased by about 20 bpm.

Here are a couple of screenshots from my Oura Ring app. The first screenshot was taken a few days before starting Reta, and the second one was taken yesterday.


Aside from the increased resting heart rate, I’ve also been experiencing a strong “heart racing” sensation. Last week, I wore a 24-hour Holter monitor and I’m still waiting for the results.

I suspect that this increase in resting heart rate may be too high. On the other hand, I really like the appetite-control effects of Reta.

Has anyone else experienced such a dramatic increase in resting heart rate?

Would you stop Reta completely, lower the dose (for example to 1 mg), or switch to tirzepatide instead?

P.S. For context, I'm male, 53yo, 1.72 cm/5.6 feet, 69 kg, hit the gym 3/4 times a week, not a lot of cardio,

 

[5byfive]

I would switch to Tirz. 20 is just too much. I went up about 7-8 on Tirz and am not happy about it; i couldn't live with 20. Reta is definitely harder on the system and it seems like its especially hard on yours. You are almost at your goal and there is no reason to think Tirz wouldn't be effective for getting you there and maintaining. It seems like all upside and no downside to switch.

 

[woundcarping]

My first thought is to be wary and skeptical of the data as it’s presented.

Your resting heart rate is under Readiness, which would likely be a more a more accurate way of gauging vs eyeballing two days charts.

I have more history with my Apple Watch, so I use it to track RHR. I also prefer how Apple presents the data, but I haven’t merged Oura and the Watch’s data in Apple Health.

 

[Jfrick11]

Recently a post about Reta and heart rate, made me realise that I am probably taking some unnecessary risks.
I have been on Reta for about 4 months, currently at 5mg a week (2.5mg x 2). I have lost more than 10Kg. (22 lb) and I am almost at my target weight (69 kg).
I am also stacking with Tesamorelin, and lost a ton of visceral fat. Reta really works.

Now for the downside: my resting heart rate has increased by about 20 bpm.

Here are a couple of screenshots from my Oura Ring app. The first screenshot was taken a few days before starting Reta, and the second one was taken yesterday.

View attachment 23548 View attachment 23549
Aside from the increased resting heart rate, I’ve also been experiencing a strong “heart racing” sensation. Last week, I wore a 24-hour Holter monitor and I’m still waiting for the results.

I suspect that this increase in resting heart rate may be too high. On the other hand, I really like the appetite-control effects of Reta.

Has anyone else experienced such a dramatic increase in resting heart rate?

Would you stop Reta completely, lower the dose (for example to 1 mg), or switch to tirzepatide instead?

P.S. For context, I'm male, 53yo, 1.72 cm/5.6 feet, 69 kg, hit the gym 3/4 times a week, not a lot of cardio,

The heart racing sensation matters more to me than any number. A resting HR increase without symptoms is one thing. Palpitations, pounding heartbeat, skipped beats, chest discomfort, shortness of breath, dizziness, etc all change the conversation quickly.
You're already near goal weight.... I’d personally consider at least reducing dose or better yet pausing until the Holter results come back.
And if all looks good, Tirzepatide generally seems to cause less HR elevation than Reta, likely because it lacks the glucagon agonism. You mentioned you liked the suppression.... I think you'd find it even stronger with Tirz.
If anything looks off, I'd let your doc decide if even Tirz is a good idea.

 

[DunningKruger]

Middle-aged, athletic female here, although you wouldn’t know it from my baseline cardio. I had the same RHR issue.

How close to goal are you? Mine started to normalize once I began titrating down.

I did go for an ECG and had a 24-hour Holter to check for rhythm issues, and both came back normal. I would have liked an echocardiogram to check for structural changes, but my PCP declined.

With the cardiac testing normal and my RHR improving, I’ll continue titrating off over the next few weeks. That said, if I need a GLP again in the future, I’ll likely use Tirz for this reason.

 

[BNLFL]

Mine went to 76-80 from 70-72 . Now in the mornings it's been 72. When sleeping, my HR is around 53-62 depending on the day. I'm good with that. No weird beats or anything. BP has been great at 117/70 the last couple of mornings.

 

[jordekorn]

My scale has a heart rate measure component, so I’ll be in the house, and walk to the scale from the couch or the bedroom, and weigh myself, before Reta the hr was 80s, on 1 mg Reta, about a month in, hr was 133. Normal walking hr also increased, 98 to 110 area. I stopped taking it, tried a year ago, and again a month ago. Same results, maybe even higher this last time.
Seems sketchy for me to take. I’m back down to low 80s hr after two weeks off Reta.

 

[BNLFL]

My scale has a heart rate measure component, so I’ll be in the house, and walk to the scale from the couch or the bedroom, and weigh myself, before Reta the hr was 80s, on 1 mg Reta, about a month in, hr was 133. Normal walking hr also increased, 98 to 110 area. I stopped taking it, tried a year ago, and again a month ago. Same results, maybe even higher this last time.
Seems sketchy for me to take. I’m back down to low 80s hr after two weeks off Reta.

Been to a cardiologist lately? Serious question.

 

[JCO79]

I was reviewing the phase 2 data from Reta studies today. Looks like the Reta group had a 6% incidence of minor arrhythmia issues compared to 3% in the placebo group, and this was statistically significant. The heart rate increases peaked at 24 weeks, on average, and then started to decline. Going into the 130s, you likely were not in normal rhythm. Could be atrial fibrillation or SVT. I agree you should consider seeing a cardiologist if that happens off Reta.

 

[SeaGypsy]

My scale has a heart rate measure component, so I’ll be in the house, and walk to the scale from the couch or the bedroom, and weigh myself, before Reta the hr was 80s, on 1 mg Reta, about a month in, hr was 133. Normal walking hr also increased, 98 to 110 area. I stopped taking it, tried a year ago, and again a month ago. Same results, maybe even higher this last time.
Seems sketchy for me to take. I’m back down to low 80s hr after two weeks off Reta.

This is exactly what I experienced on Reta. It would shoot up just walking to the bathroom. Serval times just watching TV and I would start feeling lightheaded, check my rate and it's in the 130/140s. I dropped Reta and went back to Tirz. Haven't had the issue since

 

[swimmer]

Are you sure it is caused by the retta? 2mg. Tessamorelin raises my heart more than 10 bpm. I had to drop it to 1mg to feel ok. I am not even on Reta.

 

[CMA Pooky]

This is exactly what I experienced on Reta. It would shoot up just walking to the bathroom. Serval times just watching TV and I would start feeling lightheaded, check my rate and it's in the 130/140s. I dropped Reta and went back to Tirz. Haven't had the issue since

What dosage of Reta were you on and what dosage of Tirz did you start back at? I'm getting closer to goal weight and also want to switch from R to T once I reach goal weight due to the higher resting heart rate on Reta.

 

[birdwhacker]

There might be something wrong with your health. Are you supplementing potassium, magnesium daily? Omega 3? Trace minerals?

I have some kind of heart problem where I get palpitations if I don't take magnesium. Had it since I was like 17. Also abused stimulants for heavily for years, coke meth etc, and for a while my resting heart rate was like 90bpm, probably about 5 years ago.

On 4.66mg a week mine is resting around 65bpm, lowest it's been in years. Need more data actually but I think that's close.

27 years old male in meh shape, down to 210 from 235.

 

[SeaGypsy]

What dosage of Reta were you on and what dosage of Tirz did you start back at? I'm getting closer to goal weight and also want to switch from R to T once I reach goal weight due to the higher resting heart rate on Reta.

I was only at 2.5 Reta. I went to 3mg Tirz and started titrating up. I'm at 4mg Tirz now

 

[jordekorn]

Been to a cardiologist lately? Serious question.

No, but I could use a work up probably. I don’t worry about it because walking hr is normal, blood pressure is normal? My watch has never alerted for a fib, I did an afib test. (Mother in law has some machine from her dr)

This has me curious though, I have never felt more depleated than when on Reta, I have been naturally lacking magnesium since menopause.

 

[lessthanhalf]

This is exactly what I experienced on Reta. It would shoot up just walking to the bathroom. Serval times just watching TV and I would start feeling lightheaded, check my rate and it's in the 130/140s. I dropped Reta and went back to Tirz. Haven't had the issue since

Depending on how long the heart rate stays high , it could be postural hypotension or postural tacchycardia, especially with the lightheadedness. Reta itself will drop blood pressure, as will weight loss, and the fluid loss that happens when you start losing weight will also drop blood pressure, and all can impair the blood pressure response to standing up . It is easy to get a blood pressure machine and measure heart rate and blood pressure sitting in a chair, then standing up and keep doing that every few minutes until it normalises, or does not. And then maybe consult a doctor for advice with that data written down. There is not a lot of reason the same issues could not happen with tirz. It does not increase heart rate as much directly, but will definitely cause postural bp issues.

My scale has a heart rate measure component, so I’ll be in the house, and walk to the scale from the couch or the bedroom, and weigh myself, before Reta the hr was 80s, on 1 mg Reta, about a month in, hr was 133. Normal walking hr also increased, 98 to 110 area. I stopped taking it, tried a year ago, and again a month ago. Same results, maybe even higher this last time.
Seems sketchy for me to take. I’m back down to low 80s hr after two weeks off Reta.

This also sounds like it might be postural hypotension or tacchycardia, but not as clear, I would expect the walking heart rate to normalise as walking usually increases blood flow return to the heart. But if you are obese or unfit walking heart rate can easily be that high. If your heart rate stayed at 133 at rest for a fair while, that is definitely not normal. Probably also worth getting a blood pressure measuring machine and doing the same thing described above. If you have lost a fair bit of weight that alone can cause those issues even without the reta. Depends a bit on how old you are and if obese or other risk factors, and the older you are and more overweight the more important it is to get it checked out. But a basic checkup on heart health , ECG, lipids blood sugar etc is not a bad idea. Tirz increases heart rate less than reta, so might be a better option.