I have Afib with RVR. What has been your experience been with increased heartrate from Reta?

[keangkong]

I've only had one episode of Afib- but it sticks with ya forever!
I really want to add reta to my tirz, but I hear about the elevated HR and I worry it will agitate my heart. I take beta blockers for the Afib RVR, so maybe that will combat the heartrate issue?

Is the elevated HR temporary?
Is there a sizable group of people that don't get those symptoms at all?

I started taking reta 10 weeks ago. I currently take 1.9 mg per week. My average resting heart rate went up to the mid-50s. Yesterday I received an Apple Watch low heart rate warning stating that my heart had been beating at less than 40 beats per minute for 10 minutes. I decided to disable that feature. My cardiologist previously told me not to worry about my low heart rate. Still, it seems like for me the elevated heart rate passed quickly. Of course, that would likely change if I increased my dose.

I am unqualified to give even a lay opinion as to the dangers of a person who has had afib taking reta.

 

[Garbo]

What dose did you start Reta on and what was your titration schedule/protocol? When did you notice the HR sides?

Started at 2mg, titrated by 2s to 8mg over the course of a few months. Heart rate increased from the get-go and kept going up. Like 30, 40 points.

I ignored it. Why?

Short version: I was a willful idiot, deliberately wearing blinders.

Longer version: I was living in fantasy dreamland. I was energetic, thin as a rail, and told myself I mustn't waste all those expensive vials left in the kit. (Was back when Reta cost a lot more.)

Ended up paying a lot higher price than the Reta cost.

Make no mistake, my heart issue was my fault.

If I had stopped using sooner, I would've been fine. That's my only caution to fellow researchers: "Don't be like me." Pay attention and act accordingly and you'll be fine.

Reta is a wonder and appears to be safe for the majority of folks. I just wasn't one of them.

 

[Cantthinkofauserna]

What was your heart scare, if you don’t mind my asking? I had a bout of persistent afib last year that was ‘fixed’ with a cardioversion and seemingly ‘cured’ with an ablation. I’ve since lost 50 lbs on Tirz (plus diet plus intense exercise routine) and have been maintaining for the last 6 weeks or so. I’m also super fit now as well. Am curious about Reta as a tool to help me maintain (currently experimenting with various Tirz doses, from 3-week hiatus to 5mg, and various doses in between). I’m obviously weary about Reta given the reports of heart issues. Given I’m in maintenance I would start/stay at microdose levels.

Started at 2mg, titrated by 2s to 8mg over the course of a few months. Heart rate increased from the get-go and kept going up. Like 30, 40 points.

I ignored it. Why?

Short version: I was a willful idiot, deliberately wearing blinders.

Longer version: I was living in fantasy dreamland. I was energetic, thin as a rail, and told myself I mustn't waste all those expensive vials left in the kit. (Was back when Reta cost a lot more.)

Ended up paying a lot higher price than the Reta cost.

Make no mistake, my heart issue was my fault.

If I had stopped using sooner, I would've been fine. That's my only caution to fellow researchers: "Don't be like me." Pay attention and act accordingly and you'll be fine.

Reta is a wonder and appears to be safe for the majority of folks. I just wasn't one of them.

 

[runawayjim123]

Y'all are scaring me, my resting is 85-95 Maybe I table the idea of reta.

Mine is similar, I haven’t seen anything indicating this is a problem, have you?

 

[GimmeABreak]

I was diagnosed with Atrial Flutter (similar to AFIB) in Jan-24 which basically caused high heart rate (in the 160's) for a few hours at a time. I had a bunch of testing done by my cardiologist and basically my plumbing was fine but my electrical system wasn't. Treated with Nebivolol 2.5mg and told to monitor it. Went on vacation on a chartered yacht in April in the BVI's and my heart rate went to 161 and stayed there for >24 hours. (I think massive quantities of alcohol was to blame). Went to an ER on Tortola (I don't recommend) and they tried to chemically cardiovert me 8 times with no success. They called my cardiologist and he recommended meds to get it under control. Got stable enough to fly home and had a cardiac ablation in May. My heart rate has been kind of under control since the ablation but still all over the place and can go over 100 for no reason just sitting on the couch.

I started Tirz in late July and noticed about a 5-10bpm increase. I regularly hang out in the mid-80s. Made it to maintenance earlier this year and started reducing Tirz and ramping Reta with a slow titration (2mg 4w, 3mg 4w and now at 4mg). My average heart rate for Jan/Feb/Mar was 80 and RHR has been in the 65-67 range for the past 4 months. So far, Reta has not increased my HR any more than Tirz.

If you are switching from Tirz to Reta I recommend you follow a low and slow titration schedule and closely monitor your HR. If you find it is increasing too much (or you fall out of sinus rhythm) you can alway stop it and go back to Tirz.

 

[Garbo]

(...) and ramping Reta with a slow titration (2mg 4w, 3mg 4w and now at 4mg). My average heart rate for Jan/Feb/Mar was 80 and RHR has been in the 65-67 range for the past 4 months. So far, Reta has not increased my HR any more than Tirz.

If you are switching from Tirz to Reta I recommend you follow a low and slow titration schedule and closely monitor your HR. If you find it is increasing too much (or you fall out of sinus rhythm) you can alway stop it and go back to Tirz.

Yes. This is the way : ))

 

[raw_oyster_eater]

i think the survo elevates too but to a much lesser extent.

 

[Garbo]

What was your heart scare, if you don’t mind my asking? I had a bout of persistent afib last year that was ‘fixed’ with a cardioversion and seemingly ‘cured’ with an ablation. I’ve since lost 50 lbs on Tirz (plus diet plus intense exercise routine) and have been maintaining for the last 6 weeks or so. I’m also super fit now as well. Am curious about Reta as a tool to help me maintain (currently experimenting with various Tirz doses, from 3-week hiatus to 5mg, and various doses in between). I’m obviously weary about Reta given the reports of heart issues. Given I’m in maintenance I would start/stay at microdose levels.

Please forgive me, but my serious heart emergency was rare enough that, to name it here, would pretty much ID me to anyone in my life who might be on this site.

(my username is a reflection of my outsized need for privacy ... if you're old enough to understand the reference, lol.)

And again, I did not mean to frighten you off Reta. I only shared much of my story to caution you to monitor your heart rate trend, and to *act on it* if appropriate.

Chances are good that you will be fine! — because not only are you "super fit," but you are almost assuredly not blinded by the same disordered thinking that I was (am).

 

[raw_oyster_eater]

people can take nebividol to tamp it down.

 

[Cantthinkofauserna]

Please forgive me, but my serious heart emergency was rare enough that, to name it here, would pretty much ID me to anyone in my life who might be on this site.

(my username is a reflection of my outsized need for privacy ... if you're old enough to understand the reference, lol.)

And again, I did not mean to frighten you off Reta. I only shared much of my story to caution you to monitor your heart rate trend, and to *act on it* if appropriate.

Chances are good that you will be fine! — because not only are you "super fit," but you are almost assuredly not blinded by the same disordered thinking that I was (am).

No problem. So I guess it wasn’t a case of you had afib, cured it, then Reta put you back into it! That was my main question/concern.

 

[Garbo]

No problem. So I guess it wasn’t a case of you had afib, cured it, then Reta put you back into it! That was my main question/concern.

No, and I *would have* told you if it were, I promise

 

[raw_oyster_eater]

carry a set of paddles around?

plug them into a wall outlet. voila.

 

[chmuse]

Mine is similar, I haven’t seen anything indicating this is a problem, have you?

I'm a girl, they just said it's anxiety. It's just below concerning level, so I think it's withing normal bounds.

 

[raw_oyster_eater]

I'm a girl, they just said it's anxiety. It's just below concerning level, so I think it's withing normal bounds.

please take some happy meds ASAP!

 

[GimmeABreak]

people can take nebividol to tamp it down.

Note that I have zero medical training but Primum Non Nocere is a doctor and posted a multi-post writeup on this topic on The Roundtable. This a paraphrase from his post.

The glucagon-like-effect of Reta is what raises your heart rate. Nebivolol is a beta blocker which is a different channel. Glucagon is one of the meds that can be used in the ER to treat overdoses of beta and calcium channel blockers. While these meds can lower your baseline heart rate the glucagon-like-effect of Reta could actually counteract these meds from lowering you heart rate.

I know someone is going to ask for references so here you go: (he always provides them)

Glucagon mode of actionhttps://www.vumc.org/poison-control...why-do-we-give-glucagon-beta-blocker-overdose

BB and CCB toxicity and treatment optionshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767195/

​

 

[raw_oyster_eater]

yea, that's why i say it tamps it down. doesn't aleviate.

i take a full 20 mg nebivolol.

 

[GimmeABreak]

yea, that's why i say it tamps it down. doesn't aleviate.

i take a full 20 mg nebivolol.

Damn!

I was on 2.5mg 2x and my BP was borderline low (90/60) so I couldn't really increase my dosage. A month or two ago I switched to metoprolol 25mg 2x and I am experimenting with substituting 20mg of propranolol for my morning dose every few days. The propranolol works great and better than the other two, but I don't think I want to switch to it 100% because of the side effects and I think its pretty hard on the liver.

I make the changes and let my cardiologist and electrophysiologist know when I have appointments with them. They are both like, "whatever works".

 

[raw_oyster_eater]

so i wonder and believe that heart rate has to go up to get energy burning and fat burning effect.

so if i take reta and a bunch of beta blockers what's the advantage of reta?