Reta and a 20 bpm resting heart rate jump: stop, lower, or switch?

I would move to tirzepatide. Twenty beats is simply too large an increase. On tirzepatide my own rate rose only seven or eight beats and that already bothers me. Reta seems tougher on the body in general and clearly harder on you. You are close to goal weight, so there is little reason to expect tirzepatide would not finish the job and hold the results. Switching looks like all gain and no loss.

My first reaction is to question how reliable the numbers look when taken from the Readiness screen. That view is probably more consistent than glancing at two single-day charts. I track resting rate with an Apple Watch because I have longer records there and prefer the way it displays the data, though I have not combined the two sources in Apple Health.

The racing sensation worries me more than the exact number. A rise in resting rate without symptoms is one matter. Palpitations, pounding, skipped beats, chest discomfort, shortness of breath or dizziness shift the picture fast. Since you are already near goal, I would at least lower the dose or pause until the Holter results arrive. Tirzepatide tends to lift heart rate less than Reta, probably because it lacks glucagon activity. You said you value the appetite effect; most people find it even stronger on tirzepatide. If the monitor shows anything off, let your doctor decide whether tirzepatide is still appropriate.

Middle-aged athletic woman here, though my baseline cardio numbers would not suggest it. I ran into the same resting-rate problem. Once I started lowering the dose the rate began to settle. I had an ECG and a 24-hour Holter; both were normal. I asked for an echocardiogram to check for structural changes but my doctor said no. With the tests clear and the rate improving I plan to finish tapering over the next few weeks. If I ever need a GLP again I will probably choose tirzepatide for this reason.

Mine moved from the low seventies up to the high seventies. In the mornings it now sits around seventy-two. During sleep it runs between the low fifties and low sixties. I have no odd beats and blood pressure stays around 117 over 70, so I am fine with the change.

My scale shows heart rate. Before Reta, readings after walking from the couch or bedroom were in the eighties. After a month on 1 mg they reached 133. Normal walking rate also climbed from the high nineties into the one-teens. I stopped, tried again a year later and again a month ago, and saw the same or higher numbers. Two weeks after stopping I am back in the low eighties. It feels risky for me.

I looked at the phase-two trial data today. The Reta arm showed a six-percent rate of minor arrhythmia problems versus three percent on placebo, and the difference was significant. Average heart-rate increases reached their highest point at twenty-four weeks and then began to fall. Readings in the one-thirties probably meant you were not in normal rhythm and could point to atrial fibrillation or SVT. Seeing a cardiologist makes sense if that pattern appears off the drug.

Are you certain Reta is the cause? Two milligrams of tesamorelin alone lifts my heart rate more than ten beats. I had to cut it to one milligram before I felt normal, and I am not even using Reta.

There may be another health factor at play. Are you taking daily potassium, magnesium, omega-3s and trace minerals? I have had palpitations since age seventeen if I skip magnesium. Years of heavy stimulant use left my resting rate around ninety for a while. On 4.66 mg a week of Reta mine now sits near sixty-five, the lowest in years. I am twenty-seven, male, not very fit, and have come down from two-thirty-five to two-ten. More data would help.

How long the heart rate stays up might point to postural hypotension or tachycardia, especially when lightheadedness shows up too. Reta lowers blood pressure, weight loss does the same, and the fluid shifts that come with early weight loss add to it, so the body can struggle to keep blood pressure steady when standing. A basic blood pressure monitor makes it simple to check pulse and pressure while sitting, then stand and repeat every couple of minutes to see whether things settle or stay off. That record could be useful if you talk to a doctor. Tirzepatide can create the same standing-related blood pressure problems even though it does not push heart rate up as directly. The pattern here looks like it could be postural hypotension or tachycardia as well, though the signs are less obvious. Walking heart rate would normally come back down because walking improves blood return to the heart, but extra weight or low fitness can easily keep it high during activity. If your heart rate stayed at