Week 10 on semaglutide: resting HR up 7 bpm, anyone else tracking?

Opposite trend in a lot of the tracking logs I've seen—RHR down about 4 by week 8. Hydration seems to be the lever there; electrolytes helped.

The part people forget: that same pattern tends to show up in HRV tracking too — dips only for the first 3 weeks after each increase, settled by week 6.

Caffeine same. Sleep shorter because appetite is low and I train later. Not sure it's the med.

I’m not enrolled, but I’ve been watching NCT06897475 because 200 is a decent sample. No HR results posted yet. The 62 in NCT07401992 is small, so I’d treat any wearable signal there as very preliminary. NCT06989203 has 140 and is still recruiting, which is middle ground. Your glucose shift is interesting—mine went 99 to 94 by week 9, but RHR stayed flat. The trial names don’t tell us much without endpoints, though. I’ve seen a lot of people attribute this to sleep and caffeine, but your HRV drop sounds real. Are you logging morning HR or overnight average?

The glucose drop with flat RHR is the opposite of my pattern. What’s your weekly weigh-in trend?

Down 1–2 lb/week then stalled at week 7. RHR stayed up. CRP didn’t move much for me.

Does it usually settle without a dose change? That’s the thing people end up debating—ride it out, or not. Common surprise: sometimes it does level off on its own; sometimes it doesn’t.

Rode it out and resting HR came down 5 bpm over three weeks. Evening caffeine got cut around the same time, so that muddies it. Sleep tracker showed more wakeups early on, then leveled off. The trial enrollment numbers are interesting, but without posted HR endpoints it's just noise. Morning readings at the same time every day are what I'd log.

Same-time morning readings made my data way less noisy. Garmin’s overnight average was all over.

Alcohol doe sthat to me too—more than caffeine. Mine adds 6 bpm for two nights.

My RHR went 54 to 62 around weeks 8–12, then slid back to 57 by week 16. The weird part: the turnaround started when I stopped doing fasted morning workouts and ate a real breakfast, not when I hit some week number. My sleep was also about 25 min shorter, and my Garmin showed that before the HR bump. Down 16 lb and waist is 2.5 in smaller.

Oura user here, and my HRV drop was mostly a weekend-alcohol lie, not this itself. Weeks 7–11 I went from 51 ms to 39 ms, resting HR 56 to 63, and I was sure it was just the weight loss until I looked at the Friday/Saturday graphs. Two glasses of wine tanked my HRV by 10–12 points and added 4–5 bpm, and that showed up for two days. I cut it out for a month, kept losing about 1.1 lb/week, and HRV came back to 47 by week 15 while RHR stayed 3–4 bpm above my old baseline until week 18. The sleep length barely changed, but my deep sleep was trash after those nights. Not saying that’s your case, just one variable worth checking if your tracker breaks it out by night.

Mine tracked way more with speed of loss than week number. Any week I dropped over 2 lb, my Garmin RHR jumped 4–6 bpm and HRV fell 8-ish points; at 1 lb/week it stayed flat. Week 10 was my fastest drop and also a stressful work week, so I stopped weighing daily and added an evening walk. By week 14 it evened out even though I was still losing.

Mine settled around week 13, but HRV lagged a solid month behind RHR. The sleep thing took een longer.

Mine went 56 to 63 around weeks 7-9, and what actually pulled it back down 4 bpm was adding a 20-min after-dinner walk plus one full rest day. I was doing too many hard gym sessions on low sleep. My HRV stayed ugly until sleep steadied, but RHR noticed the recovery first.

Salty takeout night = HRV nosedive, scale up 2 lb, then whoosh. Every time.

I stopped using overnight HRV as my main metric. My Garmin showed a 9 ms drop, but a seated 3-min morning HR was only up 2 bpm. Turns out my sleep tracker was flagging 'poor' on nights I felt fine and missing the nights I was actually stressed about work. Now I compare weekly averages, not daily scores, and the trend looks way less scary.

My leggings are looser while my RHR is higher—body, pick a lane.

My sleep tracker was the tell for me — I was down to 6:50 a night by week 9 versus 7:35 before, and when I dragged lights-out back 45 minutes for two weeks my resting HR slid from 67 to 62 without changing anything else. Weird part: my deep sleep number never budged, so the overnight average was lying to me. Check your sleep duration trend before blaming this.

Mine swings 5-6 bpm on single readings, so I switched to a 7-day rolling average around week 8 and the whole picture got boring — 60 to 64 and holding. Counterintuitive bit: my RHR peaks on my biggest deficit days, not my highest-step days. More food, same steps, HR drops 3-4 bpm within 48 hours. Worth logging intake next to it for two weeks.

Fixed-effort numbers told a different story than my resting HR. I walk the same 3.2-mile loop at 3.4 mph, and my average HR on it went from 129 bpm at week 6 to 120 by week 16 while my resting HR sat stubbornly at 64 the whole time. The reversal: I blamed the med, but the bump lined up with two bad sleep weeks and a work deadline, and once I stopped scrolling in bed and ate an actual lunch it came down to 59 by week 20. The leggings comment cracked me up — waist down 3 inches, RHR up 6 bpm, make it make sense. If you want one number to watch, watch HR at the same pace, not at 3 a.m.

I'd push back on the week-12 timeline — mine didn't settle until around week 22, and HRV never got back to 48. It came back to 43 with a new lower baseline, and the watch kept flagging it as low for another month because it was comparing to my old numbers, so I reset the 90-day baseline manually and the 4 a.m. 'stress' alerts that were themselves trashing my sleep finally stopped. I get why people drop overnight HRV as a main metric. My 90-day baseline now sits at 41 ms, meaning a normal week reads as balanced despite lower raw values, which honestly feels like chasing the baseline more than the physiology. Give it six or eight weeks and look at the trend, not day one.

Mine climbed 58 to 64 around weeks 6-9, and the thing that pulled it back was boring: I was eating almost nothing after 4pm and sleeping like crap. Added a real dinner (protein plus a starch), electrolytes in the afternoon, and RHR eased down 3-4 over two weeks. HRV lagged another week behind that. Not saying it's your cause, but under-eating and short sleep were my levers, not the calendar.

My HRV is a drama queen. One glass of wine and it drops 8 ms overnight, then recovers by Tuesday.

Week 10 is when my after-dinner walks became daily, and I think that messed with my own tracking more than I expected. My RHR went 57→63, but it also lined up with walking later, closer to bed. When I moved walks to before breakfast and added a slow 10-minute cool-down, my overnight HRV crept from 40 to 44 over two weeks. Not claiming cause, just what my Garmin showed. Are you looking at sleep stages or just total sleep? My deep sleep dropped about 15 minutes even when total time was close, and that tracked my HRV dip more closely than overall sleep did.

Similar RHR bump here, but mine mapped more to sleep architecture than the med. Garmin showed total sleep down ~15 min, deep sleep down ~12, and awakenings up; HRV bottomed the same weeks. When I targeted earlier bedtime and a cooler room, RHR dropped 3–4 bpm over ~10 days while calories/deficit stayed same. Are you seeing stage shifts or just shorter total sleep? Also, what’s your overnight respiratory rate/SpO2 doing? Those two moved before my CRP/glucose did, and they’re easy to overlook in Garmin trends.

i’m a few weeks behind you, but mine went 56→62 with a similar HRV dip. The odd part was my Garmin respiration rate ticked up 13.4→14.8 and overnight stress got spikier before RHR moved. Fasting glucose/CRP both improved too, so it feels less like fitness crashing and more like my body running a bit hotter/lighter. Curious—did your respiration rate or Body Battery change, or just RHR/HRV? I only notice mine when I look at 7-day averages, not the daily graph.

Something I track alongside RHR and HRV is Garmin’s overnight respiration and skin-temperature variation. Mine ticked up about 1.5 breaths/min and +0.4°F during a stretch when RHR rose 6 bpm and HRV fell 8 ms; once I cooled the bedroom and kept a consistent wind-down, both drifted back. The 20-minute sleep loss you mentioned can move those before RHR does. Are your respiration and skin-temp trends showing anything, or is it only the HR/HRV side? No medical take, just curious.

RHR is a lagging indicator for me. It only makes sense against a 7-day rolling baseline, sleep midpoint, and overnight respiratory rate. Mine rose ~6 bpm around weeks 8–12 and settled once I held a consistent after-dinner walk and moved my last real meal earlier. HRV stayed dumb until sleep regularity caught up. If respiratory rate and skin temp are flat, I’d treat the

Mine did something similar around weeks 8–12, but the tell was my Garmin “stress” score spiking after late dinners. Moving dinner earlier and a 15-minute walk after helped my RHR drift down 3–4 bpm over two weeks. Are you tracking respiratory rate? Mine bumped up ~1.5 breaths/min when HRV dipped. Also, is your shorter sleep onset or maintenance? My 3 a.m. wake-ups seemed to matter more than total time.

I’m week 14 and had the same puzzle. My RHR went 57→63 by week 7, but when I lined it up against overnight respiratory rate and skin temp in Garmin, the trendline fit better than weight loss itself (r² ~0.6). The lever for me was boring: last meal 3 hrs earlier and less sodium at dinner. RHR settled 63→60 over 9 days; HRV came up ~4 ms, while fasting glucose stayed flat. Did your respiratory rate or body temp shift at the same time? That’s the next column I’d add to your sheet.

One thing I didn’t see mentioned: I started tagging my Garmin nights with “late dinner” vs “done by 6:30.” My RHR was consistently +4–6 and HRV -5–8 on late-dinner nights, even when total sleep was similar. Once I moved my last real meal earlier and stopped fluids 90 min before bed, the morning RHR trend flattened within a week. Might be worth checking your meal timing relative to sleep, not just sleep duration. Are you eating later than usual since your appetite changed, or is your dinner time stable?

I had a similar RHR bump around weeks 8–11: 54→60, HRV 52→43. Mine tracked with low sodium/under-hydration during a work-stress spike, not clearly the med. Garmin’s overnight respiration barely moved, but my skin-temp variation and stress score both rose. Once I started tracking fluids/sodium and front-loaded caffeine earlier, RHR came back down ~4 bpm over 10 days. Did your respiration rate or skin temp shift? Those are the two Garmin metrics I wish I’d logged sooner, since they helped separate general autonomic strain from just weight loss.

I’m a daily weigher/trend-line person too, and my wearable had a weird 8–12 week arc: RHR +5, HRV −7, while fasting glucose and CRP were both improving. The only thing that shifted it back was backing off evening HIIT and staying on top of hydration/electrolytes—my Garmin stress score was basically screaming recovery debt. Took about 3 weeks for RHR to drift down 3 bpm while weight kept trending. Did your stress/body battery chart shift too, or is it only the overnight RHR/HRV numbers?

Systems take: RHR is usually a lagging indicator. Mine tracked sodium/fluid balance harder than anything else—less food volume meant less sodium, and my pulse drifted up. I now log electrolytes like I log protein. Adding consistent sodium/potassium and a 2-hour fluid cutoff before bed dropped RHR 3–4 bpm in a week; HRV lagged another 10 days. What’s your overnight respiratory rate doing? That was my first canary, before RHR moved.

I’ve been maintaining about 14 months. My RHR did a similar +6 climb around weeks 8–12, then quietly came back to baseline by month 4. What finally helped me make sense of it was separating training load from digestive load: late, heavier dinners pushed my overnight RHR up 4–5 bpm even when sleep duration was fine. I started logging “last bite to bed” and kept it over 3 hours; the trend smoothed out. The glucose/CRP improvements while the wearable looked worse was the confusing part. Did your Garmin show any change in overnight respiratory rate or skin temp, or was it only RHR/HRV?

I’m at week 12 and my HRV dip tracked more with sleep timing than total sleep. I was falling asleep 30–40 min later even when the duration looked close. Moving my last coffee to before noon helped my overnight HR drop ~4 and HRV come back ~6 ms. Are you waking earlier or falling asleep later? Also, any new evening workouts or late protein shakes? Those two messed with my overnight numbers way more than the scale did.

Three years here and the sleep-timing angle still feels under-discussed in these HRV/RHR threads. Mine lined up almost exactly with sleep midpoint drifting 45+ min on weekends, even when total sleep was close. Garmin buried it under the sleep score. Once I anchored a consistent wake time and got 10 min of morning light, HRV stabilized within a couple weeks. Did your data show more night-to-night timing variability, or mostly the 20-min-shorter pattern? Curious if that’s the hidden variable for you too.

I use Garmin too; when my RHR rose, it tracked more with sleep fragmentation from a bigger calorie deficit and a colder bedroom than with the med itself. Once I kept my sleep midpoint within 30 minutes and the room at 65–67°F, RHR settled in about 3 weeks. Did your Garmin show overnight respiratory rate or stress score shifting alongside HRV? That helped me separate sleep debt from whatever the medication was doing.

yo week 9 here. my rhr went 54->61 but i noticed it spiked on days i played ranked till 2am and had a zero-sugar soda after dinner. dropping the late caffeine/soda + adding a 10 min cool-down walk before bed brought it back to 56ish in a week. hrv still lagging. did you change caffeine or sodium around week 10? also curious if your garmin stress score moved at the same time as rhr.

I’ve been here since 2022, and my RHR/HRV shift tracked less with recovery scores than with fueling and training load. Around week 8 I was doing more fasted morning walks, and my hard sessions felt harder even as weight dropped; RHR +6, HRV -7. Once I moved tougher workouts out of the fasted window and added an afternoon snack with carbs/protein, both drifted back toward baseline over about 2–3 weeks. Weight loss didn’t stall. Are you doing more fasted sessions or higher intensity now than at week 1? That was the hidden variable in an old 2022 thread on “cardiac drift after GLP.”

Congrats on 14 lb and those glucose/CRP shifts—that’s a big deal. I’m on a similar timeline and my RHR/HRV dip seemed way more tied to hydration/electrolytes than sleep. My Garmin flagged higher RHR after low-sodium days or when I front-loaded caffeine and skipped afternoon water. Are you tracking fluid/sodium intake or caffeine timing? Also, has your workout intensity crept up as you’ve lost weight? I know for me, same pace felt harder for a bit, and backing off one weekly session helped my numbers settle. Curious what your Garmin “readiness” looks like on the higher-RHR days.

I’m week 13 — lost, regained, now back down 9. My HRV dip looked like yours, but the weird one was my watch’s overnight stress score going from ~17 to ~26. It clustered in the first 3 hours after falling asleep and eased when I moved my last real meal earlier by 90 min. Resting HR is still up 3-4 bpm though. Did your respiration rate or overnight stress change too, or is it mainly RHR/HRV?