12 weeks on tesofensine: RHR up 9 bpm, appetite gone

Sleep debt drives my RHR more than anything.

Same pattern tends to show up in the numbers people post: RHR up about 8 by week 8, BP basically unchanged. Worth knowing before anyone compares notes — magnesium might account for maybe 3 bpm of that, except sleep usually improves around the same time, so it's hard to tell what's doing what.

My RHR number was garbage until I pinned the conditions down: same alarm, five minutes flat on my back before I sit up, no bathroom trip first. Coffee the night before or a 2am wake-up swings me 6-8 bpm. Your 58 baseline may have been taken more relaxed than the 67. I'd log sleep hours right next to it for a week — half my 9 bpm scare turned out to be sleep debt, not anything else.

Contrarian take: losing weight usually drags RHR down, so an upward drift makes me look at sodium and hydration first. I dropped 2.5 kg in six weeks and my RHR climbed 5 bpm while my BP stayed flat, because I'd cut food volume and salt so hard. Added electrolytes and a real dinner, dropped back 3 bpm in ten days. Worth ruling out before you blame anything else.

TSH sittig unchanged while appetite just vanishes is the most on-brand thing I've read today.

What's your waist tape doing, though? 4.3 kg over 12 weeks is a steady ~0.35 kg a week, and that usually shows in a belt notch before the scale plays nice. My scale sat still three weeks while a pair of 34s went from snug to comfortable, which kept me sane. Are you measuring at the same spot and time each week, or just eyeballing it?

Chest strap or wrist? My watch reads 5-7 bpm higher than my strap if I check it cold right after waking.

Mine went the same direction and it was sleep debt, not the scale. I sat at 62-63 bpm for years, then around week 4 I started getting 5.5-6 hours instead of my usual 7.5 because I kept waking at 3am wired, and my readings crept to 68-70 with nothing else changed. What pulled it back was boring: blackout curtains, no caffeine after noon, and moving my walk from 9pm to 6pm. Eleven days later I was back to 63-64 and it's held for six weeks. The annoying part is I was so sure the higher number meant I was overdoing it that I halved my walking volume for two weeks, and it made zero difference, which tells you how useless that guess was. Second thing I'd look at is how you take the reading. Roll out of bed, bathroom, then sit five minutes and I'm 3-4 bpm lower than testing the second I open my eyes. Same body, same morning. I started writing sleep hours and time-of-reading in the same note as the RHR and the pattern showed up in about a week. Also, my number climbs 2-3 bpm on weeks I lift twice and settles by the weekend, so a heavy week can look scary all by itself.

My weekends are the tell. Friday to Monday I can swing 1.4 kg and pick up 3-4 bpm from late dinners and one beer, then it's gone by Wednesday. If a Monday reading has you rethinking everything, go look at Friday first. And the thing that beat the scale for me was a pair of jeans I couldn't button in January suddenly closing in March.

The thing I’d add: my RHR spike was tied to morning coffee and not eating until noon because appetite was gone. Swapped to a protein shake + electrolytes during the school run, afternoon snack-drawer raids stopped, and resting HR settled a few bpm. Not saying that’s your deal. But are you tracking when you actually eat, not just the scale? With two kids I was unintentionally running on caffeine and air until 2pm and wondering why my heart felt jumpy.

Cold watch readings get me every time — strap or it didn't happen 😂

cold watch readings got me too, my soda swap just made me a shaky little gremlin lol

one thing I’d add: compare RHR to sleep length, not just week number. My numbers looked scary (+7) until I lined them up with a stretch of 5.5h nights and 9k-step “rest days” from walking to the far dining hall. On 7h nights it was more like +2. Cheap dorm protein that didn’t wreck my morning: canned tuna, microwave rice, sriracha, frozen peas. Did yours track with sleep, or was the HR bump stubborn even on good nights?

One thing I didn’t see mentioned: steps/NEAT. When appetite tanked, my daily steps quietly dropped ~2k because I felt flat, and my RHR rose even on identical sleep. I started logging a 10-min walk after dinner + 1L water by noon, and my week 12 RHR was 63 instead of 67. Not claiming causation, just that my activity floor explained more than the week number. Anyone else tracking steps alongside RHR? Curious if the spike follows the step drop for you too.