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Semaglutide titration and HRV crashing, anyone else tracking this?

Posted by emma335 in Weight Loss & Metabolic - 2 points, 3 comments.

So I've been titrating up on semaglutide over the last while and I keep a fairly detailed spreadsheet because I'm that kind of person, tracking HRV, resting heart rate, sleep stages, the whole lot, and I've noticed something a bit odd that I can't fully explain. My HRV drops noticeably for about two to three days after each dose increase before it settles back to baseline, and my deep sleep takes a hit too, like it goes from my usual numbers down a fair bit and I feel it in the mornings even though the appetite suppression is working grand. I'm wondering if it's just the GI stress putting my body under load because I do get a bit of nausea on the higher doses, or if there's something about the GLP-1 pathway itself affecting autonomic tone, but I can't find much out there that maps this out properly.

Has anyone else here been tracking HRV or sleep data while titrating and noticed a similar pattern? I'd be really curious to compare notes because for me it seemed to stabilise after about week three at each dose level but I'd love to hear if that matches what others have seen, or if I'm just reading noise into my own data.

Comments

  • weekend_tinkerer: Thats really interesting because i had something similar when i was messing around with a GLP-1 a few months back. My HRV would tank for a couple days after bumping the dose, then crawl back up over the next week or so. Deep sleep took a hit too, felt groggy as anything those first mornings even though weight was coming down nicely. I reckon the GI stress angle makes sense, nausea alone would bump up sympathetic tone right? But i also wonder if its just the calorie drop. When appetite suppressi
  • emma335: Yeah the calorie drop angle is something I hadn't really pulled apart properly, I've been so focused on the GLP-1 mechanism itself that I sort of glossed over the fact that I'm dropping a good chunk of my usual intake in those first few days after titrating. I'm going to try holding calories steady for a week after my next dose bump and see if the HRV still dips the same way or if it softens a bit. Cheers for that, gives me a proper variable to isolate.
  • practicalluis: Yeah the calorie drop angle is a good shout, ngl i didn't think about it that way at first but it tracks. When i dropped intake hard on a cut without any peptide my rhr went up and hrv dipped for a week or so, so maybe the glp-1 is just amplifying that effect. Probably both things going on at the same time, no?
  • emma335: That's a really actually, I hadn't separated out the two things cleanly enough in my head. 5mg step so my intake dropped well below what I'd normally eat on a cut, so it could absolutely be both stacking together. I'll try keeping calories closer to maintenance for the next titration step and see if the HRV still dips as much, that'd help me figure out which is doing more of the damage. Did your numbers come back up once you adjusted intake, or did it take a few weeks?

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