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ForumsSemaglutide (Ozempic / Wegovy)Heart rate increase on sema — when to worry vs normal physiology Page 2

Heart rate increase on sema — when to worry vs normal physiology

Dr.RaviCardio Thu, Apr 9, 2026 at 10:07 AM 7 replies 593 viewsPage 2 of 2
BethLabQueen
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Apr 9, 2026 at 11:18 PM#6

One concrete data point for the thread. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

25 20maya_sedona, stefan_berlin, Dr.EM_Chicago and 22 others
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raj_cambridge
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Apr 10, 2026 at 4:31 AM#7

One thing that is still open after Dr.PulmRoch’s answer:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

24 19DoseLogDan, SleepFixSam, PurityPaulOR and 21 others
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paige_pharma
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Apr 10, 2026 at 9:44 AM#8
BethLabQueen said:
Worth knowing that the injection site changes very little.

Adding the part of the answer the thread has not reached. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

23 18adam_van, Dr.SurgeonPGH, rachel_ABQ and 20 others
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Dr.RaviCardio
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Apr 10, 2026 at 2:57 PM#9

Reporting back.

Update since I posted: I held at 1.7mg for a further twelve weeks and lost another 4kg slowly, which settles it for me. I was escalating because the number was available, not because I had stopped responding.

22 17hans_munich, jason_sac26, chris_chi24 and 19 others
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jason_sac26
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Apr 11, 2026 at 4:01 PM#10
paige_pharma said:
The dose-response is real but shallow at the top.

That is correct as far as it goes, and here is where it stops going. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

20 18Dr.PulmRoch, maya_sedona, stefan_berlin and 17 others
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