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Pre-treatment: Measure morning resting heart rate for 5 days Calculate average baseline Record any existing caffeine or stimulant use During treatment: Measure resting heart rate 3 times weekly during dose escalation Continue at each dose for minimum 4 weeks before increasing If resting HR exceeds baseline by more than 15 BPM, hold dose for an additional 2 weeks If resting HR exceeds 100 BPM at rest on two or more measurements, consult physician Expected timeline: Weeks 1-8: minimal heart rate change at starting doses Weeks 8-24: gradual increase of 5-10 BPM at therapeutic doses Weeks 24+: stabilization and gradual decline toward baseline This is the approach most researchers follow successfully, and it aligns with the standard retatrutide dosing protocol used in clinical trials

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One-way or two-way repeated measures ANOVA were used to analyse all studies

The UK product information includes a warning (though not a formal contraindication) for patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, advising vigilance for symptoms such as neck lumps or hoarseness