How Peter uses HR variability as an important metric with patients & for himself personally (AMA #3)

Original release date: 10/29/18
This AMA Clip is a segment pulled from an "Ask Me Anything" episode of The Drive titled: #26 - AMA #3: supplements, women’s health, patient care, and more
Show notes page: peterattiamd.com/ama03/
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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[@lambertronix]

love the HRV early adopter flex followed by lengthy non sequitur

[@adamharlan8422]

You probably dont give a damn but does anyone know of a trick to get back into an instagram account? I was stupid forgot my account password. I love any tips you can offer me

[@mylesjamir4232]

@Adam Harlan instablaster =)

[@sadikvlogs7445]

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[@CoachJohnKelly]

I was thinking the same lol

[@BelleOmbreGrey]

He can be very annoying. Clearly thinks a lot of himself

[@Snowsea-gs4wu]

Starts at 9:00.

[@marionharris5952]

Thanks bro

[@wildcsgotactics]

I'm 34 years old and my Oura ring data says that my HRV in 2019 was ~100. Now it's around 50 which sucks. I'm pretty healthy and my lifestyle didn't change that much in the last few years. Anyone else also experienced such a big drop in a few years? Maybe the Oura algorithm changed?

[@joannsmith3589]

dawback of oura ring: kzbin.info/www/bejne/iqDXnqesq82ofNE

[@NAKMUAYACADEMY]

I'm very curious if you ever used and your opinion regarding Whoop Polar H10 Morpheus ? Oh what is accually happen to the heart long term during long slow cardio and during fast hitt style cardio ? Does one slow one makes heart bigger and the hitt one makes the heart walls thicker ? Regards Mariusz

[@nataliepipe]

The link to the show notes doesn’t have information related to this discussion. I’d love the link to the podcast with more info about the LF/HF numbers. Thanks!

[@Brenthruska]

For a long time I thought my low HRV was due to caffeine intake. I switched from caffeine drinks that were not coffee but same milligrams caffeine and my HRV over a 2 week period doubled. Something about coffee is driving the system into overdrive and it isn’t caffeine. This is my theory

[@hugozavalaflores3953]

Can you please explain more?? So no more caffeine intake?

[@Fisc35]

Thanks for the Clip! I would consider fx. the Oura Ring the most pratical wearable compaired to chest straps and watches. But is it also in the highend in terms of hrv, hr, sleepmeasure, readinessscore and restitutionmeasure before next training session? Best regards Fischer

[@sadikvlogs7445]

kzbin.info/www/bejne/hqOng6mLdrBgadU

[@orbifold4387]

13:30 From EF Team & Whoop, "Curious just how fit the EF team is? On the day the Tour began, the team members’ average resting heart rate was 42 beats per minute (the American Heart Association says that anything between 60 and 100 bpm is normal to push the standard amount of oxygen through your bloodstream), and their average heart rate variability was 139 milliseconds (the average HRV for all WHOOP members is 64 ms). As the Tour progressed, it naturally took a toll on these impressive metrics. After the first week, the team’s average RHR had risen to 51 bpm, and its average HRV had dropped to 73 ms. However, it took just one day of rest for these numbers to bounce back. Following the riders’ day off prior to Stage 10, the EF team’s average RHR and HRV were actually better than they were before the race began, at 40 bpm and 152 ms, respectively. The team also averaged a 90% WHOOP recovery (a measure of the body’s readiness to take on strain) after the first rest day, better than the 73% on the morning of Stage 1."

[@sumitagg1]

I’m a 49 yr old diabetic, 5’6” male. Initially diagnosed in 2017, I weighed 158lbs with a 34.5” waist, a fasting glucose of 160 and HbA1C of 6.8. I then started fasting and dropped 20lbs. My hba1c dropped only to 6.2 with no change in fasting. Doc told me things will improve and I should just continue what I’m doing. In September 2021, found out my hba1c had gone to 8.2% but fasting was 165. Ive now lost another 13lbs using 2days a week of 36 hour water fasts and eliminating sugars. Now am down to 125 lbs. waist is 30.5”. My fasting glucose is down to 100. But my sugar goes up to 130-160 despite not eating till 1pm. When I exercise in the morning, even zone 2, the sugar goes up even more. This makes it impossible to lower my average sugar. It seems I’m better off not exercising. HELP

[@LLee0]

Check out ketogenic diet. It helps me tremendously.

[@mayamagick]

Have you increased mineral/electrolyte consumption?

[@sadikvlogs7445]

kzbin.info/www/bejne/hqOng6mLdrBgadU

[@alexanderohanlon8825]

Are you sure you don't have a really fast red blood cell turn over? Might be worth using a continuous glucose to see what glucose tops out at postprandially and how long it takes to recover , because honestly if you hit 160 and it recovers to 100 with in 30-40min your fine. Also get your fasting insulin checked and look at your trig and hdl ratio 1:1 or lower is better. Also check you cortisol levels as cortisol will cause glycogenolysis and insulin resistance at the muscles... slightly, unless sky high. Also what ever diet you follow get rid of seedoils, too dodgy for how rancid they are and if you're getting what you think.

[@slim_DEE]

Are your trainings high intensity? If so, it might stress your body and produce cortisol that would increase your blood sugar. I would suggest moderate intensity and also focus on building muscle as it is best to improve insulin resistance. Good job with the fasts and cutting sugars, you are on the right path. Keep it up 👌

[@hugozavalaflores3953]

Whats up! Im a 36 yo endurance cyclist, and have a 30 hrv, no matte what I do, I cant get it up... Any suggestions on breathing exercises, pills, etc?

[@guidoravs]

dude on the right be like, "I forgot my steroid smoothie this morning, no deadlifts for me today!"

[@neoneherefrom5836]

Stay on point Pete lol

[@timhood9986]

Does a Fitbit Charge 3 track heart rate variability accurately?

[@imachieving7018]

Wearing one right now. Doesn't track it at all.

[@theantiqueactionfigure]

With the latest firmware it now does.

[@amandamate9117]

try the huawei watch fit. budget smartwatch with spo2 measurement and accurate HRV

[@DanSalazarish]

did you guys ever get the data from the cyclists wearing the oura ring?

[@007StarKiller]

Hello everyone! I am 40 years old and I've been cycling for over 5 years now and recently doing some gym work. I've been measurement my HRV for over a year first with Oura ring and now with Whoop and since the beginning I have shown a really high HRV reading of around 180 on average and as high over 220 when the average for my age it's around 40 to 60. I've been searching the whole web and haven't found any information why I have this abnormally high reading and when consulted my cardiologist didn't have a clue about it. Does anyone have any idea why this is it or coul point me to a direction that I could investigate myself. Any help would be appreciated it. Thanks a lot.

[@ToxicLucidity]

Try another device. Perhaps an Apple Watch or a Garmin?

[@b33u]

I'm the same. I regularly have high HRV readings from 170 -215. Were you able to find any additional information information on higher HRV's. I wear a whoop band.

[@gutchiespencer2714]

​@@b33uHe's asking you you're asking him....😂

[@drsus0]

The whole EF team wore whoop bands, one of them has to be willing to show you what it recorded

[@donmulder8061]

I did all the things they say to do. I dropped my HBA1C. I lost weight. I work out daily two to three times for my whole life. I don't eat crappy food. I meditate. I lowered my BP. Then I was drinking a cold drink and had an arrythmia that I was able to end with vagal maneuvers. But after that my heart rate is all over the place. My fitness devices and trackers and home BP monitor no longer tracks heart rate due to inconsistency. My BP monitor says irregular heart beat. The more your heart rate varies, the more likely you have atrial fibrillation. The more likely you will go into non-sinus arrhythmia. "Heart rate variability" means heart rate that varies. High HRV means heart rate that varies more. Take that to its highest limits and you will see a heart rate that changes too much = heart rhythm disorder. Heart rate stability would be better. Heart rate that doesnt skyrocket when you breathe or hear a loud noise. I read about people who die from an alarm going off due to heart attack. Probably not because their heart rate didnt change over minor stimuli. This is all pseudo science. Peel the onion back and you'll find chiropractors pimping special rings, crystals and meditation music.

[@gutchiespencer2714]

Interesting observation 🤔

[@4242brvrdbd]

Important question, what is dr Peter drinking here?

[@DanElton]

Wow small world .. I know will Eden

[@banditkarim2577]

Foot n’mouth. I do that

[@KR-ei2fw]

Love the bedtime story.

[@patriciap5918]

Why might an extremely fit person in their 30s have a very low HRV (20-25ms)?

[@fhowland]

Overstrained or fighting off an illness

[@AlexanderMoen]

has it consistently been like that, or was it a drop-off? If it's a drop-off, was it slow or all at once? Diet, exercise, and sleep are always the first things I look at when my HRV is lower than usual. If those things are on point and it was a slower drop, for me it tends to be something like stress or potentially overtraining. If it was a sudden drop, then I look at what I did the last day or two and consider additional rest and easier (or no) exercise routine that day and also consider the possibility of my body fighting off a sickness or something along those lines too.

[@Cathy-xi8cb]

Stress.

[@thepatternforms859]

My Garmin watch considers 20-25 to be good and healthy. In the green zone…

[@yefremjr]

@@thepatternforms859 garmin uses relative data over your own history, not absolute values. So it's green if it's in line with what you had during last 3 weeks

[@aravindp1862]

Does Apple Watch track HRV accurately?

[@apcut]

check HRV4Training blog, they claim it does

[@ToxicLucidity]

Yes.

[@tusker4954]

Not when compared to Polar H10 but it can show trend.

[@user-je5td9vc9e]

Polar H10

[@garethbrown490]

00😊😊😊😊😊😊😊😊

[@eamonnw]

uhhh wat?

[@sadikvlogs7445]

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[@connorgames6668]

Not going to lie. That green tea drink is not the best hahaha. Had it when I was in china. Not a fan

[@mistahmots]

You had a Japanese drink in China? Ok.

[@smilebot484]

i've never heard anything that doesn't make me think this is hot bs

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