Ozempic Heart Palpitations: What You Need to Know

1. Dehydration

Ozempic slows gastric emptying and reduces appetite, often leading to decreased fluid intake. Nausea and occasional vomiting can further dehydrate you. Dehydration reduces blood volume, forcing your heart to beat faster to circulate oxygen—causing palpitations.

This was my primary issue. Once I prioritized hydration (64-80 oz of water daily), my palpitations disappeared.

2. Electrolyte Imbalances

Reduced food intake, vomiting, or diarrhea can deplete essential electrolytes—particularly potassium, magnesium, and sodium. These minerals regulate heart rhythm, and imbalances can trigger palpitations, irregular heartbeats, or arrhythmias.

Common scenario: You're eating far less than before, drinking mostly water without electrolytes, and experiencing occasional nausea. Your body's electrolyte balance gets disrupted, leading to palpitations.

3. Low Blood Sugar (Hypoglycemia)

While Ozempic is less likely to cause hypoglycemia than insulin, it can happen—especially if you're also taking other diabetes medications, skipping meals, or drastically reducing carb intake. Low blood sugar triggers a stress response that increases heart rate and can cause palpitations.

Symptoms to watch for: Palpitations accompanied by shakiness, sweating, dizziness, or confusion may indicate low blood sugar.

4. Rapid Weight Loss

Losing weight quickly—especially 2+ pounds per week—can stress your cardiovascular system as it adapts to reduced body mass and blood volume. This adjustment period can sometimes trigger palpitations, even though weight loss is ultimately good for your heart.

5. Increased Heart Rate Awareness

When you lose weight and your overall health improves, you may simply become more aware of your heartbeat because you're more in tune with your body. What feels like palpitations might just be normal heartbeats you're noticing for the first time.

6. Anxiety or Stress

Starting a new medication, worrying about side effects, or stress from lifestyle changes can trigger anxiety-related palpitations. Anxiety and heart palpitations create a feedback loop where worrying about palpitations makes them worse.

Stay Aggressively Hydrated

Drink at least 64 oz (8 cups) of water daily, more if you exercise or live in a hot climate. Set reminders if needed. Don't rely on thirst—Ozempic can suppress thirst cues along with appetite.

Pro tip: Keep a large water bottle with you at all times and track your intake.

Supplement Electrolytes Daily

Use electrolyte drinks or supplements (LMNT, Liquid IV, Nuun, Pedialyte) to maintain sodium, potassium, and magnesium levels. This is especially important if you're eating significantly less food than before.

Why it works: Electrolytes regulate heart rhythm and prevent the imbalances that trigger palpitations.

Eat Regular, Balanced Meals

Even when you're not hungry, eat small meals every 4-6 hours to maintain stable blood sugar. Include protein, healthy fats, and complex carbs in each meal.

Example: Greek yogurt with berries and nuts, or a small chicken breast with sweet potato and veggies.

Limit Caffeine and Stimulants

Caffeine can trigger palpitations, especially when combined with dehydration or low food intake. If you're experiencing palpitations, reduce or eliminate coffee, energy drinks, and pre-workout supplements until they resolve.

Monitor Blood Sugar Levels

If you have diabetes or are taking other blood sugar medications, check your glucose levels regularly. Keep a fast-acting carb source (juice, glucose tablets) handy for treating low blood sugar.

Manage Stress and Anxiety

Practice stress-reduction techniques like deep breathing, meditation, or gentle exercise. Anxiety about palpitations often makes them worse. Remind yourself that most palpitations are benign.

Increase Dose Gradually

If you experience palpitations after increasing your Ozempic dose, talk to your doctor about staying at your current dose longer before titrating up. Slower dose increases give your body more time to adjust.

Can Ozempic cause permanent heart damage?

No evidence suggests Ozempic causes permanent heart damage. In fact, studies show semaglutide reduces cardiovascular risk, including heart attack and stroke. Temporary palpitations from dehydration or electrolyte imbalances don't cause lasting damage once the underlying issue is resolved.

Should I stop taking Ozempic if I get palpitations?

Not necessarily. First, try addressing common causes—hydration, electrolytes, blood sugar, and stress management. Many people resolve palpitations without stopping Ozempic. However, if palpitations are severe, frequent, or accompanied by other concerning symptoms, contact your doctor before your next dose.

Will palpitations go away as my body adjusts to Ozempic?

Often yes, especially if they're related to dehydration or electrolyte imbalances that you correct. As your body adapts to the medication and you optimize hydration and nutrition, palpitations typically resolve. Mine disappeared completely after the first month.

Are heart palpitations more common with Ozempic or other GLP-1 medications?

Heart palpitations aren't a common direct side effect of any GLP-1 medication (Ozempic, Wegovy, Mounjaro, Zepbound). When they occur, it's usually due to indirect factors like dehydration or electrolyte imbalances—common to all GLP-1 drugs because they all reduce appetite and can cause nausea.

Should I see a cardiologist if I have palpitations on Ozempic?

If palpitations are frequent, severe, or accompanied by other cardiac symptoms, your primary care doctor may refer you to a cardiologist for evaluation. Tests like an EKG, Holter monitor, or echocardiogram can rule out underlying heart conditions. For occasional mild palpitations that resolve with hydration, a cardiology referral usually isn't necessary.