Low HRV: Should You Worry? Making Sense of Baselines, Trends, and Daily Swings | Dr. Andy Galpin | Be Well Moments

0:00Welcome to Live Well, Be Well, a show to help high performers improve their health and well-being.

0:10You mentioned something there which I'm really interested in, which is heart rate variability. It's become quite a big topic now of conversation. A lot of people, especially if they're wearing trackers, are aware of the heart rate variability or if they're doing certain workouts, they're always looking at that HRV. Is this a good indicator of health or not? Because mine's always very low. Yeah. Should I be worried? No. Okay. So low doesn't mean anything to me. Great. Good answer. I don't know what wearable you're using. Every one of them is different. Not only is their technology different, but the calculation that they use to derive the number is different.

0:52And so if you're simply comparing a number or a score, it is irrelevant to anybody else. because of that fact alone. Even let's say you're using the exact same wearable devices as a friend of yours, it's still almost irrelevant because your normal homeostatic range differs. In fact, we have a paper in review right now that I co-wrote with some of the folks at Whoop where they looked at, I think it was 2 million data points or 2 million days with HRV score over time. there's also other published research we've done this before in the past we've used stuff um what you have to consider is is it a general health metric yes resting heart rate is as well bmi is as well it is a real metric and it is generally associated with health when you have people that start getting hrvs very very low that is almost always associated with poor health and a higher hrv is generally associated with better health and there is probably 50 plus years of research on this.

1:58So if you ask, is it a real metric? Absolutely. When you ask, should I be concerned about your low score? That's why I quickly said, no, I don't know your normal homeostatic range. I don't know what device or tracker you're on. And I don't know what's normal for you. There are genetic factors, probably 20 or so percent of HRV is just simply genetic. And I don't know if yours is being measured appropriately. or properly. Last thing I'll say on that is, again, I don't know what context low means to you. Cause when I get this from people and clients, I'll get wildly different answers right past this one.

2:38Like, what does low mean? And so low typically means something like, oh, my friend has A, B and C. I'm like that. That doesn't mean shit. Where should it normally sit though? I mean, I feel like men and women are also going to be very different here. Well, okay. Yeah. Again, we have some, a little bit of data on men and women and that it is true men and women are a little bit different and HIV does change with age. That said, the more research coming out suggests that it's not as big of a change as lifestyle. So when we see changes in time via age, it's generally because of worsening health patterns and activities than it is the age per se.

3:15And in fact, in the paper that I'm discussing that'll be out, I think it'll be open access too. You will see a different curve in men and women. And again, at least according to the WHOOP data, so this is again specifically coming from WHOOPS stuff, it dips during menopause or I should say 40 to 50 year or so age because we didn't confirm it's in menopause and those individual people. It's like the menopause window, right? But then it rebounds and goes right back up. So are the numbers different? Yes, for sure. But when you ask like, where should it be? Again, if you were to pick a whoop device and an or device or our device or Morpheus or anybody else, the scores are wildly different.

3:56And so there is no like number. If you contrast that to like resting heart rate, I can give you exact numbers because every device is going to say the same thing. Everyone uses the same equation. It's not the same for HRV. So if you use a Morpheus device, which is if you care about HRV, like that's one of the gold standard ones to use, you might get a score of 20 and that's phenomenal and if you use an aura ring a 20 would be terrible so it's like you're literally talking different equations and calculations not even algorithms like if you get the exact same data in the back end they're using different calculations of heart rate variability where something like resting heart rate there is only one equation how many beats did you beat in one minute that's that's the whole equation right yeah now the technology is different but the equation itself for heart rate variability is is different so devices use them differently so it's a very difficult thing so my advice with hrv is you should pay attention to it the absolute number like pay less attention to the variability is what matters and so if you like what device do you do you mind sharing your although i mean i'll just break you down i have no watch okay so you don't use what do you use for hrv um i have this brand called no watch No watch.

5:14And they are a tracker. And they are amazing. It's called Compassionate Tech, but it basically isn't as – it gives you a rate every four days as a baseline as opposed to every single day, which I prefer because then it doesn't make me obsessive. Does it give you like an average of the four days? Yeah. Okay. A far better way to interpret that. So generally what we will say is you need 21 to 30 days to understand where your baseline is. And then the individual day, like almost has no bearing. So if you wake up today and it's down 10 % or whatever, off. So again, I don't know about company at all, but my assumption is they're giving you it every four days to say, hey, let's normalize the data a little bit, which is a great way to approach it.

5:58Generally, if we see a change in HRV that's not consistent for seven plus days, I don't care. If it is consistent for seven or more days, then we might like start to pay attention like something may be happening here. But one thing you'll see really consistently is the standard deviation that happens with HRV for each individual person, the magnitude of that deviation differs. And that's an important distinction. So let's just say you and I had the exact same device on. And like, what's the number, like give me a score that you would get on yours. It ranges between 10 and 13. Okay, again, I don't even know what that means because I don't know the units.

6:34And HRV? Well, for this device, I don't know what they're using. Okay, yeah. So the units can be different, right? But my resting heart rate is great. What's your resting heart rate? 45. Okay, that's pretty decent. And do you have any idea of like your average overnight respiratory rate? No. Okay, that's more important. Oh, okay. I'd probably pay attention to that. But let's just say 10 to 15, and that's, I assume, based on how you're saying it, that's a bad score on that device. Okay, fine. So let's say mine is 80, okay? Now, if I wake up tomorrow and instead of being at 80, I'm at 75. So I'm down five absolute units.

7:13And let's just say your average, just to make math easy, on yours is 15. And you wake up tomorrow and you're at 10. We both are down five absolute units. But who actually had something happen and who didn't in this case, me or you? Both of us? No. Neither. Nothing happened in me at all. Even though we both went down five units. Right. This is why it matters. In your case, going from 10 to 15, I'm making this all up, right? Or going from 15 to 10 represents a 50 % drop. That's a huge change. For me, going from 80 to 75, I don't know what that number is, but that's a small percent, right? And so when we see that change, when I say like your normal standard deviation, you don't have anywhere to go.

7:58And so my guess is your deviation is within one or two every day. why you can't drop 12 you don't have 12 to drop but i can drop 12 and it still maybe doesn't mean anything i might not have any actual change in my allostatic load until i drop 20 to 5 points or more which is more of a typical thing by the way so even interpreting with from person to person this again that's why i say like it gets really complicated generally roughly here is not perfect but roughly the healthier the person, the more stable their HRV in response to stressors. Generally the opposite happens. So even if somebody came in and on that same device had an 80, but they wake up tomorrow and they're at a 40 and then they're at 115, I might look at that person and go, that person's worse than you who's 15 every single day on that thing.

8:56And so it's not just the number that matters. but it's also the variability that happens. That's a bigger signal to me than the number. So one of my initial answer to you was, no, don't worry, be worried about it. It's all the stuff I laid out. I don't know that device. I don't know if that's been validated. I don't know the data behind that. I don't know what technology they're actually using. I don't know what calculation that they're using. I don't know what that number means. I don't know what units they're using. And then I don't know your variability in HRV. So overwhelming majority of the time with something like HRV, it's fine.

9:31It's not good enough of a metric for me to go, missing all that information alone, that's a problem. We see people all the time who function really, really well, but have a low HRV on a tracker. And we don't see any other signs and signals of nervous system overload or systemic overload or anything else. And so it's another one of my like classic dual answers. It is an important metric. It has been validated HRV on its surface for many decades. It's highly associated with cardiovascular disease, mortality, cancer, like tons of things. And we use it in every single person at absolute rest, at our coaching practices, at all of them.

10:12But there's a lot of context there. So you've mentioned this already. But that thing gives you a lot of like maybe anxiety may or may not be the right word. But I just probably wouldn't use it. That's why I use this one because I don't have to check it every day. And it gives me a much more comprehensive score than all the time having to check. Thanks so much for listening. To hear the full episode, there's a link in the description.