Do weight loss drugs like Ozempiz cause hair loss?

May 24, 2023 – Should you worry about hair loss if you take Mounjaro, Ozempic or Wegovy for weight loss – as some have recently claimed on social media and was reported in the news?

The consensus among dermatologists and endocrinologists contacted by WebMD is no.

It’s up to the individual to weigh the benefits of obesity treatment against the risks of the therapy, including the low risk of developing temporary hair loss, an expert says.

Mounjaro, Ozempic and Wegovy

Of the three newer drugs, only this drug has been approved by the FDA semaglutide (Wegovy) for weight control specifically for those who are obese or overweight and have at least one weight-related condition such as high blood pressure, type 2 diabetes and high cholesterol with weekly injections of 2.4 milligrams.

When Wegovy was in short supply soon after it became available, some turned to the same drug, semaglutide, but Ozempic For type 2 diabetes, administered in injections of up to 2 milligrams per week, or with tirzepatidMounjaro). Tirzepatide is approved for the treatment of type 2 diabetes in the United States, but is not yet approved for weight loss.

Wegovy deficiency must still be reported.

Hair loss was an uncommon side effect in clinical trials of these drugs. In fact, it was more common after bariatric surgery.

3% of patients received it during clinical trials Wegovy in contrast, 1% of placebo-treated patients reported hair loss. Hair loss was not reported as a side effect during clinical trials Ozempic In case of type 2 diabetes. That clinical examination Hair loss was reported in 5.7% of patients taking the highest dose of tirzepatid (15 milligrams once weekly injection), compared to 1% of patients receiving placebo.

In contrast, the review Of the 18 mostly observational studies, 57% of patients had hair loss after bariatric surgery.

Is it the drug or the rapid weight loss?

None of the experts interviewed for this story had seen patients come to them with hair loss while taking these weight loss drugs.

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“I haven’t seen any patients complain of hair loss from these drugs, but maybe it’s just a matter of time,” said Lynne J. Goldberg, MD. Professor of Dermatology, Pathology and Laboratory Medicine at Boston University School of Medicine and Director of the Hair Clinic at Boston Medical Center.

Some of my patients lose hair when they lose weight, usually as a result of the weight loss itself, not as a side effect of these medications,” said Katharine H. Saunders, MD, obesity physician and co-founder of Intellihealth. and assistant professor of medicine at Weill Cornell Medicine in New York.

Hair loss due to rapid weight loss is very common [and] not necessarily a side effect of the drug itself, but rather a result of how quickly the weight loss occurs,” he said Susan Massick, MD, is an associate professor of dermatology at The Ohio State University and a dermatologist at the school’s Wexner Medical Center.

“Hair loss is a tricky thing,” she said Anne Peters, MD, director of Clinical Diabetes Programs at the University of Southern California. “Losing weight and/or changing your diet can cause hair loss. Stress can cause hair loss. Therefore, it is difficult to separate the weight loss from the medicinal effect.”

Stress relief with rapid weight loss

Experts agreed that hair loss is associated with rapid weight loss.

“It’s rare, but we see patients who have diffuse hair loss, called telogen effluvium or ‘stress loss,’ and rapid weight loss,” said Michael A. Weintraub, an endocrinologist at NYU Langone Health in New York. City.

This hair loss occurs during a physical (surgery, pregnancy, illness) or emotional stressful event, said Weintraub, an assistant professor at the NYU Grossman School of Medicine.

Hair loss due to rapid weight loss can be caused by an anti-obesity drug, but other obesity treatments, such as bariatric surgery or even drastic dietary changes, can also cause it. Hair loss is usually short-lived and reversible.

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According to Messick, about 80-85% of hair is in the anagen (growth) phase, about 5% is in the transition (catagen) phase, and the rest is in the telogen (resting or shedding) phase. In telogen effluvium, hairs that are normally in the growth phase suddenly enter the telogen phase and cause rapid hair loss.

“T“Telogen effluvium can be caused by rapid weight loss, major surgery, severe COVID infection, high fever, or a death in the family,” he said. normal 100 hair loss per day.

“I counsel my patients about the possibility of hair loss before they undergo bariatric surgery,” Saunders said. “In general, the health benefits of losing weight and maintaining weight outweigh the risks of temporary hair loss.”

Nutritional deficiencies and malnutrition can also contribute to hair loss, and iron deficiency is sometimes the culprit, he said.

“If anyone is concerned” about weight loss, “see your doctor,” Peters said. “If you’re on thyroid hormone, levels should be repeated, especially after weight loss.”

“Hair loss is more common after bariatric surgery than with anti-obesity drugs,” Weintraub said, and it’s not clear whether that’s because the weight loss is more dramatic after surgery and thus a greater source of stress, or nutritional deficiencies or something. completely different.

Iron and vitamin D deficiencies are the most common nutritional deficiencies that can cause hair loss, he said.

Slow and steady weight loss, not rapid

“I recommend that patients try to maintain a slow and steady weight loss, not a rapid one,” Goldberg said. “

Follow a balanced diet strategy with plenty of protein, vegetables and some fruit,” Saunders said. Health care providers should monitor lab tests to check for and treat vitamin deficiencies, and registered dietitians can be key in ensuring proper nutrition. She advises patients. : “Find coping strategies to reduce stress and get enough sleep. If your iron levels are low, start an iron supplement under your provider’s supervision.

“Some of my patients swear by biotin supplements, prenatal vitamins, or hair, skin, and nail vitamins,” she added. If hair loss persists, a dermatologist can seek other contributors and discuss strategies for hair restoration.

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People who have had bariatric surgery need lifelong vitamin supplementation and annual (or more frequent) lab tests, he noted.

For example, with bariatric surgery or any dietary changes, you want to make sure you’re still maintaining a balanced diet, whether it’s calories, protein, iron, zinc, vitamins (like vitamin D),” Massick said.

Similarly, Peters advises, “I would say stick to a normal, healthy diet, even if you’re eating less. Exercise. Do all the healthy things. Taking a daily multivitamin isn’t a bad idea. Talk to a nutritionist. Use an appetite suppressant method. the drug that can be combined with a healthy diet.”

“If someone has new hair loss, they should see their clinician to look at all possible causes,” Weintraub said. “Their provider can assess for underlying causes, such as thyroid dysfunction, iron deficiency, and vitamin D deficiency.”

However, if the pattern of hair loss occurs in patches, there are completely different reasons, probably unrelated to the anti-obesity medication, and this should be evaluated.

Weintraub says working with a nutritionist to make sure patients are getting enough protein and nutrients can reduce the risk of hair loss and other complications. “This is especially important with certain forms of bariatric surgery … as it can lead to malabsorption of certain vitamins and minerals that need to be measured and replenished regularly.”

If you start taking obesity medication, taking a daily multivitamin does little harm and can help you get the essential minerals and vitamins you need. However, no study has yet specifically examined this.

“Ultimately, as with any medical intervention, it is important to weigh the benefits of anti-obesity drugs against the potential risks,” Weintraub said.

“The goal of treating obesity is to reduce the risk of heart disease, stroke and several cancers,” he said. the development of temporary hair loss.”