May 24, 2023 – Should you be anxious about hair loss when taking Mounjaro, Ozempic or Wegovy for weight reduction – as recently claimed by some people on social media and reported in news?
The dermatologists and endocrinologists contacted by WebMD agree: No.
It is as much as the person to weigh the advantages of obesity treatment against the risks of therapy, which include the small risk of temporary hair loss, says an authority.
Mounjaro, Ozempic and Wegovy
Of these three newer drugs, the FDA has only approved the drug Semaglutide (ways) for weight control — specifically for individuals with obesity or obese plus at the least one weight-related disorder similar to hypertension, type 2 diabetes and high cholesterol — with a dosage of as much as 2.4 milligrams per week as an injection.
When Wegovy became scarce shortly after its launch, some people resorted to the identical drug, semaglutide, but sold under the name Ozempic for type 2 diabetes, which is run in injections of as much as 2 milligrams weekly, or to tirzepatide (Mounjaro). Tirzepatide is approved within the United States for type 2 diabetes, but not yet for weight reduction.
Wegovy bottlenecks further reports are being made.
Hair loss was a rare side effect in clinical trials of those drugs. In fact, it was more common after bariatric surgery.
In clinical trials, 3% of patients received ways in comparison with 1% of patients on placebo reported hair loss. Hair loss was reported in clinical trials with Ozempic for type 2 diabetes. In a clinical study In a study of tirzepatide for weight reduction in obesity, 5.7% of patients taking the best dose (a weekly injection of 15 milligrams) reported hair loss, compared with 1% of patients receiving a placebo.
In contrast to review Of 18 predominantly observational studies, 57% of patients reported hair loss after bariatric surgery.
Is it the medication or the rapid weight reduction?
None of the experts interviewed for this text had seen patients coming to them with hair loss while taking these weight reduction medications.
“I have not seen any patients complaining about hair loss from these drugs, but perhaps it is only a matter of time,” said Lynne J. Goldberg, MD, a 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 once they shed pounds, generally consequently of the load loss itself and never as a side effect of those medications,” said Katharine H. Saunders, M.D., an obesity physician, co-founder of Intellihealth and assistant professor of medicine at Weill Cornell Medicine in New York City.
“Hair loss on account of rapid weight reduction may be very common [and] not necessarily a side effect of the drug itself, but moderately a consequence of the speed at which weight reduction occurs,” said Susan Massick, MD, associate professor of dermatology at Ohio State University and a dermatologist at the school's Wexner Medical Center.
“Hair loss is insidious,” said Anne Peters, Director of Clinical Diabetes Programs at the University of Southern California. “Losing weight and/or changing weight loss plan results in hair loss. Stress could cause hair loss. Therefore, it’s difficult to separate weight reduction from the consequences of medication.”
Stress relief through rapid weight loss
The experts agreed that the hair loss appears to be related to rapid weight loss.
““It's rare, but we see patients who experience a period of diffuse hair loss, called telogen effluvium or 'stress hair loss,' while also losing weight rapidly,” said Dr. Michael A. Weintraub, an endocrinologist at NYU Langone Health in New York City.
This hair loss occurs during a stressful event that’s either physical (surgery, pregnancy, illness) or emotional, says Weintraub, an assistant professor at NYU Grossman School of Medicine.
Hair loss on account of rapid weight reduction might be brought on by an obesity medication, but it may also occur with other obesity treatments, similar to bariatric surgery and even drastic dietary changes, he said. The hair loss is frequently short-lived and reversible.
About 80 to 85 percent of hair is within the anagen phase (growth phase), about 5 percent is within the transition phase (catagen phase) and the remainder is within the telogen phase (resting phase or hair loss phase), Messick said. Telogen effluvium: Hair that is generally in the expansion phase suddenly enters the telogen phase, leading to rapid hair loss.
“T“Telogen effluvium might be brought on by rapid weight reduction, major surgery, a severe COVID infection, high fever or a death within the family,” she said. “With telogen effluvium, you won't go bald, but you could notice that you just lose a major amount of hair,” much more than the normal loss of up to 100 hairs per day.
“I counsel my patients about the potential for hair loss before bariatric surgery,” Saunders said. “In general, the health advantages of weight reduction and maintenance outweigh the danger of temporary hair loss.”
Nutrient deficiencies and malnutrition can also contribute to hair loss, and sometimes iron deficiency is a culprit, she said.
“If someone is worried” about losing their hair due to weight loss, “they need to see their doctor,” Peters said. “Especially if the person is taking thyroid hormones, the degrees ought to be re-measured after weight reduction.”
“Hair loss appears to be more common after bariatric surgery than when taking anti-obesity medication,” Weintraub said. It is unclear whether this is because the weight loss after surgery is greater and therefore a greater source of stress, or whether it is due to a nutrient deficiency or something else entirely.
Iron deficiency and vitamin D deficiency are the most common nutritional deficiencies that can cause hair loss, he said.
Slow and steady weight loss instead of rapid
“I’d recommend that patients shed pounds slowly and steadily moderately than shedding weight quickly,” Goldberg said, “and keep on with any vitamin and mineral supplementation plans they’re given. Patients undergoing bariatric surgery are given dietary counseling and a supplementation plan.”
““Follow a balanced eating strategy with plenty of protein, vegetables and some fruit,” Saunders said. Health care providers should monitor lab tests to discover and treat vitamin deficiencies, and board-certified dietitians might be crucial to making sure proper nutrition. She advises patients to “find coping strategies to reduce stress and get enough sleep. If iron levels are low, start taking an iron supplement under the supervision of your doctor.”
“Some of my patients swear by biotin supplements, prenatal vitamins or vitamins for hair, skin and nails,” she added. If hair loss doesn't stop, a dermatologist can search for other causes and discuss hair restoration strategies.
People who undergo bariatric surgery require lifelong vitamin supplements and annual (or more frequent) lab tests, she noted.
““For example, if you may have bariatric surgery or any variety of dietary change, you need to be certain that you proceed to eat a balanced weight loss plan when it comes to calories, protein, iron, zinc and vitamins (similar to vitamin D),” Massick said.
Peters also advises: “I’d say you need to eat normally and healthily, even in the event you eat less. Exercise. Do all those healthy things. Taking a every day multivitamin will not be a foul idea. Talk to a nutritionist. Combine the appetite suppressant effects of the medication with a healthy weight loss plan.”
“If someone is newly experiencing hair loss, they need to see their doctor to have all possible causes evaluated,” Weintraub said. “The doctor may investigate underlying causes similar to thyroid dysfunction, iron deficiency and vitamin D deficiency.”
However, if hair loss occurs in patches, it has completely different causes that probably have nothing to do with the anti-obesity medications and should be investigated.
Working with a nutritionist to ensure patients are getting adequate protein and nutrients can lower the risk of hair loss and other complications, Weintraub said. “This is particularly necessary with certain forms of bariatric surgery … as this may result in malabsorption of certain vitamins and minerals that should be measured and supplemented usually.”
If you start taking obesity medication, taking a daily multivitamin will do little harm, he said, and can help ensure you're getting essential minerals and vitamins, though there are no studies yet that have specifically examined this.
“Ultimately, it is vital to weigh the advantages of anti-obesity drugs against the potential risks, as we do with any medical intervention,” Weintraub said.
“The purpose of treating obesity,” he said, “is to scale back the danger of heart disease, stroke and several other forms of cancer. It is as much as each individual to weigh these advantages against the risks of treatment, which include the small risk of temporary hair loss.”