Could 24, 2023 — Do you have to be involved about hair loss when taking Mounjaro, Ozempic, or Wegovy for weight reduction — as was just lately claimed by some individuals on social media and reported in information tales?
The consensus amongst dermatologists and endocrinologists WebMD contacted isn’t any.
It’s as much as the person to weigh the advantages of treating weight problems towards the dangers of the remedy, together with the low danger of creating short-term hair loss, says one skilled.
Mounjaro, Ozempic, and Wegovy
Of those three newer medicines, the FDA has authorized solely the drug semaglutide (Wegovy) for weight administration — particularly for individuals with both weight problems or with obese plus at the least one weight-related dysfunction reminiscent of hypertension, sort 2 diabetes, and excessive ldl cholesterol — with a dosage as much as a 2.4-milligram weekly injection.
When there was a brief provide of Wegovy quickly after it grew to become accessible, some individuals turned to the identical drug, semaglutide, however marketed as Ozempic for sort 2 diabetes, which is given in injections of as much as 2 milligrams weekly, or to tirzepatide (Mounjaro). Tirzepatide is authorized for sort 2 diabetes within the U.S. however not but authorized for weight reduction.
Wegovy shortages proceed to be reported.
Hair loss was an unusual aspect impact within the medical trials of those medicines. In actual fact, it was extra widespread after bariatric surgical procedure.
In medical trials, 3% of sufferers receiving Wegovy versus 1% of sufferers on placebo reported hair loss. Hair loss was not reported as a aspect impact in medical trials of Ozempic for sort 2 diabetes. In a medical trial of tirzepatide for weight reduction in weight problems, 5.7% of sufferers taking the very best dose (a 15-milligram once-weekly injection) reported hair loss in comparison with 1% of those that received a placebo.
In distinction, a assessment of 18 principally observational research reported that 57% of sufferers had hair loss after bariatric surgical procedure.
Is It the Drug or the Speedy Weight Loss?
Not one of the consultants consulted for this story had seen sufferers who got here to them about hair loss whereas taking these medication for weight reduction.
“I’ve not seen sufferers complaining of hair loss from these medicines, however maybe it’s only a matter of time,” mentioned Lynne J. Goldberg, MD, a professor of dermatology and pathology and laboratory medication at Boston College Faculty of Drugs and director of the hair clinic at Boston Medical Middle.
“A few of my sufferers lose hair once they drop some weight, typically on account of the load loss itself, and never as a aspect impact of those medicines,” mentioned Katharine H. Saunders, MD, an weight problems medication physician, co-founder of Intellihealth, and an assistant professor of drugs at Weill Cornell Drugs, in New York Metropolis.
“Hair loss from speedy weight reduction is quite common [and] not essentially a aspect impact of the remedy itself however extra on account of how rapidly the load loss happens,” mentioned Susan Massick, MD, affiliate professor of dermatology at Ohio State College and a dermatologist on the college’s Wexner Medical Middle.
“Hair loss is difficult,” mentioned Anne Peters, MD, director of the College of Southern California’s Scientific Diabetes Applications. “Reducing weight and/or altering your weight loss program causes hair loss. Stress could cause hair loss. So it’s laborious to separate weight reduction from remedy impact.”
Stress Shedding With Speedy Weight Loss
The hair loss appears to be related to speedy weight reduction, the consultants agreed.
“It’s uncommon, however we will see sufferers who’ve a interval of diffuse hair loss, known as telogen effluvium or ‘stress shedding,’ with speedy weight reduction,” mentioned Michael A. Weintraub, MD, an endocrinologist at NYU Langone Well being in New York Metropolis.
This hair loss happens throughout a disturbing occasion that’s both bodily (surgical procedure, being pregnant, sickness) or emotional, mentioned Weintraub, who’s an assistant professor on the NYU Grossman Faculty of Drugs.
Hair loss resulting from speedy weight reduction could possibly be attributable to an weight problems remedy however it may additionally happen with different weight problems therapies, reminiscent of bariatric surgical procedure and even drastic dietary modifications, he mentioned. The hair shedding is usually short-lived and reversible.
About 80% to 85% of hair is within the anagen (development) part, about 5% is in a transitional (catagen) part, and the remaining is in telogen (resting, or shedding) part, Messick mentioned. In telogen effluvium, hairs which can be usually within the development part get out of the blue shifted to telogen part and trigger speedy hair shedding.
“Telogen effluvium may be attributable to speedy weight reduction, main surgical procedure, extreme COVID an infection, excessive fever, or dying within the household,” she mentioned. “You’ll not go bald with telogen effluvium, however you may discover that you could be lose a great quantity of hair,” rather more than the conventional lack of as much as 100 hairs a day.
“I counsel my sufferers about the potential of dropping hair earlier than they bear bariatric surgical procedure,” Saunders mentioned. “Usually, the well being advantages of weight reduction and weight upkeep outweigh the danger of short-term hair loss.”
Dietary deficiencies and malnutrition can contribute to hair loss as nicely, and iron deficiency is usually a wrongdoer, she mentioned.
“If somebody is apprehensive” about hair loss related to weight reduction, “they need to see their physician,” Peters mentioned. “If they’re on thyroid hormone, specifically, the degrees ought to be retested after weight reduction.”
“Hair loss seems extra widespread after bariatric surgical procedure than with anti-obesity medicines,” Weintraub mentioned, and it’s unclear whether or not it is because the load loss is extra dramatic after surgical procedure and thus a larger supply of stress or resulting from nutrient deficiency or one thing else fully.
Iron and vitamin D deficiencies are the commonest dietary deficiencies that may trigger hair loss, he mentioned.
Sluggish and Regular Weight Loss Reasonably than Speedy
“I’d recommend that sufferers attempt to hold the load loss sluggish and regular, quite than speedy,” Goldberg mentioned, “and observe any vitamin/mineral supplementation plan that they’re given. Sufferers with bariatric surgical procedure have dietary steering and a supplementation plan.”
“Comply with a well-balanced dietary technique with ample protein, greens, and a few fruit,” Saunders mentioned. Well being care suppliers ought to monitor lab assessments to examine for and deal with vitamin deficiencies, and registered dietitians may be essential to make sure correct diet. She advises sufferers: “Discover coping methods to scale back stress and get sufficient sleep. If iron ranges are low, begin an iron complement underneath your supplier’s supervision.
“A few of my sufferers swear by biotin dietary supplements, prenatal nutritional vitamins, or ‘hair, pores and skin, and nails’ nutritional vitamins,” she added. If hair loss doesn’t cease, a dermatologist can search for different contributors and talk about methods for hair restoration.
Individuals who bear bariatric surgical procedure require lifelong vitamin supplementation and yearly (or extra frequent) lab testing, she famous.
“With, for instance, bariatric surgical procedure or any sort of weight loss program change, you need to be sure you nonetheless preserve a balanced weight loss program, whether or not its energy, protein, iron, zinc, nutritional vitamins (vitamin D for instance),” Massick mentioned.
Equally, Peters advises: “I’d say to keep up a standard, nutritious diet even when consuming much less. Train. Do all these wholesome issues. Taking a day by day multivitamin isn’t a nasty thought. Speak with a nutritionist. Use the urge for food suppression of the remedy to mix with wholesome consuming. “
“If somebody is having new hair loss, they need to see their clinician to guage for all doable causes,” Weintraub mentioned. “Their supplier can consider for underlying causes like thyroid dysfunction, iron deficiency, and Vitamin D deficiency.”
Nonetheless, if the sample of hair loss happens in patches, this has a wholly completely different set of causes seemingly unrelated to their weight problems remedy and ought to be evaluated.
Working with a nutritionist to verify sufferers have enough protein and vitamins can decrease the danger of creating hair loss and different problems, Weintraub mentioned. “That is significantly vital for sure types of bariatric surgical procedure … since that may result in malabsorption of particular nutritional vitamins and minerals that should be periodically measured and supplemented.”
In case you are beginning an weight problems remedy, starting a day by day multivitamin has little hurt, he mentioned, and may also help be sure you are getting important minerals and nutritional vitamins. Nonetheless, no research have particularly investigated this but.
“Finally, it’s vital to weigh the advantages of anti-obesity medicines towards the potential dangers, as we do with any medical intervention,” Weintraub mentioned.
“The aim of treating weight problems,” he mentioned, “is to scale back the danger of coronary heart illness, stroke, and a number of sorts of cancers. It’s as much as the person to weigh these advantages towards the dangers of the therapy, together with the low danger of creating short-term hair loss.”