Might 24, 2023 — Must you be involved about hair loss when taking Mounjaro, Ozempic, or Wegovy for weight reduction — as was lately claimed by some folks 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 non permanent hair loss, says one knowledgeable.
Mounjaro, Ozempic, and Wegovy
Of those three newer medicines, the FDA has accepted solely the drug semaglutide (Wegovy) for weight administration — particularly for folks with both weight problems or with obese plus a minimum of one weight-related dysfunction similar to hypertension, kind 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 folks turned to the identical drug, semaglutide, however marketed as Ozempic for kind 2 diabetes, which is given in injections of as much as 2 milligrams weekly, or to tirzepatide (Mounjaro). Tirzepatide is accepted for kind 2 diabetes within the U.S. however not but accepted for weight reduction.
Wegovy shortages proceed to be reported.
Hair loss was an unusual facet impact within the scientific trials of those medicines. In actual fact, it was extra frequent after bariatric surgical procedure.
In scientific trials, 3% of sufferers receiving Wegovy versus 1% of sufferers on placebo reported hair loss. Hair loss was not reported as a facet impact in scientific trials of Ozempic for kind 2 diabetes. In a scientific trial of tirzepatide for weight reduction in weight problems, 5.7% of sufferers taking the best dose (a 15-milligram once-weekly injection) reported hair loss in comparison with 1% of those that bought a placebo.
In distinction, a evaluate of 18 largely 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 specialists 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,” stated Lynne J. Goldberg, MD, a professor of dermatology and pathology and laboratory drugs at Boston College College of Drugs and director of the hair clinic at Boston Medical Middle.
“A few of my sufferers lose hair after they drop a few pounds, typically on account of the load loss itself, and never as a facet impact of those medicines,” stated Katharine H. Saunders, MD, an weight problems drugs 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 facet impact of the remedy itself however extra on account of how rapidly the load loss happens,” stated 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,” stated Anne Peters, MD, director of the College of Southern California’s Scientific Diabetes Packages. “Losing a few pounds and/or altering your weight loss program causes hair loss. Stress may 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 specialists agreed.
“It’s uncommon, however we will see sufferers who’ve a interval of diffuse hair loss, referred to as telogen effluvium or ‘stress shedding,’ with speedy weight reduction,” stated Michael A. Weintraub, MD, an endocrinologist at NYU Langone Well being in New York Metropolis.
This hair loss happens throughout a irritating occasion that’s both bodily (surgical procedure, being pregnant, sickness) or emotional, stated Weintraub, who’s an assistant professor on the NYU Grossman College of Drugs.
Hair loss on account of speedy weight reduction could possibly be brought on by an weight problems remedy however it may additionally happen with different weight problems remedies, similar to bariatric surgical procedure and even drastic dietary modifications, he stated. The hair shedding is often short-lived and reversible.
About 80% to 85% of hair is within the anagen (progress) section, about 5% is in a transitional (catagen) section, and the remainder is in telogen (resting, or shedding) section, Messick stated. In telogen effluvium, hairs which might be usually within the progress section get immediately shifted to telogen section and trigger speedy hair shedding.
“Telogen effluvium might be brought on by speedy weight reduction, main surgical procedure, extreme COVID an infection, excessive fever, or loss of life within the household,” she stated. “You’ll not go bald with telogen effluvium, however you may discover that you could be lose quantity of hair,” far more than the traditional lack of as much as 100 hairs a day.
“I counsel my sufferers about the opportunity of dropping hair earlier than they bear bariatric surgical procedure,” Saunders stated. “Typically, the well being advantages of weight reduction and weight upkeep outweigh the chance of non permanent hair loss.”
Dietary deficiencies and malnutrition can contribute to hair loss as properly, and iron deficiency is typically a perpetrator, she stated.
“If somebody is frightened” about hair loss related to weight reduction, “they need to see their physician,” Peters stated. “If they’re on thyroid hormone, specifically, the degrees needs to be retested after weight reduction.”
“Hair loss seems extra frequent after bariatric surgical procedure than with anti-obesity medicines,” Weintraub stated, and it’s unclear whether or not it’s because the load loss is extra dramatic after surgical procedure and thus a better supply of stress or on account of nutrient deficiency or one thing else completely.
Iron and vitamin D deficiencies are the most typical dietary deficiencies that may trigger hair loss, he stated.
Gradual and Regular Weight Loss Moderately than Speedy
“I’d recommend that sufferers attempt to hold the load loss sluggish and regular, relatively than speedy,” Goldberg stated, “and observe any vitamin/mineral supplementation plan that they’re given. Sufferers with bariatric surgical procedure have dietary steerage and a supplementation plan.”
“Comply with a well-balanced dietary technique with ample protein, greens, and a few fruit,” Saunders stated. Well being care suppliers ought to monitor lab assessments to examine for and deal with vitamin deficiencies, and registered dietitians might be essential to make sure correct vitamin. She advises sufferers: “Discover coping methods to cut back stress and get sufficient sleep. If iron ranges are low, begin an iron complement beneath 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 focus on 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 kind of weight loss program change, you need to ensure you nonetheless keep a balanced weight loss program, whether or not its energy, protein, iron, zinc, nutritional vitamins (vitamin D for instance),” Massick stated.
Equally, Peters advises: “I’d say to take care of a standard, nutritious diet even when consuming much less. Train. Do all these wholesome issues. Taking a each day multivitamin isn’t a foul 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 attainable causes,” Weintraub stated. “Their supplier can consider for underlying causes like thyroid dysfunction, iron deficiency, and Vitamin D deficiency.”
Nevertheless, if the sample of hair loss happens in patches, this has a completely completely different set of causes possible unrelated to their weight problems remedy and needs to be evaluated.
Working with a nutritionist to verify sufferers have ample protein and vitamins can decrease the chance of creating hair loss and different issues, Weintraub stated. “That is notably essential 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 each day multivitamin has little hurt, he stated, and will help ensure you are getting important minerals and nutritional vitamins. Nevertheless, no research have particularly investigated this but.
“Finally, it’s essential to weigh the advantages of anti-obesity medicines towards the potential dangers, as we do with any medical intervention,” Weintraub stated.
“The aim of treating weight problems,” he stated, “is to cut back the chance of coronary heart illness, stroke, and a number of varieties 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 non permanent hair loss.”