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 folks on social media and reported in information tales?
The consensus amongst dermatologists and endocrinologists WebMD contacted is not any.
It’s as much as the person to weigh the advantages of treating weight problems in opposition to the dangers of the remedy, together with the low threat of creating non permanent hair loss, says one professional.
Mounjaro, Ozempic, and Wegovy
Of those three newer drugs, the FDA has accepted solely the drug semaglutide (Wegovy) for weight administration — particularly for folks with both weight problems or with chubby plus at the very least one weight-related dysfunction comparable to 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 folks 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 accepted for sort 2 diabetes within the U.S. however not but accepted for weight reduction.
Wegovy shortages proceed to be reported.
Hair loss was an unusual aspect impact within the scientific trials of those drugs. Actually, 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 aspect impact in scientific trials of Ozempic for sort 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 acquired a placebo.
In distinction, a evaluation 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 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 drugs, 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 Heart.
“A few of my sufferers lose hair after they drop some weight, typically on account of the burden loss itself, and never as a aspect impact of those drugs,” stated Katharine H. Saunders, MD, an weight problems drugs physician, co-founder of Intellihealth, and an assistant professor of medication at Weill Cornell Drugs, in New York Metropolis.
“Hair loss from fast weight reduction is quite common [and] not essentially a aspect impact of the remedy itself however extra on account of how rapidly the burden loss happens,” stated Susan Massick, MD, affiliate professor of dermatology at Ohio State College and a dermatologist on the faculty’s Wexner Medical Heart.
“Hair loss is hard,” stated Anne Peters, MD, director of the College of Southern California’s Medical Diabetes Packages. “Shedding weight and/or altering your weight-reduction plan 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 fast 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 fast weight reduction,” stated Michael A. Weintraub, MD, an endocrinologist at NYU Langone Well being in New York Metropolis.
This hair loss happens throughout a tense 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 resulting from fast weight reduction may very well be attributable to an weight problems remedy nevertheless it may additionally happen with different weight problems remedies, comparable to bariatric surgical procedure and even drastic dietary adjustments, he stated. 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 stated. In telogen effluvium, hairs which might be usually within the development part get out of the blue shifted to telogen part and trigger fast hair shedding.
“Telogen effluvium may be attributable to fast weight reduction, main surgical procedure, extreme COVID an infection, excessive fever, or dying 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,” way 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 endure bariatric surgical procedure,” Saunders stated. “Usually, 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 effectively, and iron deficiency is usually a offender, 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 drugs,” Weintraub stated, and it’s unclear whether or not it’s because the burden 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 stated.
Sluggish and Regular Weight Loss Relatively than Speedy
“I might recommend that sufferers attempt to hold the burden loss gradual and regular, quite than fast,” Goldberg stated, “and comply with any vitamin/mineral supplementation plan that they’re given. Sufferers with bariatric surgical procedure have dietary steerage and a supplementation plan.”
“Observe a well-balanced dietary technique with ample protein, greens, and a few fruit,” Saunders stated. Well being care suppliers ought to monitor lab exams to verify for and deal with vitamin deficiencies, and registered dietitians may 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 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 endure 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-reduction plan change, you wish to ensure you nonetheless preserve a balanced weight-reduction plan, whether or not its energy, protein, iron, zinc, nutritional vitamins (vitamin D for instance),” Massick stated.
Equally, Peters advises: “I might say to keep up a traditional, nutritious diet even when consuming much less. Train. Do all these wholesome issues. Taking a every day multivitamin isn’t a nasty concept. Discuss 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 judge for all potential 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 wholly completely different set of causes seemingly unrelated to their weight problems remedy and needs to be evaluated.
Working with a nutritionist to ensure sufferers have adequate protein and vitamins can decrease the chance of creating hair loss and different issues, Weintraub stated. “That is notably vital for sure types of bariatric surgical procedure … since that may result in malabsorption of particular nutritional vitamins and minerals that must be periodically measured and supplemented.”
If you’re beginning an weight problems remedy, starting a every day multivitamin has little hurt, he stated, and can assist ensure you are getting important minerals and nutritional vitamins. Nevertheless, no research have particularly investigated this but.
“Finally, it’s vital to weigh the advantages of anti-obesity drugs in opposition to 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 kinds of cancers. It’s as much as the person to weigh these advantages in opposition to the dangers of the remedy, together with the low threat of creating non permanent hair loss.”
