Carol Saffran began taking Ozempic a year ago to manage her blood sugar after other treatments hadn’t worked. She was prediabetic, meaning her blood sugar was higher than normal, and her doctor prescribed Ozempic to help prevent diabetes. She has since reached near her ideal weight and has a checkup scheduled soon to monitor her blood sugar, but after increasing to the highest dose, she noticed something unexpected.“I would brush my hair and notice more hair than usual on the brush,” said Saffran, 71, from the greater Boston area, as per CNN. “It’s not falling out in clumps, but it’s definitely thinner. My hair isn’t as full as it used to be.”Dr. Farah Moustafa, a hair loss specialist and director of laser and cosmetic treatments at Tufts Medical Center, diagnosed her with telogen effluvium, a type of hair loss caused by stress on the body. In Saffran’s case, the stress was the significant weight loss she experienced while on Ozempic.Carol Saffran said her hair isn’t as full as it was before taking a GLP-1 drug. Courtesy Carol SaffranWhat is Telogen Effluvium?Hair grows in four phases: anagen (growth), catagen (transition), telogen (resting), and exogen (shedding). Normally, anagen lasts the longest, as per Cleveland Clinic.Telogen effluvium pushes an unusually high number of hair follicles into the telogen phase, causing more shedding than usual. Dr. Anthony Rossi, a dermatologist at Memorial Sloan Kettering Cancer Center, explained that telogen effluvium often appears after periods of stress such as childbirth, anesthesia, or rapid dieting.“Any time people lose a significant amount of weight quickly, it can trigger telogen effluvium, where more hair follicles enter the shedding phase prematurely,” said Dr. Aron Nusbaum, a dermatologist and hair restoration surgeon at the Miami Hair Institute.He added that this type of hair loss can appear three to six months after a triggering event, whether it’s physical stress, emotional stress, hormonal changes, major weight loss, or a new medication.When the body is stressed, it prioritizes essential functions over nonessential ones, like hair growth. “Hair is a nonessential appendage,” Rossi said. Experts agree that the major cause of hair loss among GLP-1 users appears to be the significant weight loss rather than the medication itself.Malnutrition May Play a RoleDr. Brian Wojeck, an obesity medicine specialist at Yale School of Medicine, compared it to what happens after bariatric surgery, where rapid metabolic changes can trigger temporary hair shedding. He also suspects that sudden changes in nutrition or vitamin levels might contribute. Some people consider taking multivitamins while on GLP-1 medications, though “there isn’t strong evidence that multivitamins prevent hair loss,” he said.Rossi noted that some patients become relatively malnourished on GLP-1s because the drugs suppress appetite. “If you aren’t getting enough micronutrients, your body won’t prioritize hair growth,” he said. “It’s a mix of metabolic stress and relative protein or nutrient deficiency.”For healthy hair, people need about 1 gram of protein per kilogram of body weight daily, plus sufficient levels of ferritin, zinc, and vitamins B, D, and B-12, Rossi said.Manufacturer GuidanceA Novo Nordisk spokesperson confirmed hair loss is listed as a possible side effect of semaglutide. Clinical trials of Wegovy reported hair loss in 2.5% of participants versus 1% of placebo, with higher risk for those losing 20% or more of body weight. Alopecia is noted in post-marketing materials for Ozempic and Rybelsus.Eli Lilly confirmed hair loss has been observed with weight loss interventions. It is listed for Zepbound but not Mounjaro, which is approved for diabetes management rather than weight loss. Zepbound trials showed higher hair loss rates in women (7.1%) than men (0.5%).Treatments for Hair LossTelogen effluvium from GLP-1 use is usually temporary, but medical evaluation is advised. Chronic telogen effluvium, where shedding lasts more than six months, can occur, Rossi said.Moustafa explained that once the stressor is removed, hair should fully recover. Medications like oral minoxidil can help speed regrowth, especially for patients who must continue a medication like Ozempic. Saffran plans to lower her dose and start minoxidil while continuing treatment. Nusbaum emphasized proper diagnosis is essential. Ruling out other causes through lab tests for vitamin, mineral, and hormonal levels allows for faster recovery.For Saffran, Moustafa confirmed she had thick hair initially, with no signs of age-related pattern loss, indicating pure telogen effluvium. She advises GLP-1 users to monitor their hair shedding, track weight loss, and advocate for referrals to specialists to manage the condition.
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