Does semaglutide cause hair loss?

Whether you’re taking semaglutide to help manage type 2 diabetes (Ozempic, Rybelsus) or to lose weight (Wegovy), you probably expect some gastrointestinal (GI) side effects, especially when starting treatment. What you may not anticipate is to find yourself wondering, “does semaglutide cause hair loss?” as you stare in the mirror. 

The answer to your question is yes, semaglutide can cause hair loss. But it’s not considered a common side effect. So, why does semaglutide hair loss happen to some people? And what can you do about it if you’re shedding strands? Keep reading to find out.

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Semaglutide can cause hair loss in some individuals. However, it’s not a common side effect of the drug, and factors such as the specific brand-name drug (Ozempic, Wegovy, or Rybelsus), dosage, and amount of weight loss experienced can all impact the risk.

Out of the three brand-name versions of semaglutide, Wegovy is the only one whose prescribing information (PI) lists hair loss as a potential adverse reaction. In clinical trials of a thousand adults with obesity or overweight, 3% of those treated with 2.4 mg of Wegovy (2,116 people) reported hair loss compared to 1% of those in the placebo group (1,261 people). For context, 44% of Wegovy-treated participants experienced nausea, 30% diarrhea, and 24% constipation. 

As for Ozempic and Rybelsus? Hair loss was not reported in clinical trials for either drug and, thus, not listed in their respective PIs. That doesn’t mean hair loss didn’t—and can’t—occur while taking these drugs. Instead, it suggests that losing strands is not a common side effect of Ozempic and Rybelsus. Plus, the PIs for these two medications give more focus to the top 5–6 side effects experienced by participants in clinical trials, which include nausea, vomiting, diarrhea, abdominal pain, and constipation. All of these, BTW, are also considered the most common side effects of Wegovy.

Point being: Semaglutide hair loss is more likely to occur while taking Wegovy than Ozempic or Rybelsus, though all three brand-name drugs can technically lead to thinning or losing locks. 

While the exact cause is not fully understood (at least not yet!), the most common reason for semaglutide hair loss is rapid weight loss. That said, nutrient deficiencies and certain health conditions (e.g. type 2 diabetes) may also be to blame for the side effect. 

As a glucagon-like peptide-1 (GLP-1)  receptor agonist, semaglutide mimics a naturally occurring hormone in the gut called GLP-1. In doing so, it stimulates insulin release, inhibits the production of glucagon (a hormone that raises blood sugar levels), and slows gastric emptying (the speed at which food moves through your digestive tract). Semaglutide also signals to the brain to reduce appetite. Together, these actions allow the medication to help regulate blood sugar and promote feelings of fullness, which can ultimately contribute to weight loss. 

In general, GLP-1s act on various organs in the body, including the gut, pancreas, and brain, to affect blood sugar response and appetite. But semaglutide may also have wider-reaching effects on other organs and tissues, including your hair follicles. Here’s why semaglutide may lead to hair loss.

Rapid weight loss

Telogen effluvium (TE) is a temporary condition in which your hair sheds due to physical or emotional stress, hormonal changes (e.g. after giving birth), illness (e.g. thyroid disorders), infection, surgery, or certain medication. When one of these events occurs, it disrupts the normal hair growth cycle by pushing more hairs to shift into the resting (telogen) phase, during which they eventually fall out. Hair loss typically begins about three months after the triggering event. 

Researchers suspect the rapid weight loss that can occur due to semaglutide can cause the stress associated with TE. While the amount of weight loss varies depending on the specific drug and dosage, significant weight loss is common with semaglutide. In one study, for example, people who took 2.4 mg of semaglutide weekly lost nearly 15% of their body weight on average after 68 weeks (a little over a year); those in the placebo group only lost 2.4%. 

Nutritional deficiencies

Another possible cause of semaglutide hair loss (and, in turn, TE) may be nutritional deficiencies. The medication not only suppresses appetite but also slows digestion, which can lead you to consume fewer calories and potentially fall short on certain essential nutrients. Your diet plays a crucial role in hair growth. Research suggests that inadequate intake of protein, healthy fats, and essential micronutrients (e.g. biotin) can contribute to hair thinning, especially in the context of rapid weight loss or reduced nutrient intake while taking anti-obesity medications such as semaglutide. 

Diabetes

Many people take semaglutide in the form of Ozempic or Rybelsus to treat type 2 diabetes—after all, that’s one of the drugs’ uses approved by the US Food and Drug Administration (FDA). Diabetes, in and of itself, may be associated with hair loss. One study found that type 2 diabetes was associated with a 68% increased risk of severe hair loss in African American women. Having diabetes for at least a decade increased that risk even further. Metabolic syndrome (a cluster of conditions that increases the risk of developing type 2 diabetes) has also been linked to alopecia, aka hair loss. 

Living with a chronic condition such as diabetes can increase the stress that triggers TE. Type 2 diabetes can also lead to high blood sugar levels, especially if not properly managed. Over time, high blood sugar can impair blood vessels, reducing blood flow to the scalp and hair follicles and potentially limiting the nutrients needed for healthy hair growth. This can ultimately lead to hair shedding, thinning, or loss. Additionally, type 2 diabetes can disrupt hormone levels that influence the hair growth cycle. 

Recent preliminary data found that about 0.8% of patients taking up to 2 mg of semaglutide weekly reported hair loss within six months of starting the medication. The researchers concluded that “...semaglutide does not significantly increase the risk of hair loss.” But that doesn’t mean that you shouldn’t discount any hair loss you may be experiencing while taking the drug, especially because it has a plausible explanation. And on that note…

Scientists are still looking at how GLP-1s may affect hair follicle growth in humans.  And although there is not much you can do to change the effects of the medication, you can take some precautions  to help hold onto your hair during treatment:

Eat a nutritious diet 

Make sure you’re getting all the nutrients your body needs for proper hair health. That includes protein (found in poultry, fish, eggs, and tofu), healthy fats (such as olive oil), B vitamins (found in fish, poultry, meat, eggs, dairy, beans, and peas), vitamin D (in salmon and fortified dairy and plant-based dairy), and minerals like iron (found in beans, lentils, spinach, tofu, and dark chocolate). This can be challenging due to appetite changes from semaglutide, so working with a healthcare professional who’s knowledgeable in nutrition—be it your provider (such as that through Ro) or a registered dietitian—can help you put a plan in place.

Consider a lower dose 

Controlling the speed at which you lose weight and the amount of pounds dropped while taking semaglutide isn’t necessarily all that doable. However, research suggests that weight loss tends to be faster and more significant on higher doses of the drug. Since rapid weight loss seems to be a particular cause of TE (and not just weight loss in general), slower weight loss may theoretically lead to milder hair loss (if any). So, if hair loss is a concern for you, talk to your healthcare provider about potentially changing your semaglutide dosage, plus what a safe weight loss looks like for you.

Identify the underlying reason

There are many reasons why you might be losing your hair, some of which have to do with semaglutide, like rapid weight loss, while others may be unrelated to the medication. That’s why it’s so important to bring up any concerns with your healthcare provider; they’re best equipped to determine whether any other underlying health conditions, such as thyroid disease or anemia, may be to blame and give you the proper medical advice. To do this, your healthcare provider may order blood tests—something that could also help them figure out whether you’re low or deficient in certain key hair-helping nutrients, too. Depending on the reason for your strand struggles, your dermatologist may recommend treatment options, such as medications like oral minoxidil or topical versions (Rogaine) to encourage hair growth.

Wait it out

If your healthcare provider is confident that hair loss is due to TE, then you can feel assured that you’re most likely experiencing temporary hair loss—the key word being “temporary.” TE tends to resolve on its own, and your hair should start to regrow within six months. Plus, once your weight stabilizes, hair loss should also resolve on its own. 

What’s more, this is not all bad news. Some early research suggests that GLP-1s (as well as other medications for diabetes, like metformin) may benefit hair growth and decrease the risk of hair loss because they help treat insulin resistance and improve circulation. Semaglutide hair loss is not a guarantee, and some may find that the treatment may promote hair health in the end.

It’s normal to lose hair every day. In fact, the average person typically loses about 100 hairs daily. However, if you notice an increase in hair shedding after going on semaglutide, the medication may have something to do with it. 

• Rapid weight loss is one of the main causes of telogen effluvium, a hair loss condition in which more hair follicles shift into the “resting” phase and fall out. This appears to be the major cause of semaglutide hair loss. 

• Nutritional deficiencies can also lead to hair loss. Appetite changes associated with semaglutide can affect how much you eat. Falling short in certain nutrients like protein, healthy fats, iron, and B vitamins can make you more prone to hair loss.

• To prevent and treat hair loss that occurs due to semaglutide, you can make sure you’re eating a nutrient-rich diet, something a healthcare professional can help guide you through. 

• Hair loss from telogen effluvium typically resolves on its own as your weight stabilizes. However, there is always the possibility that hair loss may be unrelated to the medication, so it’s also important to speak to a healthcare provider who may recommend other testing if necessary.