Does tirzepatide cause headaches? 6 ways to manage them

If you’ve been taking tirzepatide and have noticed some pounding or pressure in your head, you’re not alone. While headaches aren’t considered a common side effect of tirzepatide (the active ingredient in Zepbound and Mounjaro), some people report experiencing tirzepatide headaches during treatment. 

So what’s going on? Can tirzepatide cause headaches, or is something else to blame? Ahead, we explore what the research says about tirzepatide headaches, the potential causes, and ways to get relief.

Technically, headache is not considered a common side effect of tirzepatide. It’s not listed on the prescribing information for either Mounjaro or Zepbound. But that doesn’t mean headaches don’t happen. In clinical trials of tirzepatide, anywhere from 4% to 14% of participants reported headaches, depending on the dose. 

That said, it’s still unclear whether tirzepatide itself is responsible for the side effect. Some studies have found that headaches can be more common on higher doses of tirzepatide. 

However, one study found that headaches occurred slightly more often in people taking tirzepatide than the placebo: 9.4% of people taking Zepbound or Mounjaro reported headache, compared to 7.5% taking a placebo. This makes it hard to know whether the medication is truly responsible for the side effect

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Headaches are annoying, especially when you’re already adjusting to the side effects of a new medication like tirzepatide. One thing that can provide relief? Knowing what’s causing your symptoms. Because then you can take action to prevent them. 

Common culprits of tirzepatide headaches include dehydration and low blood sugar. Let’s take a closer look. 

Dehydration 

Dehydration is a well-known cause of headaches and migraine. Tirzepatide works for weight loss in part by slowing down digestion, which makes you feel full sooner. It also reduces your appetite. Together, these effects can lead you to eat less and, thus, experience weight loss. For some people, they can also cause you to drink less, too.

Tirzepatide is associated with side effects like nausea, vomiting, and diarrhea. Unfortunately, these side effects can make it harder to drink enough fluids, resulting in dehydration, which can end up causing headaches. (It’s also worth noting that even before dehydration kicks in, nausea and vomiting can cause headaches as well.)

Low blood sugar

Tirzepatide also works by lowering blood sugar. This can be a good thing, especially if you’re taking the drug to manage your type 2 diabetes. But if you aren’t careful, tirzepatide can potentially lead to drops in blood sugar that are lower than you’d like, also called hypoglycemia. 

Headache is a classic warning sign of low blood sugar, along with dizziness, irritability, sweating, and fatigue. In addition to recognizing these telltale symptoms, keeping a source of sugar (e.g. juice or glucose tablets) on hand can help you stay prepared. 

Hypoglycemia is more likely to happen in people already taking glucose-lowering medications like insulin or sulfonylureas. This is why you should share a full list of medications with your healthcare provider before starting tirzepatide. Your provider may lower the dosage of these treatments to reduce your risk of experiencing hypoglycemia — and, in turn, a tirzepatide headache — in the first place.

Coincidence 

Sure, some headaches may be related to tirzepatide. But others may be caused by something else entirely. After all, headaches are one of the most frequent health complaints, affecting up to 16% of people worldwide. 

Common triggers and causes of headache can include: 

• Tight muscles

• Stress

• Poor sleep

• Depression or anxiety

• Head injury

• Caffeine withdrawal

• Alcohol use

• Illnesses, such as the cold, flu, or fever

• Premenstrual syndrome (PMS)

There isn’t much research on how long tirzepatide headaches last. In general, the duration of a headache can depend on what’s causing it and how quickly you take action to relieve it. Some tirzepatide headaches — especially those related to dehydration or low blood sugar — may go away fairly quickly once you replenish your fluids or restabilize your blood sugar levels. 

Tirzepatide headaches seem to be more common with higher dosages, so they may be more noticeable when increasing your dosage. Tirzepatide side effects tend to be at their worst during a dosage increase and tend to become less frequent over time as your body adjusts to the medication.

If tirzepatide headaches are causing you pain, there are some strategies you can try to help you feel better.   

1. Stay hydrated

Your best line of defense against a headache — tirzepatide-related or not — is staying well-hydrated. Studies have found that people who drink more water experience fewer and less severe headaches. 

Even if you don’t feel thirsty, make it a habit to drink water throughout the day. Setting alarms to sip from your water bottle every hour can help you fill up on fluids. Opting for soups, gelatin, and fruits with high water content (such as watermelon, it’s right there in the name) can also help you stay hydrated. Added bonus: Drinking plenty of water can also help alleviate some of tirzepatide’s other side effects, like nausea and constipation.

You may also want to reduce your alcohol intake while taking tirzepatide. Alcohol can trigger headaches and worsen side effects like nausea and vomiting.

2. Keep your blood sugar steady

To avoid dips in blood sugar, avoid skipping meals — even if your appetite is low and you’re trying to lose weight.

Choose protein- and fiber-rich foods that boost satiety and keep blood sugar spikes and side effects at bay, like eggs, whole grains, lean meats, legumes, and nuts. And in case low sugar strikes, those with diabetes should keep a glucose tablet, orange juice, or even a few teaspoons of sugar handy as a quick source of sugar.  

3. Try over-the-counter pain meds

If you’re dealing with a mild to moderate headache, medications like acetaminophen (Tylenol) or ibuprofen (Advil) may offer quick relief. But these probably shouldn’t be a long-term option. 

Generally, it’s a good idea to check with your provider before making any major changes to your routine, such as adding new over-the-counter (OTC) medications to your regimen. This is especially if you’re taking other drugs or have underlying health conditions (e.g. kidney or liver disease). 

4. Pay attention to triggers 

Keep a headache diary to track when your symptoms occur and what might be triggering them. Note when you last injected tirzepatide, what you ate and drank that day, how you slept, and your stress levels.

Identifying a pattern can help you take proactive steps, whether that means drinking more water on injection day or avoiding specific foods. For example, sleep problems are a common trigger for migraines, but following good sleep hygiene and getting better sleep significantly reduces their occurrence. 

5. Be patient

Sometimes managing headaches on Zepbound or Mounjaro means simply riding them out. The first few months on tirzepatide can be an adjustment period. Most people find that side effects become less intense over time as their bodies get used to the medication. Practicing proactive strategies like drinking more water and eating a balanced diet can also help. 

6. Talk to your healthcare provider 

If your tirzepatide headaches are persistent, severe, or getting worse, talk to your healthcare provider. They may have you slow down your dose escalation schedule, which can limit side effects. 

Depending on your response to tirzepatide, they may also recommend another medication altogether. 

Tirzepatide works in a way that is similar to many medicines in the glucagon-like peptide-1 (GLP-1) family. However, in addition to targeting GLP-1, tirzepatide also targets another hormone called GIP. The GLP-1 category also includes Ozempic (semaglutide), Wegovy (semaglutide), Saxenda (liraglutide), and others. 

Of course, other GLP-1s may also produce headaches as a side effect. But your individual response to these medications can vary. In other words, just because some people experience headaches on Wegovy or Ozempic doesn’t mean you will. 

Also, remember: If your tirzepatide headache gets worse instead of getting better or is associated with alarming symptoms like sudden severe pain, vision changes, weakness, confusion, or fever, seek emergency medical attention. There could be something else going on.

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Headaches are not explicitly mentioned as a side effect in the prescribing information for tirzepatide. That doesn’t make them any less frustrating or real. In fact, enough people experience them that it’s worth knowing what to expect and how to handle them. Here’s what to keep in mind: 

• Tirzepatide can cause headaches. In clinical trials, around 4% to 14% of participants reported headaches on Mounjaro or Zepbound. 

• Dehydration and low blood sugar are the most common causes of tirzepatide headaches. Staying properly hydrated and eating a balanced diet can help prevent headaches on tirzepatide.

• Headaches are usually treatable. Over-the-counter pain relievers and some lifestyle changes (like drinking more water and sleeping better) can help ease your discomfort.

Talk to your healthcare provider if your headaches are severe, don’t go away, or are affecting your quality of life. They may be able to adjust your dosage schedule or recommend a different medication. If you are experiencing severe symptoms, don’t hesitate to seek emergency medical care.