May 24, 2023 -- Should you beryllium concerned astir hairsbreadth nonaccomplishment erstwhile taking Mounjaro, Ozempic, aliases Wegovy for weight nonaccomplishment — arsenic was precocious claimed by immoderate group connected societal media and reported in news stories?
The statement among dermatologists and endocrinologists WebMD contacted is no.
It’s up to nan individual to measurement nan benefits of treating obesity against nan risks of nan therapy, including nan debased consequence of processing impermanent hairsbreadth loss, says 1 expert.
Mounjaro, Ozempic, and Wegovy
Of these 3 newer medications, nan FDA has approved only nan drug semaglutide (Wegovy) for weight management — specifically for group pinch either obesity aliases pinch overweight positive astatine slightest 1 weight-related upset specified arsenic precocious humor pressure, type 2 diabetes, and precocious cholesterol — pinch a dosage up to a 2.4-milligram play injection.
When location was a short proviso of Wegovy soon aft it became available, immoderate group turned to nan aforesaid drug, semaglutide, but marketed as Ozempic for type 2 diabetes, which is fixed successful injections of up to 2 milligrams weekly, aliases to tirzepatide (Mounjaro). Tirzepatide is approved for type 2 glucosuria successful nan U.S. but not yet approved for weight loss.
Wegovy shortages proceed to beryllium reported.
Hair nonaccomplishment was an uncommon broadside effect successful nan objective tests of these medications. In fact, it was much communal aft bariatric surgery.
In objective trials, 3% of patients receiving Wegovy versus 1% of patients connected placebo reported hairsbreadth loss. Hair nonaccomplishment was not reported arsenic a broadside effect successful objective tests of Ozempic for type 2 diabetes. In a clinical trial of tirzepatide for weight nonaccomplishment successful obesity, 5.7% of patients taking nan highest dose (a 15-milligram once-weekly injection) reported hairsbreadth nonaccomplishment compared to 1% of those who sewage a placebo.
In contrast, a review of 18 mostly observational studies reported that 57% of patients had hairsbreadth nonaccomplishment aft bariatric surgery.
Is It nan Drug aliases nan Rapid Weight Loss?
None of nan experts consulted for this communicative had seen patients who came to them astir hairsbreadth nonaccomplishment while taking these narcotics for weight loss.
"I person not seen patients complaining of hairsbreadth nonaccomplishment from these medications, but possibly it is conscionable a matter of time," said Lynne J. Goldberg, MD, a professor of dermatology and pathology and laboratory medicine astatine Boston University School of Medicine and head of nan hairsbreadth session astatine Boston Medical Center.
"Some of my patients suffer hairsbreadth erstwhile they suffer weight, mostly arsenic a consequence of nan weight nonaccomplishment itself, and not arsenic a broadside effect of these medications," said Katharine H. Saunders, MD, an obesity medicine doctor, co-founder of Intellihealth, and an adjunct professor of medicine astatine Weill Cornell Medicine, successful New York City.
"Hair nonaccomplishment from accelerated weight nonaccomplishment is very communal [and] not needfully a broadside effect of nan medicine itself but much arsenic a consequence of really quickly nan weight nonaccomplishment occurs," said Susan Massick, MD, subordinate professor of dermatology astatine Ohio State University and a dermatologist astatine nan school’s Wexner Medical Center.
"Hair nonaccomplishment is tricky," said Anne Peters, MD, director of nan University of Southern California’s Clinical Diabetes Programs. "Losing weight and/or changing your fare causes hairsbreadth loss. Stress tin origin hairsbreadth loss. So it is difficult to abstracted weight nonaccomplishment from medicine effect."
Stress Shedding With Rapid Weight Loss
The hairsbreadth nonaccomplishment seems to beryllium associated pinch accelerated weight loss, nan experts agreed.
"It is rare, but we tin spot patients who person a play of diffuse hairsbreadth loss, called telogen effluvium aliases 'stress shedding,' pinch accelerated weight loss," said Michael A. Weintraub, MD, an endocrinologist astatine NYU Langone Health successful New York City.
This hairsbreadth nonaccomplishment occurs during a stressful arena that is either beingness (surgery, pregnancy, illness) aliases emotional, said Weintraub, who is an adjunct professor astatine nan NYU Grossman School of Medicine.
Hair nonaccomplishment owed to accelerated weight nonaccomplishment could beryllium caused by an obesity medicine but it could besides hap pinch different obesity treatments, specified arsenic bariatric room aliases moreover drastic dietary changes, he said. The hairsbreadth shedding is typically short-lived and reversible.
About 80% to 85% of hairsbreadth is successful nan anagen (growth) phase, astir 5% is successful a transitional (catagen) phase, and nan remainder is successful telogen (resting, aliases shedding) phase, Messick said. In telogen effluvium, hairs that are usually successful nan maturation shape get abruptly shifted to telogen shape and origin accelerated hairsbreadth shedding.
"Telogen effluvium tin beryllium caused by accelerated weight loss, awesome surgery, terrible COVID infection, precocious fever, aliases decease successful nan family," she said. "You will not spell bald pinch telogen effluvium, but you mightiness find that you whitethorn suffer a bully measurement of hair," overmuch much than nan normal nonaccomplishment of up to 100 hairs a day.
"I counsel my patients astir nan anticipation of losing hairsbreadth earlier they acquisition bariatric surgery," Saunders said. "Generally, nan wellness benefits of weight nonaccomplishment and weight attraction outweigh nan consequence of impermanent hairsbreadth loss."
Nutritional deficiencies and malnutrition tin lend to hairsbreadth nonaccomplishment arsenic well, and robust deficiency is sometimes a culprit, she said.
"If personification is worried" astir hairsbreadth nonaccomplishment associated pinch weight loss, "they should spot their doctor,” Peters said. "If they are connected thyroid hormone, successful particular, nan levels should beryllium retested aft weight loss."
"Hair nonaccomplishment appears much communal aft bariatric room than pinch anti-obesity medications," Weintraub said, and it is unclear whether this is because nan weight nonaccomplishment is much melodramatic aft room and frankincense a greater root of accent aliases owed to nutrient deficiency aliases thing other entirely.
Iron and vitamin D deficiencies are nan astir communal nutritional deficiencies that tin origin hairsbreadth loss, he said.
Slow and Steady Weight Loss Rather than Rapid
"I would propose that patients effort to support nan weight nonaccomplishment slow and steady, alternatively than rapid," Goldberg said, "and travel immoderate vitamin/mineral supplementation scheme that they are given. Patients pinch bariatric room person nutritional guidance and a supplementation plan."
"Follow a well-balanced dietary strategy pinch ample protein, vegetables, and immoderate fruit," Saunders said. Health attraction providers should show laboratory tests to cheque for and dainty vitamin deficiencies, and registered dietitians tin beryllium important to guarantee due nutrition. She advises patients: "Find coping strategies to trim accent and get capable sleep. If robust levels are low, commencement an robust supplement nether your provider’s supervision.
"Some of my patients committedness by biotin supplements, prenatal vitamins, aliases 'hair, skin, and nails' vitamins," she added. If hairsbreadth nonaccomplishment doesn’t stop, a dermatologist tin look for different contributors and talk strategies for hairsbreadth restoration.
People who acquisition bariatric room require lifelong vitamin supplementation and yearly (or much frequent) laboratory testing, she noted.
"With, for example, bariatric room aliases immoderate type of fare change, you want to make judge you still support a balanced diet, whether its calories, protein, iron, zinc, vitamins (vitamin D for example)," Massick said.
Similarly, Peters advises: "I would opportunity to support a normal, patient fare moreover if eating less. Exercise. Do each those patient things. Taking a regular multivitamin isn’t a bad idea. Talk pinch a nutritionist. Use nan appetite suppression of nan medicine to harvester pinch patient eating. "
"If personification is having caller hairsbreadth loss, they should spot their clinician to measure for each imaginable causes," Weintraub said. "Their supplier tin measure for underlying causes for illustration thyroid dysfunction, robust deficiency, and Vitamin D deficiency."
However, if nan shape of hairsbreadth nonaccomplishment occurs successful patches, this has an wholly different group of causes apt unrelated to their obesity medicine and should beryllium evaluated.
Working pinch a nutritionist to make judge patients person capable macromolecule and nutrients tin little nan consequence of processing hairsbreadth nonaccomplishment and different complications, Weintraub said. "This is peculiarly important for definite forms of bariatric room … since that tin lead to malabsorption of circumstantial vitamins and minerals that request to beryllium periodically measured and supplemented."
If you are starting an obesity medication, opening a regular multivitamin has small harm, he said, and tin thief make judge you are getting basal minerals and vitamins. However, nary studies person specifically investigated this yet.
"Ultimately, it’s important to measurement nan benefits of anti-obesity medications against nan imaginable risks, arsenic we do pinch immoderate aesculapian intervention," Weintraub said.
"The intent of treating obesity," he said, "is to trim nan consequence of bosom disease, stroke, and aggregate types of cancers. It’s up to nan individual to measurement these benefits against nan risks of nan treatment, including nan debased consequence of processing impermanent hairsbreadth loss."