Does Semaglutide or Tirzepatide Cause Hair Loss?
- Joshua Silva, MD
- Sep 30, 2025
- 7 min read
Updated: Jan 23
Medically authored by Joshua Silva, MD | Evidence-Based Weight Loss at Potere Health MD
Hair Shedding During Wegovy®, Ozempic®, Zepbound®, and Mounjaro®
No. Semaglutide and tirzepatide do not directly cause hair loss.
The shedding some patients notice is almost always telogen effluvium — a temporary, reversible response to rapid weight loss and nutritional stress, not medication toxicity.
Why am I losing hair while on semaglutide or tirzepatide?
When people lose weight quickly — whether through GLP-1 medications, bariatric surgery, illness, or crash dieting— the body enters a temporary conservation response.
Normally only about 10–15% of scalp hairs are in the resting (telogen) phase, but during telogen effluvium this can rise to roughly 25–30% or more, causing noticeably increased shedding about 2–4 months after the trigger.
This process is called telogen effluvium (TE), which is why hair shedding usually begins months after starting weight-loss treatment rather than immediately.
TE is:
Common
Predictable
Temporary
Not permanent hair loss
In bariatric surgery patients — who experience rapid, medically-induced weight loss — up to 57% develop telogen effluvium, confirming that this type of shedding is driven by weight-loss physiology, not GLP-1 medications themselves.
What exactly is telogen effluvium?
Telogen effluvium is diffuse shedding caused when stressors push hair follicles out of growth mode.
Common triggers include:
Rapid fat loss
Low calorie intake
Low protein
Iron deficiency
Vitamin D deficiency
Zinc imbalance
Illness, surgery, or inflammation
Once the stress resolves and nutrition improves, hair follicles re-enter the growth phase and hair typically regrows within 3–9 months.
Which nutrients matter most for hair during GLP-1 weight loss?
These are the highest-yield nutrition factors linked to hair shedding (especially telogen effluvium) during rapid weight loss:
Factor | Why it matters for hair |
Total calorie intake (energy availability) | Rapid calorie restriction creates metabolic stress, shifting follicles into the telogen (resting) phase because hair production is a non-essential process during energy conservation |
Protein intake | Hair shafts are made of keratin (a protein); inadequate protein or essential amino acids limits hair fiber production and promotes shedding |
Iron (ferritin) | Low iron stores are commonly associated with chronic telogen effluvium, particularly in women |
Vitamin D | Deficiency is frequently found in hair-loss patients and may impair normal follicle cycling |
Zinc | Important for normal follicle function, but routine zinc supplementation isn’t recommended unless levels are low. Excess zinc can cause copper depletion, which can worsen shedding. |
Omega-3 & Omega-6 fatty acids | In controlled trials, supplementation reduced shedding and improved hair density |
L-lysine | Can improve iron absorption and may help iron-related hair shedding in some women |
Should I take biotin for hair loss?
Usually, no.
Unless you have a true biotin deficiency — which is uncommon but can occur with chronic alcohol use, pregnancy, certain gastrointestinal disorders, or long-term anticonvulsant therapy — biotin supplements:
Do not improve hair growth
Do not prevent telogen effluvium
Can falsely alter important lab tests (including thyroid levels, cardiac troponin, and hormone tests)
Multiple dermatology reviews and placebo-controlled trials show no benefit for biotin supplementation in people with normal biotin levels.
How do I prevent or reverse hair shedding on semaglutide or tirzepatide?
Most hair shedding on semaglutide or tirzepatide is telogen effluvium — a temporary response to rapid weight loss, low calorie intake, or inadequate protein. Prevention is best achieved by avoiding crash dieting, under-eating, and low-protein intake; if shedding does occur, correcting nutrition and true deficiencies usually allows hair to regrow within 3–9 months.
Evidence-based prevention and recovery
Avoid crash dieting – Aim for steady, sustainable weight loss. Rapid calorie restriction is one of the most common triggers of telogen effluvium.
Don’t under-eat – During energy shortage, the body conserves resources. Because hair production is not essential for survival, follicles pause growth and shedding increases.
Prioritize protein – Hair shafts are made of keratin (a protein). Low protein intake or amino-acid deficiency is a well-recognized cause of diffuse hair shedding during weight loss.
Use targeted labs only when appropriate – If your intake has been very restricted, you have heavy menstrual bleeding, symptoms of anemia or thyroid disease, or shedding is severe or prolonged, your clinician may check CBC/ferritin and sometimes TSH or vitamin D to identify correctable deficiencies.
Optional adjunct – In a controlled clinical trial, a supplement containing omega-3 and omega-6 fatty acids plus antioxidants reduced shedding and improved hair density. This can be reasonable if shedding has already started and diet quality is limited.
Expect regrowth – Once the trigger is corrected, hair follicles return to the growth phase, and many people see improvement within 3–9 months (sometimes longer if weight loss or deficiencies continue).
Get evaluated if it persists – Hair shedding that lasts longer than 6–9 months, becomes patchy or scarring, or occurs with other symptoms should be evaluated by a clinician to confirm TE and rule out other causes.
Should I take a multivitamin during GLP-1 weight loss?
A routine daily multivitamin has not been shown to prevent or treat telogen effluvium (TE) specifically during GLP-1 weight loss. TE is usually driven by rapid weight loss, low calorie intake, inadequate protein, and correctable deficiencies (commonly iron/ferritin and vitamin D).
That said, a standard once-daily multivitamin can be a practical backstop if appetite is very low or diet variety is limited. In a real-world observational study of GLP-1 receptor agonist users, nutritional deficiencies were diagnosed in 12.7% by 6 months and 22.4% by 12 months, with vitamin D deficiency most common.
Keep it simple
Use a multivitamin as support — not as the treatment for TE.
Don’t replace calories + protein with supplements.
Avoid high-dose “hair/skin/nails” products (often high biotin), which can interfere with lab tests.
If shedding is severe or lasts >6–9 months, that’s the point for targeted evaluation (rather than adding more supplements).
What Else Can Cause Hair Loss During Weight Loss?
Not all hair shedding during weight loss is telogen effluvium. Other medical, hormonal, and nutritional causes can contribute, including:
Iron deficiency or anemia (especially with heavy menstrual bleeding)
Thyroid disorders (hypothyroidism or hyperthyroidism)
Postpartum shedding (after pregnancy)
Androgen-pattern thinning (female or male pattern hair loss)
Autoimmune hair loss (alopecia areata; often patchy)
Recent illness, surgery, COVID-19, or major stress
Low calorie or low protein intake (even without medication)
Certain medications that can trigger shedding (retinoids, some anticonvulsants, chemotherapy)
Traction from hairstyles or scalp conditions (inflammation, scaling)
Because of this, patchy hair loss, scarring, scalp pain, or shedding lasting longer than 6–9 months should be evaluated by a clinician rather than assumed to be telogen effluvium.
How Potere Health MD helps protect your hair during GLP-1 treatment
At Potere Health MD (serving St. George, Cedar City, and Salt Lake City, Utah), we focus on preventing telogen effluvium before it starts by supporting healthy, sustainable weight loss:
Reviewing calorie and protein intake to avoid under-fueling
Adjusting GLP-1 dosing and pacing to prevent “crash physiology”
Identifying patients at higher risk for nutrient-related shedding (very low intake, heavy menstrual bleeding, prior bariatric surgery, restrictive diets)
Using targeted lab testing only when clinically indicated to identify correctable deficiencies
Providing nutrition and side-effect guidance so weight loss stays steady, not extreme
Bottom line
Hair shedding during Wegovy® or Zepbound® treatment is not a drug side effect — it is usually a sign that weight loss or nutrition has become too aggressive for the body. With proper medical guidance, this is both preventable and reversible.
With proper nutrition and physician-guided weight management, your hair grows back.
Disclaimer:
This article is for educational purposes only and is not a substitute for medical advice.
About the Author
Dr. Joshua Silva, MD, is a licensed physician and Medical Director of Potere Health MD. He earned his medical degree from the University of Hawaiʻi John A. Burns School of Medicine and completed residency training in Occupational and Environmental Medicine at the University of Utah, where he also earned a master’s degree in Occupational Health. He later completed a Master of Business Administration with an emphasis in health care administration at Ohio University.
Dr. Silva specializes in evidence-based weight management, including GLP-1 and GIP therapies such as semaglutide and tirzepatide. He provides in-person and virtual care for patients in Salt Lake City, St. George, and Cedar City, Utah.
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