A new large-scale study found that people with type 2 diabetes who are taking GLP-1 medications may have a higher risk of hair loss.
The research, published in The BMJ, compared the risk of alopecia, a form of hair loss, among adults who took either GLP-1 drugs, SGLT-2 inhibitors, or DPP-4 inhibitors for the treatment of diabetes.
Specifically, there was an increased risk of non-scarring alopecia, a typically temporary or reversible type of hair loss, which can include telogen effluvium and androgenetic alopecia.
While the researchers suggest that the absolute risk of hair loss with GLP-1 medications is low, understanding the potential for alopecia may help inform treatment decisions among patients.
GLP-1 use in adults with type 2 diabetes was associated with a higher risk of clinically recorded non-scarring alopecia, a type of hair loss that does not permanently damage the hair follicles.
The researchers examined electronic health record data from the University of Pennsylvania Health System (Penn Medicine) between January 2019 and September 2024.
They looked at electronic health record data from 12,004 GLP-1 users and 15,221 SGLT-2 inhibitor users in the GLP-1 versus SGLT2i cohort. In the GLP-1 versuss DPP4i cohort, they focused on data from 11,964 GLP-1 users and 11,238 DPP-4 inhibitor users.
Compared with adults taking SGLT-2 inhibitors, those taking GLP-1 medication to treat diabetes had a 37% higher chance of experiencing hair loss.
GLP-1 users also had a 68% risk of hair loss compared with people treating diabetes with DPP-4 inhibitors.
The findings suggest that GLP-1s were associated with a higher risk of hair loss than two alternative diabetes treatments, but they do not establish the hair loss risk in people taking GLP-1s for non-diabetes purposes.
“The findings regarding the increased risk of alopecia compared to SGLT-2 inhibitors (37%) and DPP-4 inhibitors (68%) are notable, though not entirely surprising given that significant weight loss by any means can result in hair loss,” Mir Ali, MD, a bariatric surgeon, bariatric medicine specialist and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Medical News Today.
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“The medication acts as a catalyst for weight loss, but the resulting physiological stress and hormonal changes are often the direct trigger for telogen effluvium,” Ali, who was not involved in the study, added.
As the latest research is an observational study, it cannot confirm whether any specific factor directly caused another. This means that it cannot determine that weight loss and nutritional deficiencies definitely led to hair loss.
However, the researchers did note a possible link. Telogen effluvium is already associated with weight loss, and the rapid weight loss associated with GLP-1 use could also lead to non-scarring alopecia.
In reducing calories, some people taking GLP-1 drugs may develop certain nutritional deficiencies, which can affect how hair grows. The study authors suggest that deficiencies in the following may contribute to hair loss:
“My recommendation is to ensure patients maintain adequate protein intake and supplement appropriately with key micronutrients, especially iron, zinc, and biotin, while on these medications,” said Ali. “Routine monitoring should include checking basic nutritional labs if hair loss becomes a concern.”
Other factors that may contribute to hair loss in people taking GLP-1 medications include changes in thyroid function and altered absorption of oral drugs, such as thyroid hormone or sex hormone medications, due to delayed gastric emptying.
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Around six or seven in every 1,000 people taking GLP-1 medications experienced hair loss each year, according to data cited in the study paper.
While the absolute risk of hair loss with GLP-1 drugs is low, it is necessary for people to be aware of the possibility so that they can weigh the benefits of the treatment against the risks and make an informed decision about their treatment plan.
Speaking to MNT, Manish Mittal, MD, hair transplant surgeon at Mittal Hair Clinic, who was not involved in this study, explained that “the vast majority of patients will never experience clinically significant hair loss, but the study reinforces that shedding can occur in a small proportion of people and is something clinicians should discuss before treatment.”
Thus, individuals taking GLP-1 medications for type 2 diabetes should be aware of all options available to them, which could include SGLT-2 inhibitors and DPP-4 inhibitors, depending on individual circumstances.
It is particularly important for people to be aware of the risk of hair loss in cases where they already have an increased risk of alopecia.
Ali further emphasized that the benefits of taking GLP-1s as prescribed usually outweigh the risks:
“For the vast majority of patients seeking treatment for obesity or diabetes, the metabolic benefits of GLP-1s significantly outweigh the risk of temporary, non-scarring hair loss, which usually resolves once weight stabilizes. Groups who might be more at risk for hair loss are those with pre-existing nutritional deficiencies or those experiencing very rapid, significant weight loss.”
“People who lose weight very rapidly, have pre-existing nutritional deficiencies, women with low iron stores, individuals recovering from bariatric surgery, or those with underlying androgenetic hair loss may notice shedding more readily because they already have reduced hair reserve,” Mittal added.
Working closely with a healthcare professional can help you manage hair loss or monitor for any changes when taking GLP-1 medications.
Opel Baker, MBChB, DipOccMed, MRCGP, a general practitioner at the Mayfield Clinic in Brigthon, United Kingdom, who was likewise not involved in the study, spoke to MNT about what a person can do if they have concerns about hair loss while taking a GLP-1.
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“The most important advice is not to panic and not to discontinue treatment without medical advice. We encourage patients to lose weight at a sustainable pace rather than as quickly as possible, prioritize adequate protein intake, and attend regular follow-up appointments,” Baker said.
“If hair shedding develops, it’s sensible to assess dietary intake and, where clinically indicated, arrange blood tests to check for iron deficiency, thyroid disease, vitamin B12, or other contributing factors. Monitoring is straightforward and can form part of routine reviews,” he added.
Some general tips for managing non-scarring alopecia include:
“Patients shouldn’t stop treatment because they’re worried about hair loss alone. Instead, they should focus on prevention,” explained Mittal.
He advised that:
“Maintaining adequate protein intake, avoiding excessive calorie restriction, and ensuring sufficient iron, zinc, and other micronutrients can make a significant difference. If someone notices increased shedding, particularly after 3 to 6 months, they should seek assessment early rather than assuming it’s permanent. A specialist can identify whether this is temporary telogen effluvium or an unrelated hair condition requiring different treatment.”
