Does tirzepatide cause hair loss?

Key Points

• Tirzepatide doesn't directly cause hair loss but may occur from rapid weight loss and your body's stress response
• Low appetite on tirzepatide can lead to vitamin and mineral gaps that affect hair growth
• Not eating enough protein while taking tirzepatide can weaken hair structure and cause thinning
• Adjusting medication dosage and focusing on nutrient-rich foods can help protect your hair

Tirzepatide, marketed as Mounjaro and Zepbound, has emerged as a powerful tool to help people lose weight and manage type 2 diabetes.

Significantly, it lowers the volume of “food noise”—intense food cravings for sugary, fatty, and processed foods, making it easier to make healthier food choices.

With all the benefits of tirzepatide, it does come with some side effects. Nausea, diarrhea, vomiting, and constipation are more common, but some people report hair loss after taking tirzepatide. The FDA product label for Zepbound also acknowledges hair loss as an adverse effect.

How exactly is tirzepatide linked to hair loss? How do you minimize the risk or protect your hair? Let’s explore.

Can tirzepatide make your hair fall out?

Tirzepatide does not cause hair loss directly, but may do so indirectly. This may seem like splitting hairs, but it’s an important distinction.

It could mean that your body’s reaction is due to some effects of tirzepatide but not the medication itself. In this type of situation, it’s possible that you could continue to take tirzepatide while making adjustments to lower the risk of hair loss.

Potential reasons why some people experience hair loss could be:

• The body’s stress response to rapid weight loss
• Not getting enough protein
• Nutritional deficiencies due to a reduced appetite
• Underlying hormonal changes
• Genetic factors

Let’s examine these factors and how to stop hair loss on Mounjaro and Zepbound.

Reasons for hair loss on tirzepatide

1. Rapid weight loss

When people lose weight on tirzepatide, in some cases, the weight loss can be really rapid. While losing weight super fast may sound great, it has other effects on your body.

The human body does not like dramatic weight loss; it’s wired to do everything in its power to prevent you from starving. So, losing weight fast triggers the body’s stress response, and it prepares for a potential emergency.

During stress, the body saves energy and directs nutrients to the brain, heart, lungs, nervous system, and muscles. It also pauses or slows down the nice-to-have processes—hair growth, skin repair, strong nails, and more.

Stress-induced hair loss can occur even after bariatric weight loss surgery, such as gastric bypass or gastric sleeve surgery, other types of major surgery, trauma, times of high stress, and more.

Signs of hair loss due to stress

Some signs of stress-induced hair loss include thinning without an itchy, red, scaly, or irritated scalp. You may notice hair strands falling out a few months after the stressful event.

This condition, known as telogen effluvium, occurs when stress pushes many hair follicles into a resting phase. Hair follicles are tiny tunnels in the scalp from which hair grows.

What do you do about it?

“On the positive side, most hair loss due to stress is temporary. Lowering the stress on the body can help overcome this issue,” Gia Eapen, MD, explains. “Regarding tirzepatide, talk to your doctor about hair loss and other symptoms. Discuss whether weight loss on Zepbound or Mounjaro is too fast and if you need a different dose.”

2. Low in essential vitamins and minerals

Tirzepatide is highly effective at lowering appetite. For people bombarded by "food noise"—nagging, persistent thoughts about food—being on the medication can feel like finally finding the mute button.

The downside? Some people may skip meals or eat too little when they're not experiencing hunger sensations as they did before. Their bodies could be missing vital vitamins and minerals that keep hair growing strong.

These include:

Vitamin A

A deficiency in Vitamin A can cause dry, brittle hair that breaks and thins more easily. In severe cases, it might trigger follicular hyperkeratosis, where keratin blocks hair follicles and potentially causes hair loss. Fortunately, increasing your Vitamin A intake can help reverse this condition.

Eapen, MD, says, “Be careful not to take too much Vitamin A as it can cause other issues; balance is key. The scalp may overproduce sebum (a natural oil) and disrupt the natural hair growth cycle. In extreme cases, too much Vitamin A may cause permanent hair loss.”

How much Vitamin A do you need?

According to the National Institutes of Health, the amount of Vitamin A needed is based on age and sex.

• Adult males: 900 mcg
• Adult females: 700 mcg

Foods rich in Vitamin A

Vitamin A is found in many types of foods, including:

• Liver (particularly beef liver)
• Fish
• Egg yolks
• Dairy products
• Dark leafy greens like kale, spinach
• Broccoli
• Sweet potatoes
• Carrots
• Fruits like cantaloupe and mango

Registered dietitian, Rita Faycurry, RD, says, “Beef liver is an excellent source of Vitamin A, but requires careful portioning. Just 1 ounce (about the size of 3 dice) provides over 150% of your daily Vitamin A needs, making portion control essential to prevent Vitamin A toxicity and high cholesterol.”

Foods rich in B vitamins

Our hair is largely made up of a structural protein called keratin. Several B vitamins affect hair growth. Biotin (Vitamin B7 or Vitamin H), in particular, is necessary to produce keratin.

The good news is that biotin is readily available in everyday foods. It can be found in:

• Egg yolks
• Peas, beans, and lentils
• Seeds and nuts
• Mushrooms
• Broccoli
• Bananas
• Avocados
• Unpolished rice
• Dairy products

A deficiency in other B vitamins, such as B2 (riboflavin), B3 (niacin), B9 (folate), and B12, may also contribute to hair loss.

“The best way to get B vitamins is through food. So, if you eat a nutritious, balanced diet, you do not need biotin or vitamin B supplements,” says Faycurry, RD. “However, if you think you may be deficient, talk to a doctor or a registered dietitian to learn if you’re low on essential vitamins and minerals, including the B-complex vitamins.”

Vitamin D

Vitamin D is a powerhouse vitamin that creates hair follicles. Low levels of Vitamin D can lead to hair loss and thinning.

The first step to reversing hair loss due to low Vitamin D is to get a 25-hydroxy vitamin D blood test and learn whether you’re deficient.

Range of Vitamin D levels

Vitamin D is measured as ng/mL (nanogram per milliliter).

The range of Vitamin D levels is as follows:

• Deficient: Below 12 ng/mL (30 nmol/L)
• Insufficient: 12-30 ng/mL (30-75 nmol/L)
• Sufficient: 30-50 ng/mL (75-125 nmol/L)
• Excessive: Greater than 50 ng/mL (125 nmol/L)

Eapen, MD, notes, “If you’re too low in Vitamin D, your doctor may recommend Vitamin D supplements to stabilize your levels. However, you could get Vitamin D from your food if you are moderately or slightly deficient.”

Foods rich in Vitamin D

To get Vitamin D in your diet, eat:

• Oily fish like salmon and sardines
• Egg yolks
• Red meat
• Liver (including beef liver)
• Vitamin D fortified dairy products

Faycurry RD advises, “Vitamin D is a fat-based vitamin; if you take too much, the excess amount is not eliminated when you pee. Instead, it builds up in your fat cells, potentially leading to Vitamin D toxicity. So, it’s important not to take high-strength Vitamin D supplements without checking with a healthcare provider first.”

Iron

Iron is extremely important for our bodies to function. It’s a part of hemoglobin, a protein in your blood that transports oxygen to different cells. Low iron is also related to hair loss, with excessive shedding. Hair may also grow more slowly and look thinner. Signs of an iron deficiency also include low energy, dizziness, headaches, and more.

“Hair loss due to an iron deficiency can be reversed, but it can take a few months for iron levels in the body to be restored and hair growth to resume,” says Faycurry, RD. “A healthcare provider or registered dietitian may advise you on iron supplements if you need them. Do not take iron supplements if your iron is in the normal range.”

Foods rich in iron

• Red meat, including beef and lamb
• Chicken and turkey
• Seafood like tuna and sardines
• Egg yolks
• Beans, lentils
• Dark, leafy greens like spinach
• Dried fruit like raisins and prunes
• Nuts and seeds
• Iron-fortified foods like certain breakfast cereals

Zinc

Zinc is integral to a host of processes in the body, including sight, skin health, wound healing, immunity, and hair health. A zinc deficiency can lead to hair shedding and breakage.

The recommended amount of zinc is:

• 11 mg per day for adult men
• 8 mg per day for adult women

Faycurry, RD, notes, “Zinc is usually easy to find in food. But since it is not stored in the body, it must be eaten every day.”

Foods rich in zinc

• Beef liver
• Beef and lamb
• Seafood like shrimp, crabs, and oysters
• Peanuts
• Dairy products like milk and cheese
• Nuts and seeds
• Lentils (but soak them before you cook them to get the most zinc out of them)

3. Not getting enough protein

Our protein intake plays a starring role in maintaining hair health because hair is largely made of a protein called keratin. Like all proteins, it is made of amino acids, which your body gets or makes from the protein you eat.

Not eating enough protein in your diet can lead to dry, weak, and brittle hair that breaks easily.

Since tirzepatide reduces appetite, some people forget to eat meals or find it hard to eat well-proportioned, nutritious meals. This may result in not getting enough protein and lead to hair loss.

How much protein do you need?

Faycurry, RD says, "Protein needs vary based on weight, activity level, and individual factors. A registered dietitian can assess potential deficiencies and guide you as you reintroduce an appropriate amount of protein to your diet."

4. Other underlying hormonal imbalances

Eapen MD says, “When we start a new medication and notice hair loss, it’s normal to assume it’s because of the drug. In some instances, it may just be a coincidence. Changes in hormones like testosterone and estrogen may also lead to hair loss.”

For example, what if you take tirzepatide but are also going through perimenopause or menopause? Your hair loss may not be due to the medication. High levels of androgens like testosterone, seen in women with PCOS (Polycystic Ovary Syndrome), are linked to hair loss.

Additionally, an imbalance in thyroid hormones can lead to excessive shedding and premature greying.

5. Genetic factors

Genes strongly influence hair loss, particularly androgenetic alopecia, which is commonly known as male and female pattern baldness. Research shows 30-50% of men will experience pattern baldness by age 50.

While genetic hair loss is permanent and can't be prevented, treatments like minoxidil, oral medications such as Propecia, and hair transplants could potentially delay or help manage its appearance.

How to stop hair loss on tirzepatide?

It’s normal to lose 50-100 strands of hair each day, but it may be excessive if you notice clumps of hair falling out, a thinning scalp, a widening or receding hairline, or bald patches. An itchy, red, or flaky scalp might also indicate that you're experiencing hair loss.

According to Faycurry, RD, "Hair loss occurs for many reasons, with or without tirzepatide. Seek medical evaluation to determine the root cause and find an appropriate solution. You could start by consulting a dermatologist or another healthcare provider. If blood tests reveal nutritional deficiencies or you cannot eat the recommended amount of nutrients daily, a registered dietitian can assess your needs and recommend interventions to support hair regrowth.”

Find the best Zepbound diet. Consult a registered dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.