Semaglutide and Hair Loss
Semaglutide does not cause hair loss as a recognized side effect based on current clinical evidence and guidelines. While semaglutide has several documented adverse effects, hair loss is not among them.
Known Side Effects of Semaglutide
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for treating type 2 diabetes and obesity. According to comprehensive safety reviews, the most common adverse effects include:
Gastrointestinal effects: Most common and dose-related 1
- Nausea (reported in up to 40% of patients)
- Vomiting
- Diarrhea
- Dyspepsia
- Constipation
Gallbladder disorders: Increased risk of cholelithiasis 1
Other potential concerns:
- Risk of pancreatitis
- Potential impact on diabetic retinopathy in patients with pre-existing conditions
- Thyroid concerns (theoretical risk based on animal studies)
Evidence on Safety Profile
The safety profile of semaglutide has been extensively studied in clinical trials:
The SUSTAIN and PIONEER trial programs evaluated subcutaneous and oral semaglutide, respectively, and found no reports of hair loss as a side effect 1
A comprehensive safety review published in Frontiers in Endocrinology concluded that semaglutide has "no unexpected safety issues" beyond those known for the GLP-1 receptor agonist class, with hair loss not being mentioned among the documented adverse effects 1
In weight loss trials such as STEP 1, where participants received semaglutide 2.4 mg weekly for 68 weeks, hair loss was not reported among the adverse events despite careful monitoring of side effects 2
Pre-treatment Assessment and Monitoring
When initiating semaglutide therapy, clinicians should focus on established risk factors:
- Screen for personal or family history of medullary thyroid carcinoma and multiple endocrine neoplasia syndrome type 2 3
- Assess for history of pancreatitis or gallbladder disease 3
- Monitor for diabetic retinopathy in patients with pre-existing disease 1
- Evaluate renal function, though no dose adjustment is required even in advanced renal insufficiency 3
Practical Considerations
When counseling patients about semaglutide:
- Inform them about the common gastrointestinal side effects, which are typically mild-to-moderate and transient 1
- Follow the standard titration protocol to minimize gastrointestinal side effects:
- Start with 0.25 mg weekly for 4 weeks
- Gradually increase every 4 weeks until reaching the target dose 3
- Reassure patients that hair loss has not been identified as a side effect in clinical trials or post-marketing surveillance
Conclusion
While patients may have concerns about potential hair loss with medication use, the current evidence does not support an association between semaglutide and hair loss. The well-documented side effect profile of semaglutide primarily includes gastrointestinal symptoms and gallbladder disorders, with no evidence suggesting impact on hair growth or retention.