Can tirzepatide (a glucagon-like peptide-1 receptor agonist) cause hair loss in patients?

Does Tirzepatide Cause Hair Loss?

Tirzepatide may cause hair loss (alopecia), though this is an emerging adverse effect that is not yet well-characterized in the medical literature. 1

Evidence for Hair Loss with GLP-1 Receptor Agonists

Alopecia has been reported as a potential adverse effect across the entire class of GLP-1 receptor agonists, including tirzepatide, semaglutide, liraglutide, and dulaglutide. 1

• More than 1,000 spontaneous cases of hair loss have been reported to the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) in association with GLP-1 receptor agonists 1
• The most frequently identified clinical patterns of hair loss are telogen effluvium and androgenetic alopecia 1
• The mechanism appears to involve alterations in the hair follicle cycle, though the exact pathophysiology remains unclear 1

Clinical Context and Frequency

While gastrointestinal symptoms (nausea, vomiting, diarrhea) remain the most frequently documented adverse effects of tirzepatide, occurring in the majority of patients 2, 3, hair loss represents a less common but increasingly recognized concern.

• Hair loss with tirzepatide has been documented in retrospective observational studies and pharmacovigilance analyses 4, 1
• The temporal relationship suggests hair loss typically occurs within the first 6 months of treatment initiation 4
• Most reported cases lack formal dermatological diagnostic confirmation 1

Mechanism and Risk Factors

Rapid weight loss itself may be a contributing factor to hair loss in patients taking tirzepatide. 4

• Tirzepatide produces substantial weight loss of 20.9% at 72 weeks with the 15mg dose 2, 3
• Enhanced monitoring is recommended for patients experiencing rapid weight loss 4
• The distribution of GLP-1 receptors in multiple organ systems, including potential effects on hair follicle cycling, may contribute to this adverse effect 1

Clinical Recommendations

If hair loss occurs during tirzepatide treatment, consider the following approach:

• Document the pattern and severity of hair loss, ideally with dermatological consultation to confirm the diagnosis (telogen effluvium vs. androgenetic alopecia) 1
• Assess nutritional status, as rapid weight loss can lead to nutritional deficiencies that contribute to hair loss 2
• Consider the temporal relationship between medication initiation/dose escalation and onset of hair loss 4
• Weigh the benefits of continued treatment (substantial weight loss, glycemic control, cardiovascular benefits) against the impact of hair loss on quality of life 2, 1

Important Caveats

• A definitive causal relationship between tirzepatide and hair loss has not been established, though the recurrence of cases across diverse settings signals a potential safety concern 1
• Hair loss is not currently listed in the official drug prescribing information for tirzepatide 4
• Awareness of this possible effect may improve therapeutic adherence and prevent unnecessary diagnostic interventions 1
• Further dermatological research is needed to better characterize the frequency, temporality, and underlying mechanisms of GLP-1RA-associated alopecia 1