Excessive Hair Shedding — Is Stopping Tirzepatide Really Necessary?

ETA: I took the leap and started on .625mg of oral minoxidil just now. Forgot to ask the dermatologist specifically if she thought that tirzepatide could be causing my hair loss independently of my weight loss ☹️ I did ask her about stopping tirzepatide all together and she said I’d have to take to my prescriber about that. Hi! I wanted to get your thoughts on something I’ve been struggling with. I started my tirzepatide journey in March, and by June I began experiencing significant hair shedding. Unfortunately, five months later, I’m still shedding excessively, and it’s becoming incredibly upsetting. In August, I had bloodwork done and discovered my ferritin was only 21. My PCP wasn’t particularly concerned about that number. Instead, he recommended cutting my tirzepatide dose in half and eventually stopping the medication altogether if I could maintain my weight for a month. I decided to see a dermatologist, who diagnosed me with telogen effluvium. She recommended focusing on getting my ferritin to at least 75 and prescribed low-dose oral minoxidil and Ketoconazole. However, I’ve been too nervous to start the minoxidil because of the possibility of increased shedding initially. After seeing how much hair I lost following yesterday’s shower, I’m honestly at my breaking point. I have another appointment with my dermatologist today, and I’m terrified she’s also going to recommend discontinuing tirzepatide. I’ve had tremendous success with this medication and really don’t want to give it up, especially since I believe my low ferritin may be contributing significantly to the shedding. I’m curious what Belle’s thoughts are. Have you seen prolonged telogen effluvium in patients taking tirzepatide, even after their weight has stabilized? Is discontinuing the medication typically necessary, or can the shedding resolve while continuing treatment if underlying issues like low ferritin are addressed? I’ve been working on my ferritin levels for 10 weeks now. It is at a whopping 33 now. I’d really appreciate your perspective because I’m struggling with what to do next.

1. Belle member

   I currently am seeing a dermatologist as well who has me on oral Minoxdil and Finasteride for hair shedding. The Minoxdil does work and I saw hair shedding briefly but than had lots of regain growth.

2. Belle member

   @member wilhelm have you noticed hair growth anywhere else on your body? I wanted to try this, but I was concerned about the places where I didn't want it.

3. Belle member

   @member I have not had that issue at all, only my head.

4. Belle member

   @member wilhelm my dermatologist prescribed .625 mg to start. I seriously don’t think I can withstand much more. My hair is waist length and was thick but not anymore 😞 This was after the shower so not even what came out in it.

5. Belle member

   Beth, My personal experience: I lost SIGNIFICANT volume of my hair early on during weightloss. Many days of tears and panic - I understand your struggle. Now a year in maintainence my hair is growing back in normal volume again and very healthy. Actually the healthiest its ever been. Things to know: our hair sheds in 3-6 month cycles, it is a normal process in weightloss and hormonal changes Changes I made: *made a concious effort not to panick and trust in the process, eliminate un-necessary stress (the hardest mental change) *focused on eating protein first and whole nutrient dense foods *took multi-vitamins, also vit D with K2, vit c, 7 different magnesiums (I’ve read others have mentioned taking pre-natal vitamins) *removed all possible stress on my hair: I stopped using hair tyes, no hair products, only low heat on my hair dryer, I had very long hair when I started and cut it to collar length, changed my shampoo & condtioner to the brand Vita Prima (chemical free). I also switched to shampooing only twice a week. I started Tirzepatide two years ago. I never stopped taking my weekly shots and I never lowered my dose. I’m thriving with all the health benefits in addition to the weightloss taking Tirzepatide. Hope this helps you!

6. Belle member

   I have low iron and thyroid issues along with post menopause which is cause for hair loss. I went on oral script and still Taking triz as I been in maintenance I know How you feel it hard but I am seeing results now 6 months on script and they had me use a special shampoo for the first few days and it seem to help. I have to send name after work as I don’t get home till about 8 pm mst

7. Belle member

   @member wilhelm same here what few chin hair came I had before the script and it not often

8. Belle member

   @member thank you so much for your thoughtful reply. I’ll tell you which one of your suggestions I’m struggling with most is making a conscious effort to not panic. I’m terrible. I will only wash my hair once a week. I’m great on protein with at least 81g a day. And my vitamins are blood levels are spot on. I’m so over the top at this point that I made a chart to document the time I take each of my supplements. I truly don’t want to stop this medication but if I have to to save my hair I will.

9. Belle member

   @member thank you for your reply. I am on day 5 of HRT! Thinking part of the issue is the heavy periods I had right after starting the medication. It has been crazy so I know that’s not helpful for my ferritin. Now here I sit on day 54 and not a period in sight. Maybe it jump started menopause for all I know.

10. Belle member

    Your hair grows and sheds in cycles. Unfortunately most weight produces hair shedding. The best thing you can do is try to get ahead of it by taking minoxidil. I have seen derms say certain dandruff shampoos also help - specifically Nizoral works to combat hair loss.

11. Belle member

    I take freeze dried (dessicated) grass fed beef liver capsules for ferritin etc to prevent this from happening.. if your ferritin levels are low that causes hair loss whether you’re on a glp-1 or not. If you don’t solve your malnutrition it won’t stop, even if you stop the GLP-1. Nutrition is incredibly important. Sidenote: there are various supplements like selenium that can cause hair loss when you’re overloading on them. I really wonder if some people who have worse hair loss are doing too much to try to prevent it.

12. Belle member

    @member it very well could be as I know the cards was all stacked against me as the post meno definitely play a roll and heavy cycles are rough on low iron. I definitely wouldn’t give up on your journey as I been in maintenance for a year since Oct and have hair that to my butt so it been hard having it fall out I just wish I did the script sooner

13. Belle member

    Beth this may seem like a superficial answer given the depth of your struggle. But I was having the same issue and have long thick hair. I noticed not only was it falling out in the shower but the strands felt thinner. These three things over the past 6 weeks brought it back. Not fully yet but so much better. - daily biotin - Aveda scalp renewal. Overnight serum. I’ll post a photo. - I had a handyman install a mineral based shower head. With the scalp serum I also put a silk bonnet over my hair at night. It helps trap the natural oils. I’m actually shocked by how much improvement there is. Feeling for you on this. Today I experienced hardly any hair coming out in the shower.

14. Belle member

    Here it is

15. Belle member

    @member What dose of oral minoxidil are you taking?

16. Belle member

    @member she also prescribed me Ketoconazole shampoo. I was hesitant starting it because it can be drying but I’ve now used it a couple times. I just lather my hair in coconut oil first. I took the leap and started the oral minoxidil tonight.

17. Belle member

    @member Thank you for your response. I have taken a selenium supplement for years. I decided to have my level checked with my last blood draw because I saw it can cause loss if it is high. My level was 130 and the range is 93 - 198. So it is okay.

18. Belle member

    @member you! I’m so happy to hear your hair loss has slowed down! I’ve actually been thinking about getting one of those showerheads myself, so I’ll have to look into that more. I’ve been taking hair, skin, and nails vitamins since before I even started tirzepatide. I’ll definitely check out that serum, too! I’ve also considered a silk hair covering for sleeping. I already use a silk pillowcase, but I figure a little extra protection couldn’t hurt!

19. Belle member

    @member thank you!

20. Belle member

    @member mine is 2.5 minoxidil and 2.5 finasteride and 2.5 biotin 1 mg of folic acid one tablet

21. Belle member

    @member sounds like you have it covered. I definitely feel the healing effects of the serum. I massage it into scalp every night and put my hair in the bonnet. My hair has gotten softer and not losing hair like I was.

22. Belle member

    @member yeah I’m not saying that is your specific issue, just something for everyone to keep in mind, and there are other supplements besides selenium that cause hair loss in overdoses that people can research on their own if they have this issue. Your issue is very clearly that your ferritin is exceedingly low and you haven’t made much of any progress in raising it up, so the issue with your hair just isn’t going to improve. Whatever is going on with your diet is not providing you with adequate nutrition. Again regardless of the glp-1, if you don’t fix this the hair loss is not going to stop.

23. Belle member

    @member us updated!! 😘

24. Tiffany Bailey PA-C · Belle expert

    Beth, I'm so sorry. Shedding like this is really upsetting. What you're describing sounds like telogen effluvium, which is common with fast weight loss. It usually shows up a few months in and is temporary. Working on your ferritin is exactly the right move, and many people see the shedding settle without stopping their GLP-1. Whether to change your dose is a call for you and your prescriber, so message your care team in the portal. Our Hair Loss guide in Educational Resources may help too.

25. Belle member

    @Tiffany Bailey PA-C thank you so much for your response! I just started on oral minoxidil this past Monday at the suggestion of my dermatologist. She has me at .625mg and to increase to 1.25mg after 2-3 weeks if I am tolerating it okay (which I feel I am so far). Bracing myself for the dread shed though.