GLP-1 drugs Wegovy and Ozempic linked to hair loss risk in men

GLP-1 drugs such as Wegovy and Ozempic rarely stay out of the news for very long.

They have shown themselves to be highly effective for weight loss management and type 2 diabetes, yet concerns remain about the treatments’ potentially adverse health effects.

A newly published study in the Journal of Investigative Dermatology examines the latter issue: the possible drawbacks of these transformative medicines.

Earlier research has indicated a possible connection between GLP-1 drugs and hair loss, partly because a considerable number of patients have reported it as a side effect. However, firm evidence for a link has been limited.

GLP-1 drugs and male-pattern hair loss

To investigate further, researchers led by scientists at New York University (NYU) Grossman School of Medicine used a genetic analysis method as a substitute for studying people actually taking the drugs.

They determined that, among men already genetically susceptible to androgenetic alopecia, or pattern hair loss, GLP-1 drug use could be linked to a 7 percent increased risk of hair loss.

"Our study provides the first genetic link between GLP-1 use and an increased risk of male-pattern hair loss from androgenetic alopecia, an association long suspected but until now not shown scientifically," says senior investigator Lynn Petukhova, a geneticist at NYU.

Rather than tracking people using GLP-1 medications, which replicate the effects of the glucagon-like peptide-1 hormone, the team applied a technique known as Mendelian Randomization. This approach uses particular genetic variants as proxies.

Genetic variants used as proxies

For this research, the scientists identified 22 genetic variants that raise expression of the GLP-1 receptor, or GLP1R, in the blood. People carrying these variants have greater activity in the same GLP-1 pathways targeted by medicines including Ozempic and Wegovy.

The variants were then checked against a health database containing 205,327 individuals, to establish whether they were more prevalent among men with androgenetic alopecia.

The analysis also accounted for other factors that could affect the findings, including blood pressure, testosterone and body-fat distribution.

As expected, men with androgenetic alopecia were 7 percent more likely to carry GLP1R genes that increase GLP-1 receptor proteins.

This points to a potential relationship between elevated levels of these receptor proteins and hair loss. Because GLP-1 drugs increase these proteins, it follows that they could also play a part in pattern hair loss.

That said, the comparison is not an exact one-to-one equivalent. Carrying GLP1R genetic variants is not precisely the same as regularly taking GLP-1 drugs, although the similarity is sufficient to indicate that a genuine association may exist.

"These findings should therefore be interpreted as evidence supporting involvement of the GLP1R pathway rather than direct pharmacologic effects," write the researchers in their published paper.

What the findings could mean for treatment

The researchers say the same association may also be relevant to women, although this study concentrated on men because substantially less data is available on patterned hair loss in women.

As with other GLP-1 drug side effects, such as nausea and constipation, awareness of the medicines’ possible consequences can help clinicians and patients decide whether they should be prescribed.

"Our findings suggest that, if future experiments prove successful, some men, and possibly women too, could be screened and benchmarked for their risk of hair loss before being prescribed GLP-1 medications," says Petukhova.

"We could also envision these findings leading to some GLP-1 users being prescribed combination treatments to prevent hair loss, such as minoxidil or some other drug."

These results are consistent with a study released earlier this year, which identified a link between GLP-1 drugs and hair thinning when compared with conventional diabetes treatments.

The researchers suggest GLP-1 medications could affect hair follicles directly, or indirectly through other elements of the body’s metabolism. The reason for the association is currently uncertain, but it may become clearer over time.

"Overall, these findings support a potential causal relationship between increased GLP-1R expression and male pattern hair loss risk," write the researchers. "The observed effect size is modest and, while statistically robust, its clinical relevance remains uncertain."

The research was published in the Journal of Investigative Dermatology.

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