I have lost 3st (19kg) in six months with Mounjaro injections, but I’ve noticed my hair is getting much thinner. Is there anything I can do?
Frances Roberts, Brighton.
Dr Martin Scurr replies: You are correct in your suspicions. There is evidence that people using weight-loss drugs containing semaglutide (brand name Wegovy) and tirzepatide (Mounjaro) can experience widespread thinning of the hair on their scalp.
I’ve also seen patients complaining of brittle and flaking fingernails, or reduced nail growth. One patient who came to see me about this had very obviously lost a lot of weight since her last appointment, but it wasn’t until close questioning about this that she admitted, with some embarrassment, to obtaining the injections online.
It’s thought that the hair and nail changes are related to nutritional deficiency and rapid weight loss, rather than a toxic effect of the drugs.
In clinical trials of semaglutide, 3 per cent of patients reported hair loss, compared to 1 per cent in the placebo groups. The hair loss with tirzepatide was more than 5 per cent.
Hair shedding with rapid weight loss is like that following a pregnancy, or when recovering from an acute illness: known as alopecia effluvium, it is temporary and relates to the physiological stress of what the patient has been through.
Normally, the hair follicles across the scalp are in one of three stages – active growth, resting or shedding. Under stress conditions, follicles go into a resting and then shedding. Once the patient is back to normal health, the regular pattern of hair growth is restored.
In the case of eating less because you’re taking an appetite-suppressing drug (e.g. Mounjaro), it is also possible that you’re missing out on nutrients such as iron, zinc and biotin, along with other molecules important for hair follicle health.
The answer for you is clear: while you remain on the jabs losing weight, your hair may continue to shed.
But focus on eating plenty of protein and foods rich in iron (e.g. red meat, poultry, seafood, dark leafy veg, nuts) and zinc (e.g. dairy, eggs, wholegrains, nuts) – alongside a healthy, balanced diet. Include oily fish or flaxseed oil (if you’re vegetarian) and keep hydrated, as this is also important for hair health.
In clinical trials of semaglutide, 3 per cent of patients reported hair loss, compared to 1 per cent in the placebo groups. The hair loss with tirzepatide was more than 5 per cent
I had spinal surgery six months ago and the feeling I had in my toes before – like I was walking on balloons – is now worse, having spread across the bottom of both feet.
Thomas Poole, by email.
Dr Martin Scurr replies: It sounds like you had compressed nerves in your lower spine. This is often caused by spinal stenosis (essentially age-related wear and tear, such as bone spurs or bulging discs) that leads to the spinal canal becoming narrowed. This in can put pressure on the nerves that supply the legs and feet.
While decompression surgery (such as trimming a disc or fusing the vertebrae) can be effective, the nerves don’t always recover afterwards – they have been too damaged. Scar tissue can form at the surgery site, which can further trap nerves.
On rare occasions, a haematoma (where blood pools beneath the skin) or infection after the surgery can also cause nerve compression, although this is normally seen soon after the operation, not six months later.
The surgery itself can also damage the nerve roots in the spine and this might explain why your symptoms are worse. This usually tends to resolve within a few months.
Assuming you don’t have an underlying illness such as diabetes (which can lead to nerve damage), my view is that your symptoms – despite the degree of worsening – are neither unusual nor sinister and there is still time for improvement.
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context. Always consult your own GP with any health concerns.
