Episode Transcript
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Speaker 1 (00:00):
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello everyone,
(00:21):
this is Karen Nickel, family nurse practitioner, and you are
listening to Itchy and Bitchy, a podcast that provides answers
to your many unanswered health questions. The use of diabetes
and weight loss medications like ozimbic or wagovi called GLP
one drugs many of you out there may have used them,
has absolutely exploded in recent years. As a matter of fact,
(00:43):
the use of these meds is up six hundred percent
in the last six years. According to a June twenty
twenty four pole The poll shows that twelve percent of
US adults have used one despite of the cost. That's
almost forty one million people. Holy cow. What we don't
(01:06):
talk about is the fact that fifty to seventy five
percent of people who start taking these drugs stop using
them within a year. It is not clear why this
is true, but it is thought that it could be
due to the high cost of the meds, due to
people stopping the med when they have reached their weight
loss goal, and due to medication side effects. The most
(01:30):
common side effects with GLP one medications are gastro intestinal
problems like reflux, diarrhea, constipation, nausea, and or vomiting, and
they can be quite severe. Another side effect that may
lead people to stop the med is hair loss. And
that's what I want to talk to you about today.
(01:52):
I had a couple of patients who had this complaint
when they used a GOLP one medication like Wagovi for
weight loss. They would say to me, Karen, this medication
really works, but I don't want to be skinny and bald.
That's not the goal. And fair enough, I understood their concern.
It's not an ideal trade off. We have several different
(02:13):
GLP one medications currently available for treatment of type two
diabetes or obesity, including ozimbic, Goovi, Rebelsis, Munjaro, zep bound, Trulicity, Victoza,
and Saxenda. Hair Loss, medically known as alopecia, can be
a distressing side effect of certain medications, including these GLP
(02:37):
one medications. While these meds are highly effective in managing
diabetes and in achieving weight loss, some people may experience
hair loss as a very much unwanted side effect. So
why do GLP one meds cause hair loss? Well, of course,
like so many things in medicine, the exact reason GLP
(02:59):
one meds may be contributing to hair loss is not
yet known. However, Also like so many things in medicine,
there are several theories. Some individuals may experience nutrient deficiencies
while taking these meds, especially if they already have poor
dietary habits or malabsorption issues. It is also possible that
(03:23):
because GLP one meds have properties that suppress appetite, and
boy they suppress appetite, people have less food intake and
that can potentially cause nutrient deficiencies and in particular, protein deficiencies,
which has been shown to be associated with hair loss. Additionally,
(03:45):
since these meds can cause vomiting, this could also be
a reason for the loss of nutrients and resultant hair
loss for those individuals who do not supplement with vitamins
and minerals while they're on these meds. The loss of
these essential nutrients, such as biotine, zinc, and iron can
cause hair loss, thinning, or delayed growth, and the loss
(04:07):
of iron in women can be especially detrimental to hair growth.
Golp one's work by mimicking the action of a hormone
called glucagon like peptide one. That's GLP one glucagon like
peptide one. This hormone helps regulate blood sugar levels. Hormone fluctuations,
(04:27):
particularly changes in insulin levels, may disrupt the hair growth cycle,
leading to hair loss. It is hypothesized that some GLP
one meds can lead to hormonal shifts that increase the
risk of something we call androgenic alopecia. This is also
known as male pattern baldness and that's when the hair
(04:51):
thins at the crown and the frontal hairline in men
and female pattern loss, which is thinning of the hair
all over the scalp and can result in permanent hair
loss in spite of stopping the medication. Androgenic alopecia is
influenced by genetics, so there is a predisposition to this problem.
(05:13):
Managing a chronic condition like diabetes can be stressful, and
stress is a known factor in hair loss. Additionally, the
emotional distress of experiencing hair loss itself can make the
problem worse. But the most likely cause, based on a
twenty twenty five study, is that golp ie medications often
(05:33):
cause very rapid weight loss, inducing physiological stress that leads
to telligen effluvium. This is a condition in which a
large number of hair follicles prematurely enter the resting phase
called the telligen phase of the hair growth cycle, leading
to increased shedding of hair. In the Wagovi clinical trial,
(05:58):
the people in the trial who lost more than twenty
percent of their body weight reported hair loss more often
than those who lost less than twenty percent of their
body weight. This further supports that the mechanism for hair
loss while on glp ie meds may be due to
the physiologic stress on the body from rapid weight loss
(06:22):
causing a disruption of hair cycle leading to hair loss.
In the Wagovi trial, three percent of the people reported
hair loss as a side effect while taking the med.
While hair loss is a relatively rare side effect of
these popular drugs, it is apparently prevalent enough that the
FDA is paying attention. As of January fourth, twenty twenty four,
(06:46):
the US Food and Drug Administration is currently quote evaluating
the need for regulatory action end quote due to serious
side effects, including hair loss, in people taking medications like
ozimp Munjaro, and wagov. More research may be needed to
determine whether hair loss is a direct result of these medications,
(07:08):
but many experts estimate that hair loss taking place after
taking ozimbic, wagovi or Munjaro or medications like it is
associated more with rapid weight loss and pre existing conditions
like diabetes, rather than the drug itself. So great, I
lose weight and lose my hair? What options do I have?
(07:32):
Fear not? There are options, and I will share those
with you after this quick break. So, if you are
(07:55):
planning on going on a golp one medication to treat
diabetes or for way loss management, and you want to
be proactive about preventing hair loss, or if you are
already on a golp one and are experiencing hair loss,
here are some strategies to mitigate the problem. Make sure
you maintain a balanced diet rich in essential nutrients. Gosh,
(08:20):
how many times have you heard me say that nutrient deficiencies,
especially in proteins, vitamins, and minerals, can contribute to hair loss.
Remember that hair is primarily made of a protein called keratin.
Include protein rich foods like lean meats, fish, eggs, and
(08:41):
legumes in your diet. To help offset hair loss, strive
to consume between point six and one gram of protein
per pound of body weight daily. I'm going to say
that again, point six to one gram of protein per
pound of body weight daily, and this is a minimum
(09:03):
of eighty grams ideally a minimum of one hundred grams
per day. Years ago, when I told a couple of
my good friends that they need to take in that
much protein every day, I thought they were going to
cause me bodily harm. They were angry and simply said, impossible,
Karen Nicol. Impossible. Well, it is possible, but you have
(09:26):
to be very intentional about the process to get one
hundred grams of protein in your diet every day. If
you want more info on how to do this, you
can listen to my podcast episode entitled Muscle is a
Must dated March second, twenty twenty four. Muscle is a
Must March second, twenty twenty four. Vitamins A, C, D,
(09:51):
and E, along with magnesium, calcium, zinc, and iron play
crucial roles in hair health. Get these nutrients buying, incorporating fruits, vegetables, nuts,
and whole grains in your diet. If needed, you can
add a daily supplement that includes these vitamins and minerals.
One good option is Naturulo's one daily multi vitamin for
(10:12):
women over fifty. It's vegan friendly, plant based, and it's
a whole food vitamin, and Natrullo is spelled in a
inno is nancy at u r Elo. It has been
third party tested by Consumer Lab and is not only approved,
but is also a top pick. It's one capsule a day.
(10:35):
Essential amino acids are also vital for hair health, and
you can get those from lean meats, fish, eggs, dairy products,
and plant based options like quinoa and soy. This daily
requirement can be obtained by a daily supplement or a
balanced diet rich in these nutrients. One good supplement option
(10:56):
that will also give you your protein is now Food Sports
Nutrition P Protein Now Foods Sports Nutrition P Protein that
contains twenty four grams of protein and nine essential amino
acids in one scoop. It is approved and a top
pick by a third party tester, Consumer Lab. Other supplements
(11:21):
to consider for hair health include biotin, which is known
for its role in hair growth and can be beneficial
a daily dose of two point five milligrams twice daily
is often recommended. That's twenty five hundred micrograms or two
point five milligrams twice daily. Omega three fatty acids can
also be helpful because they reduce inflammation and promote hair growth.
(11:43):
And there are some specialties supplements for hair support to
consider if you are going to start using a GLP
one medication or are currently using one. Viviscal and neutrophil.
I have patients who have used these supplements with very
good results. Viviscal hair growth supplements contain a blend of vitamins, minerals,
(12:06):
and marine complex called amino mar designed to nourish hair
from within and promote growth. Users typically take the supplements
twice daily and noticeable results can often be seen within
three to six months. It doesn't happen right away because
the hair growth cycle is a long cycle. Viviscal helps
(12:27):
to strengthen existing hair, reduce shedding, and improve overall hair health,
making it a beneficial addition to your hair care regimen
while on GLP one therapy. Neutrophil is designed to support
hair growth and improve hair health. It contains a blend
of vitamins, minerals, and botanicals that target the root cause
(12:50):
of hair thinning, such as stress, hormonal imbalances, and poor nutrition.
When purchasing this product, make sure you select the age
of appropriate formulation that best meets your needs. Keep in
mind again that it may take three to six months
for you to see the full effect. Many of you
(13:10):
already know about monoxidil or the brand name rogaine, which
is an over the counter topical treatment that can stimulate
hair growth. It comes in two percent and five percent strengths.
You apply it directly to the scalp as directed by
the product instructions. Although topical monoxidil isn't proven to promote
(13:32):
hair recovery intelligent effluvium in particular, in theory, it can
provide benefits, and if you want to be proactive while
on a GOLP one med this could be an option. Women,
you know you can use the higher strength of five
percent that is typically marketed to males if you tolerate
(13:52):
it okay. Recent trials show oral monoxidil as an effective
and a well tolerated alternative for both both men and women.
For those struggling with topical formulations. The oral form is
by prescription only. And note do not use any form
of monoxidil if you are pregnant. Do not use any
(14:16):
form of monoxidil if you are pregnant. There are some
other measures you can take practice gentle hair care. Use
mild sulfate free shampoos and conditioners, avoid heat styling tools,
avoid harsh treatments like frequent coloring, perming, or straightening, and
minimize tension on the hair from tight hairstyles to prevent
(14:39):
further damage to fragile hair. Regular scalp massages can increase
blood circulation to hair follicles, promoting hair growth. Use natural
oils like coconut or ragon oil for added nourishment. Some
lifestyle modifications to lessen hair loss while on these meds
include managing your stress through regular physics, activity, mindfulness training, yoga, meditation,
(15:03):
or whatever works for you, and getting seven to eight
hours of good sleep each night. I know, I know
it's not always easy, but it's always an important goal.
In some cases, switching to an alternative diabetes medication or
weight loss medication that does not have hair loss as
a side effect may be the only solution, but this
(15:25):
is something you should discuss with your health care provider.
There are a couple of procedural therapies that can be
used if other methods are not working for your hair loss.
One is platelet rich plasma therapy or PRP therapy. PRP
involves injecting platelet rich plasma from your blood into the scalp.
(15:47):
This can stimulate hair growth by enhancing blood supply to
hair follicles. PRP is typically administered by a dermatologist or
a specialist in hair restoration. Another option is using bochulinum
toxin a, which is branded name Botox, or multi vitamin mesotherapy.
(16:07):
One brand is called derma Heel. They are products that
are injected into the scalp. Recent studies have also shown
that both bochulinum toxin a and multi vinamin mesotherapy are
effective in treating intelligent effluvium. A few take home thoughts
for you today. Make sure you are going to your
(16:28):
regularly scheduled checkups when you are on a GLB one
medication and let them know what, if any side effects
you are experiencing. If you are having hair loss, let
them know that so that appropriate labs like thyroid and
iron levels can be checked to make sure those problems
are not part of the picture. Also, if the hair
(16:48):
loss is persisting or worsening, schedule and an appointment with
a dermatologist who specializes in hair loss so they can
provide a personalized treatment plan for you. Experienced hair loss
can be very distressing. I know I saw many patients
deal with this, but please remember that you are not
(17:09):
alone and there are always ways to address the problem.
Thank you all for listening. Wherever you listen to this podcast,
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(17:31):
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leave comments or questions for me. Our website is itchymbitchi
dot com, where there are blogs with some of our
subjects available for you to read. As always, thanks to
Forest Wincel my Son, our producer and composer of our
theme music, and the person who does all the behind
(17:51):
the scenes work to make this podcast possible. Thank you.
Forest Boris is gearing up to go into his second
year at Peabody Music Conservatory. I'm sure there's exciting stuff ahead.
For him, so proud of him. Remember your health is
in your hands.