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.