Study Uncovers First Genetic Link Between GLP-1RA Use and Male-Pattern Hair Loss

Men with androgenetic alopecia may have a 7% added risk of hair loss if they use drugs like semaglutide (Ozempic/Wegovy, Novo Nordisk) and tirzepatide (Zepbound, Eli Lilly and Company) for type 2 diabetes and obesity, a new study in the Journal of Investigative Dermatology shows. The study focused on the GLP1R gene, which naturally increases the body's levels of glucagon-like peptide-1 (GLP-1) receptor proteins, and used it as an indicator of GLP-1 agonist activity. More GLP1R activity means there are more GLP-1 receptor proteins. The researchers compared the presence of GLP1R genes with the presence of genes found in men with androgenetic alopecia. Many glucagon-like peptide-1 receptor agonists (GLP-1RAs) users, both men and women, have reported thinning hair as a side effect, with researchers so far attributing the shedding to the rapid weight loss driven by the medications. Often, GLP-1RA users have found that hair growth resumes several months after their weight stabilizes. Until now, researchers have only suspected a genetic connection between GLP-1RA use and hair loss. For the study, researchers accessed large, publicly available genetic databases, including the eQTLGen database of 31,684 mostly White men and women, and the Complex Traits Genetics group database of 205,327 mostly White men. They found that that the GLP1R genes that naturally cause higher levels of GLP-1 receptor proteins are more likely to be present in men who have androgenetic alopecia. The researchers then adjusted their analysis to discount for known risks of hair loss from hypertension, and The 7% added risk remained the same. Researchers also checked their risk analysis against other potential drivers of hair loss, including insulin resistance and lowered testosterone levels. Still, the increased risk of hair loss from GLP-1 use remained at 7%. Because the study involved genes active in both GLP-1 users and men with hair loss, any overlapping risk suggests that the two are biologically linked, the researchers note. '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 study senior investigator Lynn Petukhova, PhD, an Assistant Professor in the Ronald O. Perelman Department of Dermatology and the Department of Population Health at NYU Grossman School of Medicine in New York, NY, in a news release. '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,' adds Dr. 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.' Further research is needed to understand the biological mechanisms that cause GLP-1RA use to weaken hair follicle growth and to determine if the links seen in men apply to women, she says.