Zepbound Hair Loss: Tirzepatide Rates by Dose, Timing and What to Do

Short answer: yes, hair loss is a listed adverse reaction for Zepbound. In its two main trials it was reported by 4% to 5% of adults on tirzepatide and 1% on placebo, by 7.1% of women against 0.5% of men, and the label ties it to weight reduction.^[1] The Mounjaro label, for the same molecule, lists alopecia only from post-marketing reports.^[2] The shedding usually described is telogen effluvium, which starts a few months after the trigger and usually grows back.^[3][4]

This page is the tirzepatide angle: what the Zepbound and Mounjaro prescribing information and the trials record, dose by dose, what 2026 research adds, and what is worth doing. What telogen effluvium is in depth, the semaglutide evidence and the bariatric surgery comparison are in our longer piece, does Ozempic cause hair loss. The nutrition side sits under our guide to what to eat when you're eating less.

General information, not medical advice. Figures are from the FDA labels and the published studies cited, as of November 13, 2026. Talk to your prescriber before changing anything about the medication.

Zepbound hair loss at a glance

Question	What the evidence says
How common on Zepbound?	5%, 4% and 5% on 5, 10 and 15 mg against 1% on placebo, up to 72 weeks[1]
Who reports it more?	Women: 7.1% on Zepbound against 1.3% on placebo; men 0.5% against 0%[1]
Mounjaro?	No trial figure; alopecia is listed under post-marketing reports[2]
Against semaglutide, head to head?	8.3% on tirzepatide against 6.1% on semaglutide in SURMOUNT-5, an open-label trial with no placebo group[5]
Why?	The label says it was "associated with weight reduction"; 2026 records studies point the same way but cannot prove cause[1][6]
When does it start?	Telogen effluvium typically begins two to three months after the trigger[3]
Does it grow back?	Usually: the AAD says hair tends to regain its normal fullness within six to nine months[4]
Did anyone stop the drug for it?	No one on Zepbound in the trials; one person on placebo did[1]

Does Zepbound cause hair loss, according to the label?

Zepbound's prescribing information pools two placebo-controlled trials (Study 1 and Study 2) in which 2,519 adults with obesity or overweight took tirzepatide for up to 72 weeks. Hair loss appears in the table of adverse reactions reported in at least 2% of people and more often than on placebo, and in the summary list of the most common reactions. It is also on the list of common reactions in the Medication Guide that comes with the pens.^[1]

The label adds three details. Hair loss reports on Zepbound, in its words, "were associated with weight reduction". It was reported more often in women than in men. And no one on Zepbound discontinued the study drug because of it, while one person on placebo did.^[1]

How common is tirzepatide hair loss by drug and dose?

Medication	Trials in the label	Hair loss on the drug	Placebo
Zepbound (tirzepatide) 5 mg	Studies 1 and 2, adults with obesity or overweight, up to 72 weeks	5%	1%
Zepbound 10 mg	Same	4%	1%
Zepbound 15 mg	Same	5%	1%
Mounjaro (tirzepatide) 5, 10, 15 mg	Placebo-controlled trials in type 2 diabetes	No trial figure. Alopecia is listed under post-marketing reports	–
Wegovy (semaglutide) 2.4 mg	Three trials, adults with obesity or overweight, up to 68 weeks	3%	1%
Wegovy 7.2 mg	Two 72-week trials	6% (3% on 2.4 mg in the same trials)	1%
Ozempic (semaglutide) 0.5, 1, 2 mg	Trials in type 2 diabetes	No trial figure. Alopecia is listed under post-marketing reports	–

Sources: Zepbound prescribing information, section 6.1, Table 1;^[1] Mounjaro, sections 6.1 and 6.2;^[2] Wegovy, section 6.1, Tables 3 and 4;^[7] Ozempic, sections 6.1 and 6.2.^[8] The labels warn that rates from different drugs' trials cannot be directly compared.

Three things are worth reading out of that table.

• No clear dose step for tirzepatide. 5%, 4% and 5% across the three Zepbound doses is flat. The semaglutide labels do show a step: 3% at 2.4 mg and 6% at 7.2 mg in the trials that compared them directly, and the 7.2 mg text gives 5.8%.^[7]
• The placebo column is not zero. About 1 in 100 people reported hair loss on placebo. Some shedding turns up in any large group followed for more than a year.
• Most people on the drug did not report it. Roughly 95 in 100 on Zepbound did not.

Is hair loss more common on Zepbound than on Wegovy?

The only head-to-head trial is SURMOUNT-5, in which 751 adults with obesity and without type 2 diabetes took the highest dose they tolerated of tirzepatide (10 or 15 mg) or semaglutide (1.7 or 2.4 mg) for 72 weeks. Body weight fell by an average of 20.2% on tirzepatide and 13.7% on semaglutide.^[9] In the trial's results on ClinicalTrials.gov, alopecia was recorded in 31 of 374 people on tirzepatide (8.3%) and 23 of 376 on semaglutide (6.1%).^[5]

Two cautions. The trial was open-label, so everyone knew which drug they were on, and it had no placebo group, so it cannot say how much of either figure is the drug. The gap is modest, and it sits alongside a larger change in body weight on tirzepatide, which fits the labels' "associated with weight reduction" without proving it.

Why does the Mounjaro label have no hair loss figure?

Mounjaro and Zepbound are the same molecule at the same doses. The labels differ because the trials did. Mounjaro's table comes from people with type 2 diabetes and lists only reactions reported in at least 5% of people on the drug; Zepbound's comes from people with obesity or overweight and lists reactions at 2% and above.^[1][2] A reaction reported by around 4% or 5% can fall under one threshold and not the other.

What the Mounjaro label does say is that alopecia has been reported since it went on sale. It is careful about what that means: such reports come voluntarily from a population of uncertain size, so it is "not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure".^[2] The Ozempic label uses the same wording for the same entry.^[8] So "Mounjaro hair loss" is real enough to be on the label, but there is no trial rate for it.

Why are women affected more?

Both obesity labels split the figures by sex, and the gap is large:

Trials	Women on the drug	Women on placebo	Men on the drug	Men on placebo
Zepbound, Studies 1 and 2	7.1%	1.3%	0.5%	0%
Wegovy 2.4 mg, Studies 2, 3 and 4	4%	2%	0.9%	0%
Wegovy 7.2 mg trials	8.4%	1.5%	0.2%	0%

Source: the hair loss paragraphs in section 6.1 of each label.^[1][7] The labels do not explain the difference. A 2026 systematic review of 24 studies also found women disproportionately affected across GLP-1 medications.^[10] Part of it may simply be noticing: longer hair makes shedding visible sooner, and women are likely over-represented among people who seek treatment for shedding.^[3]

What did 2026 research add on tirzepatide and hair?

Three pieces of work published in 2026 looked at the question from outside the trials. None is a randomized trial.

• A matched records study (Laryngoscope). Using the TriNetX records network, adults on semaglutide or tirzepatide were matched to similar adults not on them. Both drugs were linked to higher odds of non-scarring hair loss. For tirzepatide, the odds of telogen effluvium were higher at every follow-up point (1, 1.5 and 2 years), and higher than with other GLP-1 medications. Alopecia areata, an autoimmune condition used as a check, showed no link, and people who developed hair loss had a lower follow-up BMI than those who did not. The authors suggest the physiological stress of a falling body weight may contribute.^[6]
• A second records study (Journal of the American Academy of Dermatology). A research letter, also using TriNetX, examined the risk of new-onset hair loss with semaglutide and tirzepatide and reported a higher risk.^[11]
• A systematic review of 24 studies (Science Progress). Semaglutide and tirzepatide showed the highest reported rates among GLP-1 medications. Tirzepatide, which produces the largest change in body weight, was the one most often linked to telogen effluvium, and rapid change in body weight emerged as a potential contributor. The authors say causality has not been established.^[10]

Honest summary: the link is consistent enough to counsel people about, the pattern is mostly the temporary kind, and the evidence still cannot separate the drug from the speed of the change it causes.

When does hair loss start on tirzepatide, and does it grow back?

Telogen effluvium is diffuse, non-scarring shedding after a shock to the whole body. Its recognized triggers include calorie restriction and severe protein deficiency. Shedding generally begins two to three months after the trigger, and the acute form lasts less than six months and usually resolves once the trigger is removed.^[3] The American Academy of Dermatology describes the same timing in plain terms: most people notice the extra shedding a few months after the stressful event, losing 20 pounds or more is on its list of triggers, and within six to nine months hair tends to regain its normal fullness.^[4]

That delay is why the shedding often appears just as the first months on Zepbound are going well, and why it is easy to blame the wrong week. Normal shedding is 50 to 100 hairs a day.^[4] Shedding that goes on past six months is classed as chronic, and the longer it lasts, the more likely the trigger is ongoing.^[3]

Do protein, iron, zinc or biotin make a difference?

No nutrient has been tested as a way to stop shedding on tirzepatide. What the evidence supports is making sure intake is not the trigger, and testing before taking anything.

Nutrient	What the evidence says	What that means in practice
Protein	Low protein intake is a recognized trigger for shedding.[12] The 2025 joint advisory notes 1.2 to 1.6 g per kg of body weight a day has been proposed while body weight is coming down, against an adult RDA of 0.8 g/kg.[13]	The one worth planning around. Numbers by body weight are in how much protein to eat on a GLP-1 and the protein calculator.
Iron	The advisory lists iron among nutrients of concern on GLP-1 therapy.[13] Correcting a documented deficiency is reasonable; benefit without one is unproven.[12]	Ask for ferritin and a blood count. Iron from plant foods absorbs better with vitamin C.[14]
Zinc	Also on the advisory's list.[13] Severe zinc deficiency is a recognized trigger,[3] and the adult upper limit is 40 mg a day.[15]	Test rather than stack products; more is not better.
Biotin	Deficiency is rare on an ordinary mixed diet,[16] and a review found biotin's efficacy for hair largely unsubstantiated outside deficiency.[17] High doses can distort some lab tests, including thyroid tests.[16]	No evidence it does anything for hair without a deficiency. If you take it, tell whoever draws your blood.

The advisory names "excessive hair loss" among the signs of a true nutrient deficiency, alongside fatigue beyond expected levels and unusual bruising.^[13] A review of diet and hair loss adds a warning: some supplements, such as selenium and vitamins A and E, can make shedding worse or cause toxicity when overdone.^[12] Background on what is worth taking is in which vitamins matter on a GLP-1 and supplements to take with a GLP-1; a day of food on tirzepatide is in what to eat on Zepbound.

When should you see a dermatologist or call your prescriber?

• Shedding still going six months after it began, the point at which telogen effluvium is classed as chronic.^[3]
• Patches, a receding hairline or a widening part. That pattern is not telogen effluvium and needs a diagnosis.
• A sore, burning or itching scalp.
• Any time the amount worries you. The AAD's advice is not to suffer in silence, and that the sooner treatment begins, the better the outlook.^[4]
• Other signs that intake is too low: tiredness that does not lift, bruising easily, brittle nails, strength falling away. The tirzepatide figures on tiredness are in does Zepbound make you tired.
• Any thought of stopping the medication because of your hair. That is a decision for you and your prescriber together.

Bring the timeline: when the shedding began, what changed two or three months before, how fast your body weight has been changing, and what you are eating now. A dermatologist will usually look at the pattern, may do a gentle pull test, and check for deficiencies that are actually there before suggesting any supplement.^[12]

For transparency about why this page exists on our site: we make one product, Zornava Replenish, a lemon-lime daily hydration and nutrient powder for lighter appetite days, including for people on GLP-1 medications. It is a dietary supplement, not a medication, and not a treatment for anything on this page. It is not on sale yet; early access opens February 9, 2027, and the early-access list is open now.

Not sure which part of your intake is slipping on lighter days? Our two-minute quiz sorts it into water, protein, fiber and vitamins.