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Is Metformin a Cause of Your Hair Loss?

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Metformin is one of the most commonly prescribed medications for the treatment of type 2 diabetes and polycystic ovary syndrome (PCOS).

Combining metformin with a healthy diet and daily exercise greatly helps a person keep blood glucose levels within the normal range.

It is often believed that the daily use of metformin causes thinning of hair and hair loss. However, hair loss in diabetics and especially those taking metformin seems multifactorial.

Does Metformin Cause Hair Loss?

Even though metformin use has been strongly correlated with hair loss, there is no significant scientific data that directly links hair loss with metformin use.

There are a few individual reports from metformin users about hair loss.

One such report highlighted that a 69-year-old man with type 2 diabetes who used metformin in combination with sitagliptin, experienced hair loss of eyebrows and eyelashes. The lab findings suggested it to be an adverse drug reaction. [Ref]

According to another study in 2013, long-term metformin use can lead to a decrease in vitamin B-12 and folate levels – which might indirectly be the cause of hair loss.

In addition, a 2015 case-control study discovered a link between alopecia and high blood sugar levels. This suggests that the condition (type 2 diabetes) might be the cause of hair loss but not the medication (metformin).

Even in the FDA data, there is no mention of hair loss in any of the side effects caused due to metformin use. In FDA data, hair loss is not listed as a possible side effect or problem associated with metformin. [Ref]

The report only mentions the following adverse effects of metformin use:

  • Diarrhea
  • Nausea
  • Flatulence
  • Indigestion
  • Abdominal discomfort
  • Headache

Another study, that assessed the effects of metformin use in 56 women with PCOS suggested that treatment with metformin was a remedy to regulate the menstrual cycle and decrease hair loss and acne in women with PCOS. [Ref]

Based on the currently available scientific evidence, there is no direct link between hair loss and the use of metformin.

Although, hair loss in metformin users can be caused due to any other factors that are indirectly linked to metformin use.

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Causes of Hair Loss other than Metformin:

Hair loss can be caused due to a number of reasons. Some reasons that might be indirectly linked to metformin use might be the disease conditions in which metformin is prescribed or the deficiencies that can be caused due to those conditions.

Here are some factors that might cause hair loss.

PCOS (Polycystic ovarian syndrome):

PCOS is a disease in which the androgen hormone levels are significantly increased. Women with PCOS start to develop a hormonal imbalance due to which they have increased facial hair and increased hair loss on the head.

Females with PCOS have abnormally high levels of androgens, also known as male hormones by doctors. This hormonal imbalance can occasionally result in hair loss. It may also result in excessive facial hair and acne.

Studies suggest that PCOS-induced androgen excess causes female pattern hair loss. It is also suggested that PCOS-related depression might also cause excessive hair loss. [Ref]

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High Blood Glucose Levels:

High blood glucose levels might be another cause of hair loss because if there is excessive sugar in your blood, that excess is transferred along with the blood to the blood vessels resulting in vascular damage.

Due to this damage, hair follicles do not receive the proper amount of nutrients – resulting in dead and damaged hairs that easily fall out.

This might also affect the overall hair growth and your hair might grow at a slower rate.

People with type 1 diabetes are more likely to be affected by hair loss because the immune system mistakenly attacks the hair follicles causing hair loss.

In people with type 2 diabetes, insulin resistance results in improper regulation of sugar levels in the blood.

Metformin is used to treat this condition which is why if your sugar levels are still not in control, that might be causing your hair loss.

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Excessive Stress:

Stress can have a variety of effects on the body, including temporary hair loss. Living with a long-term chronic condition such as diabetes or PCOS is stressful, but so are many other aspects of life. Stress can also make it difficult to maintain a healthy diet, lifestyle, and exercise routine.

Living with a chronic medical condition, such as diabetes, can be stressful. Furthermore, people who are stressed are less likely to stick to their diabetes treatment plan.

PCOS can also result in emotional stress, which can impact hormone levels in the body. These hormonal changes could cause or contribute to hair thinning.

Vitamin B12 Deficiency:

Taking metformin for an extended period of time can result in B-12 deficiency and anemia. Hair loss can be a symptom of either of these conditions.

Metformin may impair the gut’s ability to absorb vitamin B-12. This decreased absorption may explain why people experience B-12 deficiency symptoms.

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How do you treat metformin-associated hair loss?

Here are some remedies to stop hair fall.

  • Healthy Diet:

Stick to a healthy and nutritious diet to avoid nutrient deficiencies. While specific nutrients are not linked to hair loss, healthy hair requires adequate vitamins and minerals.

If your dietary intake is insufficient or your digestive function is impaired, your body may be lacking essential nutrients that promote healthy hair.

  • Consider the following hair loss treatments:

Hair growth can be aided by medications such as minoxidil (Rogaine). It takes time to work, with the daily treatment required for at least 6 months. However, for more severe hair loss, this can be a viable option.

Over-the-counter supplements such as Zinc, Biotin, and Vitamin B12 can help in hair regrowth. Some of these supplements are also available in the form of solutions and shampoos for topical application.

  • Try to avoid stressful conditions.

When you are diagnosed with diabetes, your stress level doubles. When you develop side effects of diabetes medications, your stress level further increases.

However, relieving stress by going out on a hike with family and friends, doing yoga, and practicing spirituality can relieve stress and improve your blood glucose at the same time.

Relieving stress can help in reducing hair loss as it is one of the important factors.

  • Be gentle in brushing:

Brushing, washing, or styling your hair harshly may result in more hair breakage or loss. If your hair is already thin or you have another condition that contributes to hair loss, being harsh can make the loss appear worse.

Lastly, in severe cases and when hair regrowth is minimal with the above interventions, a hair transplant is an option.

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Can you take a few seconds and answer the questions about metformin-associated hair loss?

  • Question of

    Have you noticed hair loss with metformin?

    • Yes
    • No
  • Question of

    How serious is your hair loss issue?

    • mild (patchy and not noticeable))
    • moderate (noticeable)
    • severe (clearly visible)
  • Question of

    Have you stopped metformin or planning to stop?

    • Yes
    • No
  • Question of

    What supplements are you taking to reverse the hair loss?

    • None
    • Zinc
    • Biotin
    • Iron
    • B 12 (Cobalamin)
    • multivitamins
  • Question of

    If you have discontinued metformin, have you noticed hair regrowth?

    • Yes
    • No
    • I have not discontinued metformin

What do you think?

Written by Ahmed Farhan

I am an Internist practicing medicine for the last fifteen years. Over the years, I have learned that medicine is not about prescribing pills. True medical practice is helping people.
I do prescribe pills as well but the best results I get are when I motivate people to overcome their problems with little changes in their lifestyles.
Since most of my patients are obese and have diabetes, hypertension, and high cholesterol levels, I am writing at dibesity.com when free.
Dibesity, I know the correct word is diabesity. Ignore this! Be with us.
Also, you can contact me directly at dibesity.com@gmail.com

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