Everything was going well. Down 38 lbs, side effects manageable, feeling great about my progress. Then I started finding hair in the shower drain. A lot of hair.
At first I thought I was imagining it. Then I noticed my ponytail was thinner. Then my part was wider. Within two weeks, it was undeniable — I was experiencing significant hair shedding.
I panicked and went to a dermatologist. She diagnosed telogen effluvium — stress-induced hair shedding triggered by rapid weight loss and/or caloric restriction. She said she has been seeing this constantly since the GLP-1 medications became popular. It is not the drug directly causing it — it is the nutritional stress of losing a significant amount of weight quickly.
Her recommendations: increase protein to 80-100g daily (I was averaging about 45g, which is way too low when you are on these medications), add a biotin supplement, continue the medication, and be patient — telogen effluvium is temporary and reverses once nutrition stabilizes.
I am two months past the worst of the shedding. My hair is growing back. I was protein-deficient without realizing it because tirzepatide made me eat so much less that I was not getting adequate nutrition. This is the lesson: the appetite suppression can be so effective that you undereat to the point of causing nutritional deficiency.
Track your protein. Take your vitamins. Do not just celebrate the weight loss without making sure your body is getting what it needs to function. The drug removes the hunger, but it does not remove the nutritional requirements.