Does Metformin Cause Hair Loss?

Metformin is the most commonly prescribed medication to treat type 2 diabetes, so you can only imagine how many prescriptions are written for it each year. 

Like any medication, metformin has potential side effects – but is hair loss one of them?

If you’re wondering if metformin causes hair loss, we have the answer in this article, along with effective ways to help treat and prevent hair loss regardless of the cause!

What is metformin?

Metformin is one of the most commonly prescribed medications for type 2 diabetes, but it can also be used for other conditions (more on that soon). 

Metformin is the generic name most commonly prescribed, and the brand name for metformin is Glucophage. 

You take metformin orally in the form of tablets with doses ranging from 500-2,550 milligrams daily.

Metformin is in a drug class called biguanides, which helps to reduce the amount of sugar your liver makes while improving insulin sensitivity, helping to reduce high blood sugar. 

There are two types of metformin – regular and extended-release (XR). The extended-release tablets are only taken once a day compared to 2-3 times per day with regular metformin and can help reduce stomach upset for some patients.

Metformin doesn’t cause low blood sugar (hypoglycemia), which is one of its major benefits. 

Because it doesn’t cause low blood sugar, people with type 2 diabetes can take metformin along with other diabetes medications.

While metformin is most commonly used for type 2 diabetes, it’s also used to help treat polycystic ovarian syndrome (PCOS). 

PCOS is a hormonal disorder in women, often stemming from insulin resistance and hormonal imbalances with symptoms like irregular periods, hair thinning, acne, and others.

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Does metformin cause hair loss?

Hair loss isn’t a known side effect of metformin. However, some of the conditions metformin is used to treat (especially PCOS) might cause hair loss, which makes it possible to have hair loss while taking metformin.

You might also experience hair loss from other medications and the natural aging process, among others. 

It’s important to note that metformin might not be causing hair loss in those instances.

In some cases, metformin can cause vitamin B12 deficiency, which may result in hair loss as a symptom. 

Other signs of vitamin B12 deficiency can include:

  • Lack of energy (lethargy)
  • Breathlessness
  • Feeling faint
  • Headaches
  • Pale skin
  • Irregular heartbeat (palpitation)
  • Tinnitus (ringing in the ears)
  • Loss of appetite and weight loss

Polycystic ovarian syndrome (PCOS)

Metformin is used “off label” to treat PCOS, especially among symptomatic women with insulin resistance with symptoms like acne and hair loss. Metformin can also be used to treat PCOS among lean patients.

PCOS tends to be associated with high testosterone levels, which can cause hair thinning and loss. If you’re taking metformin for PCOS, any hair loss is likely due to the hormonal imbalance from PCOS.

Changing hormones

Hair loss is common during the postpartum period after you have a baby. If you’re taking metformin during your postpartum period, then hair loss is likely due to the fluctuating hormones during the months after delivery.

Medications that can cause hair loss

Some medications come with the potential to cause hair loss, such as:

Certain antidepressants

Antidepressants might cause hair loss, including selective serotonin reuptake inhibitors (SSRIs) like Zoloft, Prozac, and Paxil, as well as bupropion (Wellbutrin) and serotonin and norepinephrine reuptake inhibitors (SNRIs).

Anticonvulsant drugs

Some medications for seizures might cause hair loss, such as valproic acid and pregabalin

Beta-blockers

Medications like propranolol, metoprolol, and atenolol are used to treat irregular heart rhythms and high blood pressure, and they might cause hair loss in some people.

Cholesterol-lowering medications

High cholesterol and diabetes are often connected, so there’s a good chance you might be taking a cholesterol medication in addition to metformin. 

The good news is that hair loss as a side effect of statins (the most common type of cholesterol medication) is considered extremely rare, impacting around 1% of people taking them.

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Metformin, vitamin B12, and hair loss

It’s estimated that between 6-30% of patients taking metformin could develop vitamin B12 deficiency due to metformin use. 

It’s not quite clear how metformin can cause B12 deficiency, but one theory is that it interferes with the binding of intrinsic factor, a protein that helps your intestines absorb vitamin B12.

If you develop a vitamin B12 deficiency, the treatment is vitamin B12 injections. Oral vitamin B12 treatment isn’t sufficient for treating a B12 deficiency because its absorption can be impaired due to the lack of intrinsic factor to absorb it in your intestines.

How do you prevent hair loss from diabetes?

The good news is that hair loss isn’t a common diabetes symptom. However, some studies have found an association between diabetes and increased hair loss in certain populations.

In general, the best way to reduce diabetes symptoms and complications is by promoting good blood sugar control. 

By keeping your blood sugar levels at a healthy range, you can help reduce inflammation and other negative consequences of long-term high blood sugar levels.

Some ways to help control your blood sugar levels and prevent possible hair loss include:

  • Taking diabetes medications as prescribed.
  • Staying physically active – aim for at least 30 minutes of activity most days of the week at a minimum.
  • Checking blood sugar levels regularly, either at home and/or with regular blood tests through your healthcare provider.
  • Eating a healthy diet low in added sugars and moderate in fiber-rich carbohydrates, as well as eating plenty of protein and healthy fats.

If you’re experiencing hair loss, there are some treatments available such as:

  • Minoxidil (Rogaine) – an over-the-counter topical treatment applied to your scalp.
  • Finasteride (Propecia) – a prescription medication for men to help slow hair loss.
  • Spironolactone – this medication is commonly used to treat symptoms of PCOS like hair thinning and acne, and works by blocking androgen (male sex hormone) to reduce hair thinning and loss.

5 natural remedies for hair loss 

1) Rosemary oil

Using rosemary essential oil on your scalp might help with hair loss, especially in women. Some studies have compared rosemary oil vs minoxidil for their effect on hair loss. 

According to one 2020 study, rosemary oil was as effective as 2% minoxidil (Rogaine) ointment!

To use rosemary oil as a natural remedy for hair loss, try mixing a few drops of rosemary essential oil with a carrier oil (such as fractionated coconut oil) and apply it directly to your scalp after you get out of the bath or shower, or add rosemary to your shampoo.

2) Pumpkin seed oil

In a review, pumpkin seed oil increased the hair count of male participants by 30-40% from the baseline after 12 and 24 weeks, respectively. 

Like rosemary oil, pumpkin seed oil can be applied topically, or it can be taken orally, which was the case for the participants in the study just mentioned.

3) Saw palmetto

Saw palmetto is a tree that forms fruit that is used for natural medicinal purposes. Saw palmetto has anti-androgenic properties, which means it can help suppress high levels of male hormones like testosterone, which can lead to hair thinning and loss.

According to the results of five randomized controlled trials, saw palmetto (used both orally and topically) resulted in an overall 60% improvement in hair quality, 27% improvement in hair count, and around 83% improvement in hair density.

4) Beta-sitosterol

A type of plant phytosterol, beta-sitosterol is thought to prevent hair loss by blocking the production of dihydrotestosterone (DHT), a type of androgen (male sex hormone) believed to be responsible for male pattern baldness.

Beta-sitosterol is found naturally in foods like rice bran, wheat germ, peanuts, corn oil, and soybeans, but it’s also found in more concentrated amounts in supplements.

5) Stress relief

High stress levels are known to be a contributor to hair loss. When you undergo high levels of stress, your hair follicles can go into a resting phase, which then causes them to fall out when you’re brushing or combing your hair.

Some natural stress-relieving techniques can include:

  • Avoiding caffeine and other stimulants
  • Meditation
  • Exercise
  • Deep breathing techniques
  • Lifestyle changes to reduce your stress load

A note on biotin: Biotin is a protein found in your hair, skin, and nails. Biotin supplementation to help prevent hair loss and support hair growth is incredibly popular, yet scientific studies have not shown a definitive benefit of biotin supplementation for hair loss.

Conclusion

Hair loss is not a common side effect of metformin, nor is it a symptom of diabetes. However, diabetes might be correlated with hair loss among certain populations, according to some studies.

If you develop vitamin B12 deficiency from taking metformin, hair loss can be an associated side effect. Around 6-30% of people taking metformin can develop vitamin B12 deficiency related to metformin.

There are several over-the-counter and prescription treatments for hair loss, as well as natural hair loss remedies, including rosemary oil, pumpkin seed oil, saw palmetto, and beta-sitosterol. Stress management techniques can also help combat stress-related hair loss.

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Sources

  1. Kim J, Ahn CW, Fang S, Lee HS, Park JS. Association between metformin dose and vitamin B12 deficiency in patients with type 2 diabetes. Medicine (Baltimore). 2019.
  2. Lashen H. Role of metformin in the management of polycystic ovary syndrome. Ther Adv Endocrinol Metab. 2010.
  3. Calle MC, Fernandez ML. Inflammation and type 2 diabetes. Diabetes Metab. 2012.
  4. Ezekwe N, King M, Hollinger JC. The Use of Natural Ingredients in the Treatment of Alopecias with an Emphasis on Central Centrifugal Cicatricial Alopecia: A Systematic Review. J Clin Aesthet Dermatol. 2020.
  5. Evron E, Juhasz M, Babadjouni A, Mesinkovska NA. Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia. Skin Appendage Disord. 2020.
  6. Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017.

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