Can Metformin Cause Hair Loss? We Asked a Doctor

At one time or another, most of us have relied on prescription medication to soothe an ailment or illness. Unfortunately, though drugs can often help bring us back to health, sometimes they also come with some seriously unwanted side effects.

Unfortunately, one side effect that's often triggered by a prescription drug is hair loss. As the medication runs through your system to level out any health conditions, you might experience hair loss, more hair growth than usual and changes in the color and texture of your locks. And with our hair often linked to our mental wellbeing, excessive hair loss can be a particularly troubling thing to deal with — especially when you're already working through existing health issues.

One medication that has been under the spotlight for potentially causing excessive hair fall is metformin. Metformin is commonly known as a diabetes drug. Some women have also been prescribed metformin if they're living with polycystic ovary syndrome, and in recent years some patients have raised concerns about the number of strands they've lost when taking the drug. But the reports are mixed, and diabetes in and of itself has been known to trigger hair loss. So if you've recently been prescribed metformin, you might be concerned about losing hair.

To help you unravel the connection between thinning hair and metformin, we've spoken to the experts and dived into the scientific evidence, as well as information on the products you can use to support fuller looking hair. 

What Is Metformin?

Metformin or metformin hydrochloride is often prescribed to help high-risk patients manage type 2 diabetes.  Dr. Jessica Nouhavandi, the lead pharmacist, co-founder, and co-CEO of Honeybee Health, explained, "Metformin is an oral medication for hyperglycemia in type 2 diabetes mellitus patients. It's the gold standard oral medication used when hyperglycemia cannot be controlled by diet and exercise alone." Diabetes patients with the type 2 variant often have insulin resistance. Insulin helps control blood sugar levels. Metformin remedies this by managing the high blood sugar levels in a few different ways.

Diabetes is a serious health condition, which, when left untreated, can, in worse case scenarios, result in death. And diabetes is not an uncommon condition. According to the American Diabetes Association, in 2015, nearly 30.3 million adult Americans were living with diabetes. However, taking metformin and healthy lifestyle choices can decrease the risks associated with diabetes.

Metformin can also be prescribed for polycystic ovary syndrome (PCOS), and it's on the World Health Organization's (WHO) List of Essential Medicines.

Read: The Connection Between Diabetes and Hair Loss Explained

What Are the Side Effects of Metformin?

Although many people take metformin regularly with minimal side effects, the U.S. Food and Drugs Administration suggest those taking metformin could experience:

• Bloating
• Stomach pains
• Constipation
• Weakness
• diarrhea
• Muscle pains
• Heartburn
• Headaches

Metformin isn't known for causing low blood sugar (aka hypoglycemia or hypos), but hypos can occur while taking metformin with other diabetes medicines, such as insulin.

One of the more serious (but relatively rare) side effects of taking metformin is lactic acidosis, a lactic acid build. A severe condition that can potentially be fatal, lactic acidosis can occur throughout metformin therapy in humans with liver or kidney disease. Lactic acidosis has early signs that are easy to miss, so if you're new to taking the drug, check in with a healthcare provider if you experience abdominal pain, a general sense of feeling unwell and difficulty breathing.

In an unusual occurrence, since early 2021, at least 13 drug companies have recalled their extended-release metformin tablets due to potentially high levels of known cancer-causing ingredient, Nitrosodimethylamine, found in the formulas. If you're at all concerned, discuss this with your healthcare provider.

Does Metformin Cause Hair Loss?

So, does metformin cause hair loss? Though commonly associated with hair thinning, nowhere in the official metformin documentation does it state hair loss as one of the adverse side effects. That being said, there have been complaints.

In general, drugs can interfere with the normal scalp hair growth cycle. Any new medication you take can trigger fluctuating hormones and visible changes in the body, including hair loss.

Recently there has been some discussion linking a regular metformin dose to a vitamin B 12 deficiency. "Taking metformin long-term may lead to vitamin B12 deficiency, " said Nouhavandi. "One clinical trial studied the effects of metformin for a duration of 29 weeks and found out that vitamin B12 levels decreased for about 7% of the participants. This decrease is reversible when metformin is stopped, or vitamin B12 supplements are taken."

Though the link isn't entirely clear (yet), it's believed that not getting enough vitamin B 12 can result in hair loss.

B12 Deficiency

Research that took place in 2016 suggests that taking metformin long-term can trigger anemia and a B12 deficit. Hair loss and temporary hair loss is a symptom of both of these conditions.

Metformin can potentially reduce the levels of B12 in your body. This may trigger anemia or low stages of red blood cells — though this is considered a rare reaction. If you're not getting enough B12 via your diet, you risk very low vitamin B12 ranges. Your vitamin B12 tiers might improve if you stop taking metformin or introduce vitamin B12 supplements into your diet. Don't suddenly stop taking metformin without speaking to your doctor first, though.

Nouhavandi said, "ADA guideline recommends checking on B12 levels periodically. If you are experiencing hair loss while taking metformin, consult your doctor to see if an alternative therapy is appropriate for you." A simple blood test will highlight whether or not you're living with an iron or B12 deficiency, so be sure to arrange one if you're feeling concerned.

Try a B-12 Supplement for Hair

GRO Biotin Gummies contain folic acid, biotin and vitamins B15, 6 and 12, which help support the body's production of keratin and collagen. The formula is entirely vegan, gluten-free and has a tasty strawberry flavor. Supplements are a great way to complement a hair wellness routine for thicker, fuller looking hair. A well-balanced, healthy diet and considered lifestyle choices will help you maintain a mane that you're proud to show off.

Symptoms of B-12 Deficiency

In addition, Metformin may be responsible for a B12 deficiency because, over time, it potentially reduces the gut's ability to absorb the vitamin.

Symptoms of a B12 deficiency include:

• Fatigue
• Depression
• Vision loss
• Digestive issues
• Loss of balance
• Shortness of breath
• Weakness

How Do You Prevent Hair Loss From Diabetes?

Metformin and hair loss might not be intrinsically linked, but hair loss has been connected to diabetes. So, if you've been diagnosed with diabetes, your hair loss could have more to do with the condition than the drugs you're taking. A recent (but small) study of 100 men in India found that androgenetic alopecia (male pattern baldness) can be a sign of the metabolic syndrome. Metabolic syndrome presents as a collection of conditions that potentially indicate heart and diabetes-related problems. Another study of 7000 people concluded that androgenetic alopecia could actually be a predictor of heart disease and diabetes.

If you or someone you know is living with type 2 diabetes, the high blood sugar levels associated can result in damaged blood vessels. When the blood vessels are damaged, the hair follicles are unable to receive the essentials nutrients and oxygen needed for a healthy head of hair. And it's not just the hair on your head. Damaged blood vessels can slow down the hair growth cycle across the entire body, including the arms, legs and body.

You Could Experience Thinning Eyelashes and Eyebrows, Too

You could also suffer from thin looking eyelash or brows, which can be super frustrating. 

People with diabetes could also potentially suffer from alopecia areata, which occurs when the immune system directly attacks the hair follicles. In fact, dramatic hair loss can actually indicate that diabetes is present before a diagnosis has taken place.

Also: 6 Foods That May Help Block DHT

PCOS and Hair Loss

As mentioned, metformin can also be prescribed to help treat PCOS. The hormonal imbalance that boosts androgen levels in women with PCOS can trigger dramatic hair loss and thinning. It's also worth mentioning that these troubling health conditions can cause high-intensity stress and increase the body's cortisol levels. This emotional strain can not only affect hormone levels but stress can in and of itself trigger hair loss.

Alopecia areata can also be a symptom of thyroid disease or even a fungal infection. Prolonged stress and anxiety can trigger trichotillomania, a potentially permanent hair loss, hair-pulling disorder.

How Can You Help Your Hair?

To keep your hair in the best condition, the best approach is a 360° approach. This is the VEGAMOUR approach to hair wellness. Each product in the collection is completely vegan. Your hair will benefit when you're mindful about what you eat, the products you put on your hair and how to spend your time.

Diabetes medications can cause a variety of different reactions, but for many, they're a lifesaver. If you're at all concerned about serious side effects, including hair loss, talk to your doctor and get their professional advice.

More From VEGAMOUR

• Can You Take Prenatal Vitamins for Hair Growth?
• How Quickly Does Hair Grow?
• 9 Biotin-Rich Vegan Foods for Healthy Hair

Photo credit: Jason Briscoe/Unsplash