Metformin is a life-saving prescription medication for patients with type 2 diabetes, however, it comes with its share of side effects. Some people experience losing more strands than usual, especially when it's taken for prolonged periods.
So, should you stop taking the drug? Of course not.
While the jury is still out on whether or not there’s a correlation between the two, one thing is certain — excessive hair loss isn’t helping anyone. In fact, it can make people more susceptible to psychological problems. This makes it important to find the root cause, so sufferers can take a proactive approach to hair loss.
Before we delve into the finer details, let’s —
Understand What Metformin Is and Its Uses
Metformin (metformin hydrochloride) is a first-line immediate or extended-release oral medicine prescribed to patients with type-2 diabetes mellitus. This serious condition affects 37.3 million people in the United States. They often have insulin resistance, so the medication is used to control the amount of sugar in their blood.
Metformin is thus used for the management of hyperglycemia.
In addition, metformin can also be prescribed for people with polycystic ovary syndrome (PCOS). In such cases, it acts as an ovulation induction agent for non-obese women although its efficacy has yet to be fully established.
Now, onto the crux of the matter —
Does Metformin Cause Hair Loss?
Metformin is associated with hair thinning, not hair loss. That said, drugs can interfere with the hair growth cycle. There have been reports where individuals have lost strands from their head, eyebrows, and eyelashes as was the case of a 69-year-old who took metformin, with/without additional drugs like sitagliptin. While this could have been caused by the medication, the amount of research is mediocre at best.
However, the general opinion is that metformin is not to be blamed though it may indirectly contribute to hair loss.
B12 and Folate Deficiency
Evidence suggests metformin might reduce the gut’s ability to absorb essential nutrients, thereby increasing the probability of a vitamin B12 deficiency, as 2013 and 2016 clinical trials revealed.
When you don’t get enough folate or vitamin B12, the nutrient that keeps nerve and blood cells healthy while ensuring DNA synthesis, can cause a range of physiological and psychological symptoms. In addition, your follicles may not be able to grow new hair. Factor in anemia, and you have a recipe for hair loss.
High Blood Sugar
Type 2 diabetes comes hand in hand with hyperglycemia (high blood sugar).
Over time, it can damage your blood vessels, constricting the flow of nutrients and oxygen that your hair follicles need to thrive. This can lead to premature hair thinning. Over time, it can progress to hair loss.
Insulin resistance also comes into play.
A 2014 study, for example, discusses the association between the two and confirmed our worst fears: that there is a link between insulin resistance and androgenetic alopecia, a type of hair loss that could lead to total baldness.
Polycystic Ovary Syndrome (PCOS)
Another reason for hair loss could be the hormonal imbalance brought on by PCOS, a condition where androgen levels are abnormally increased. Though uncommon, it causes excessive hair growth on the face but may lead to hair thinning on the scalp. A 2016 clinical trial showed that it may be able to reduce hair loss to a certain extent.
Having said that, you could get hair loss when the symptoms of PCOS are combined with raised insulin or high levels of sugar in the blood.
Stress Brought on by Living With Chronic Diseases
Living with conditions like PCOS and diabetes can affect your stress levels. This can increase your cortisol levels which affect the function and cycle of hair follicles, starting with hair thinning and leading to hair loss.
Treatment Options To Prevent, Reverse, or Stop Hair Loss
Sometimes, it’s possible to prevent, reverse, and stop hair loss triggered by conditions treated by metformin. The key is to treat the underlying causes. Treatments can include:
- Getting checked for B12 levels. If it’s low, you’ll need to increase your intake of foods that are rich in vitamin B12. Alternatively, you can take B12 supplements to target the deficiency, but be sure to get expert advice first.
- Finding ways to reduce stress such as meditation, reading, dancing, etc.
- Keep the use of heat-based hair tools and chemical treatments to a minimum. They damage strands which can further contribute to hair loss. The same goes for tight hairstyles — avoid them at all costs as they make you susceptible to traction alopecia.
Focus on treating underlying conditions and follow your treatment plan carefully.
If you continue noticing strands that are easily breaking, thinning, or falling out, consult a medical practitioner to see if you can try an alternative therapy like minoxidil or finasteride to target hair loss. For females, this could mean going on birth control pills. They may take time to show results, but they are effective with continuous use.
If the problem is serious enough, you can explore hair transplant surgeries to achieve more immediate and dramatic results.
While there isn’t a clear link between metformin and hair loss, it’s possible to experience hair loss due to the conditions the medication treats: high blood sugar, B12 deficiency, PCOS, and stress. If you’re taking metformin or have these health issues, keep an eye out for sudden or rapid hair loss. Consult your doctor to get help on minimizing hair loss.