There are a lot of anecdotal stories about what GLP-1s do to the body. But research is needed to confirm whether these personal stories we hear from friends and family are broadly true.
People have complained about nail loss while taking GLP-1s. Now researchers compared 575 people on GLP-1s to 1,329 people with blood sugar concerns or obesity who had never taken the drugs. The results show 66 percent of people on GLP-1s reported nail problems; 53 percent of people not taking the drugs had nail problems.
The most common issue was nail discoloration. It impacted 46 percent of people taking the meds. Only 17 percent of people not using them experienced nail discoloration. The researchers said the drugs may not be to blame; the changes in nails could be caused by rapid weight loss, not the actual medication.
“Until now, nail changes associated with GLP-1 therapies had essentially been anecdotal,” study author Dr. Charles Taïeb said. “Our findings show a clear association, but they also underline an important point: not everything that happens during GLP-1 treatment is necessarily caused by the treatment itself.”
Dr. Christos Tziotzios, a dermatologist who wasn’t involved with the study, explained that fast weight loss, eating less and being deficient in nutrients like protein, iron and zinc can all cause changes in nail growth. The nail can loosen and lift away from the nail bed. He added that nails normally recover. But it takes fingernails six months to regrow and toenails even longer.
Nail fragility and ridges and grooves were more common for people taking GLP-1s. But the thing that may concern people the most was that cases of onycholysis (where nails separate from the nail bed) happened to 39.3 percent of the GLP-1 users and 8.7 percent of non-users.
“After adjusting for age, sex, country, comorbidities and so on, we have a really high prevalence of onycholysis in patients undergoing GLP-1 receptor agonist treatment,” said one of the researchers, Dr Bianca Maria Piraccini. “This is quite unusual because onycholysis cannot be related to weight loss. Weight loss is commonly associated with nail plate surface abnormalities, which can be described as rough, uneven nails. Nail detachment is not a sign of low caloric intake or protein deficiency or other signs, so we think it could be directly related to the drug. This will prompt us to do more studies.”
The researchers involved with the work and the experts who have reviewed it have all agreed on one thing: if you are taking GLP-1s, this shouldn’t be a reason to stop taking them. Changes in nail health are treatable with assistance from a dermatologist, and GLP-1s have so many other benefits that this is a relatively minor side effect.
