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Theoretically, chronic lipolysis activation could deplete essential lipid stores or disrupt adipose tissue-derived signaling pathways (via adipokines), though this remains speculative

Discuss biopsy, IgG-based tests, or HLA-DQ genotyping when appropriate

B12 deficiency triggers this through two mechanisms: Impaired red blood cell production reduced oxygen delivery to follicles Impaired DNA synthesis disrupted cell division in rapidly proliferating follicle matrix cells Clinical studies confirm lower serum B12 levels in patients presenting with telogen effluvium, and case studies document hair regrowth following B12 correction

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