the shed at month 3-6 is almost always telogen effluvium from the rate of loss, not sema reaching into your follicles directly. the trial gap (~4% vs 1%) is real but small. the problem is everyone treats “is it the drug or is it TE” as one question when it’s two clocks, and the troubleshooting stalls right there. how i actually separate them, as a tracking thing not a dosing thing: - log a shed score (count/loose pulls) against two timelines at once: weeks on drug AND your loss rate that month. TE tracks the loss rate, lagged ~3 months. if your shed spikes 12wks after your fastest drop, that’s the rate, not the molecule.
- get ferritin, not just iron. ferritin under ~40 is where regrowth stalls even if serum iron “looks fine.”
- protein floor before you blame anything else. under 1g/lb and you’ve confounded the whole experiment. i keep mine as a csv export and hand it to whoever’s reading my labs, since a shed-rate-vs-weight curve makes the lag obvious in a way a verbal “i’m shedding” never does. reading the actual ferritin number is a prescriber call. i can tell you which two clocks to plot, not what your dose should be.