Accepted answer
Week 8 is day 56: on a four-week ladder that is week 4 of dose step 2, and — at the seven-day half-life this class runs on — 8 half-lives in. Steady state is about five half-lives, so day 35 is where the concentration stops climbing on its own. Day 56 is 3 weeks past it, which means the level is no longer the variable. That distinction is most of the question: at week 4 of a step, an effect that is still accumulating is indistinguishable from one that is not resolving unless you know which side of day 35 you are on. Telogen effluvium lags its trigger by roughly three months, which is twelve weeks. Week 8 therefore points at about week 0 as the trigger — which is before the first dose, so the deficit and the agent are not the only candidates and probably not the first ones. Dose decisions are made under supervision, and nothing here is medical advice.
Patterned rather than diffuse loss is a different condition and points elsewhere.
Worth checking: ferritin, thyroid function and vitamin D. Low ferritin in particular is associated with shedding at levels that are not low enough to cause anaemia.
Gastrointestinal adverse events, indicative pooled rates
| Event | Active arm | Placebo arm | Timing |
|---|
| Nausea | 40–45 % | 15–20 % | Peaks 1–2 wk after each step |
| Vomiting | 15–25 % | 5–8 % | Follows nausea |
| Diarrhoea | 20–30 % | 10–15 % | Early, variable |
| Constipation | 20–25 % | 8–12 % | Later onset, persistent |
| Discontinuation for GI events | 4–7 % | 1–2 % | Mostly during escalation |
Ranges span agents and doses; read the specific prescribing information for a specific figure.
In telogen effluvium a stressor shifts a large fraction of follicles from anagen into telogen simultaneously. Because telogen lasts around two to three months, the shed appears two to four months after the trigger rather than during it.
The two-to-four-month latency follows directly from the duration of the telogen phase and is the diagnostic feature of the condition.
Nothing here is medical advice.
Protein intake is the modifiable nutritional factor worth attending to.
edited 25 Sept 2025 by pieter_maas — added the citation requested in comments
6The distinction between escalation-related and steady-state is the useful part. – bufferline42 8 months ago 5Worth adding that the area postrema explanation also predicts why it settles. – rosa_mendieta 7 months ago add a comment