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Researchers are not exactly sure what the mechanism is, but common triggers for telogen effluvium may include: a serious or chronic, debilitating illness or infection major physical trauma childbirth major surgery high fever hormone imbalances (like low or high thyroid) or androgen excess rapid or extreme weight loss nutritional or vitamin deficiencies that require supplementation (iron, zinc, vitamin D deficiency) psychological or emotional stress certain medications Nutritional deficiencies, low protein or caloric intake and a sudden change in eating habits can worsen the possibility of hair shedding due to rapid weight loss with these medications

Fever, vomiting, and reduced appetite deplete fluids and nutrients rapidly, and a compromised digestive system absorbs oral supplements poorly

We note that the changes in geometric mean costs for these APCs are associated with the APC recalibrations so that the services with clinical cost patterns that are more similar to each other are assigned to the same APC