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So, what are the signs it might be lupus and not something else

The terminal ileum is the most common site (~70% of cases)

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I suppose my body uses more or less at different times

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