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Alopecia areata: A multifactorial autoimmune condition

Insulin signaling also involves feedback through G-interacting vesicle-associated protein (GIV), which enhances phosphoinositide-3-kinase (PI3K)-AKT signaling, and inhibition of phosphatase by NAD(P)H oxidase 4 (NOX4)-derived H 2 O 2

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3 Regarding bowel habits, some patients experience lifelong constipation or diarrhea

Options include phentermine (stimulant-based appetite suppressant), naltrexone-bupropion (affects brain reward pathways), or non-medication approaches like diet, exercise, and behavioral therapy

Keep scheduled followups (virtual or inperson) to monitor progress, manage side effects, and make dosing changes as needed