Gut Microbiota and Trichoscopic Changes in Women With Telogen Effluvium on a Multifactorial Drinkable Nutraceutical: A Retrospective Observational Study

Telogen effluvium (TE) is a common cause of diffuse, non-scarring hair shedding in women. It is often triggered by physiological stress, nutritional deficiencies, illness or hormonal changes. There is growing interest in the role of the gut microbiota in hair health, through its effects on nutrient absorption, immune regulation and systemic inflammation (the so-called gut-skin axis). However, data on gut microbiota in women with TE are still scarce. This retrospective observational study will review the medical records of premenopausal women diagnosed with TE who received a multifactorial drinkable nutraceutical as part of routine clinical care at 2 clinics between January 2025 and July 2025. The study has two aims: 1. To describe the gut microbiota profile of these women at baseline \[and after 6 months\], as assessed by \[stool analysis method\]. 2. To describe changes in trichoscopic parameters, over 6 months of supplementation \[and to explore whether baseline microbiota features are associated with these changes\]. The study does not assign any intervention: all data were collected during standard clinical practice. Its findings are intended to generate hypotheses for future controlled studies.

Inclusion Criteria: * Women aged 18-40 years. * Premenopausal status. * Diagnosis of telogen effluvium (TE) lasting more than 3 months. * Digestive symptoms with no diagnosed underlying disease (gut microbiota dysbiosis). Exclusion Criteria: * Moderate or severe irritable bowel syndrome (IBS). * Small intestinal bacterial overgrowth (SIBO). * Prior use of the study product. * Participation in similar studies or use of anti-hair-loss products within the previous 3 months. * Skin or scalp diseases or disorders (e.g., psoriasis, dermatitis, eczema, cicatricial alopecia, or alopecia areata). * Alopecia secondary to any medical condition (e.g., hypothyroidism, anaemia, lupus). * Chronic pharmacological treatment or a diagnosed systemic disease. * Pregnancy, postpartum period (within 6 months), or breastfeeding. * Previous abdominal surgery (except hysterectomy and appendectomy). * Perimenopausal or menopausal status.