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However, these crucial advantages are accompanied by some disadvantages, including a negative impact on quality of life, psychological problems, fear of involuntary/inadvertent contamination with gluten (as demonstrated in multicenter GIP studies) [48], possible vitamin and mineral deficiencies, metabolic syndrome, an increased cardiovascular risk, and often severe constipation [171,172,173]

Grdisa M, Popovic M, Hrzenjak T

As water freezes, it forms sharp ice crystals that apply mechanical stress to the peptide chains, shearing them apart

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Treatment with clomipramine, a tricyclic antidepressant, was shown in a small double-blind study to improve symptoms, [45] but results of other studies on clomipramine for treating trichotillomania have been inconsistent