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These changes stimulate a variety of proteases, lipases, kinases, phosphatases, endonucleases, and free radicals, 41,42 as well as biological processes causing cell death, such as calpain activation, 43 oxidative stress, and mitochondrial impairment

Deisseroth, A, Fu SQ, Hanania E, Randhawa G, Claxton D, Reading C, Champlin R, Andreeff M , Logothethis C, Hong WK, Holmes F, Hortobagyi G, Benedict W

Doctors may take a wait and watch approach, but if nothing is done, this is the stage where one would begin to experience more symptoms that will eventually progress to overt hypothyroidism

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10.1016/S0140-6736(16)31678-6 218 WangD.PengY.XieY.ZhouB.SunX.KangR.et al

GM communicates with the host via metabolites such as SCFAs, bile acids, and neurotransmitters, regulating appetite, energy metabolism, immunity, and neural functions