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doi:10.1126/science.303.5662.1276
Patients with Hashimoto's often have dysbiosis, an imbalance in gut bacteria that can reduce natural GLP-1 secretion, impair nutrient absorption (including thyroid medication absorption), and perpetuate the inflammatory cycle that drives autoimmune flares
However, without direct head-to-head comparisons, treatment decisions rely on indirect evidence from heterogeneous trial populations, leaving optimal treatment choices uncertain
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