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These transmembrane enzymes utilize NADPH to reduce O 2 , directly producing H 2 O 2 (as by NOX4, DUOX1/2) [72] or indirectly via O 2 generation (by NOX1-3) [73], which rapidly dismutates to H 2 O 2

Hence, so far a conclusive evidence of improved outcomes with combination therapy remains lacking, and the benefits appear limited to specific individuals rather than the broader population of patients with Hashimoto thyroiditis and persisting symptoms (46)

each has a score of 0-10 with higher scores indicating greater impairment

Multiple controlled studies, head-to-head comparisons with established treatments, and measurable endpoints