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low T3/T4 reduces their activity *Elevated homocysteine - hypothyroidism raises homocysteine levels, which depletes glutathione and increases cardiovascular oxidative stress A study on thiol-disulfide and glutathione homeostasis in thyroid patients found that "oxidative stress remains a prevailing issue in patients with autoimmune or non-autoimmune hypothyroidism" - confirming that glutathione depletion is a consistent feature across the thyroid disease spectrum, not limited to autoimmune forms

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