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When a patient or client presents with thyroid challenges, it is worth remembering that the thyroid is a dynamically affected tissue which means that it may spontaneously revert to normal. The natural history of sub-clinical hypothyroidism is variable; thyroid function normalises spontaneously in some subjects, whereas it progresses to overt hypothyroidism in others[1],[2]

The clinical evidence is clear that prior to offering thyroid replacement, identifying underlying triggers for thyroid dysfunction is a must.

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Iron replacement therapy is a common treatment in patients with anaemia and Crohn’s disease, but oral iron supplements are less tolerated. The pathogenesis of Crohn’s disease is attributed to intestinal bacteria and environmental factors that trigger disease in a genetically predisposed host. The aim of this study was to characterise the interrelationship between luminal iron sulfate, systemic iron, the gut microbiota and the development of chronic ileitis in a murine model of Crohn’s disease.[1]

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