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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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