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Lastly, while no significant difference was observed in the overall symptom score between groups, specific hyperthyroid symptoms were significantly lower in the intervention group, including irritability, tremor, mood lability, heat intolerance, and exertional dyspnea

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TMAO also decreases the mRNA expression of Niemann-Pick C1 (NPC1L1) and ATP-binding cassette (ABC) G5/G8, inhibiting intestinal CHO absorption (Koeth et al., 2013)

Surgical thyroidectomy Surgical thyroidectomy is a potentially curative treatment with the disadvantage of requiring general anaesthesia (which may be contraindicated in some patients), and is only suitable for those cases with easily accessible hyperfunctional thyroid tissue ( Figure 2 )