Can CBD help support thyroid health?

  • A 2015 study published in BioMed Research supported evidence that cannabinoid receptors interfere with molecular pathways, making them potential therapeutic targets to inhibit the progression of human malignant and benign thyroid lesions (1).
  • Evidence from other research also suggests that CBD and other cannabinoids can be useful in managing symptoms commonly linked to thyroid disorders, such as pain, depression, dry skin, inflammation, and anxiety (2).  
  • While it is not clear how CBD’s influence on cannabinoid receptors may affect conditions like hypothyroidism or hyperthyroidism, the presence of these receptors and their impact on thyroid health and function suggest CBD may possibly have therapeutic applications (3).
  • However, CBD has been shown to interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research on rodents revealed (4). Thus, consult with a doctor experienced in cannabis use before starting a CBD regimen or combining it with current prescription thyroid medications.

Why Some People Are Using CBD for Thyroid Disorders

Although the studies on cannabinoids and thyroid are limited, so far, findings suggest that CBD (cannabidiol) may be beneficial for promoting healthy thyroid conditions (5)

In a 2015 study published in BioMed Research, researchers examined the role of the endocannabinoid system and the significance of cannabinoid receptors (CB1 receptor and CB2 receptor) in human malignant and benign thyroid lesions (6).

The results supported evidence that both receptors interfere with molecular pathways and influence the formation of thyroid tumors. Thus, these receptors could be considered as potential therapeutic targets to inhibit tumor progression.

While it is not clear how CBD’s influence on cannabinoid receptors may affect conditions like hypothyroidism or hyperthyroidism, the presence of these receptors and their impact on thyroid health and function suggest CBD may possibly have therapeutic applications (7).

Evidence from other research also suggests that CBD and other cannabinoids can be useful in managing symptoms commonly linked to thyroid disorders, such as pain, depression, dry skin, inflammation, and anxiety. 

Researchers of a study published in the Journal of Experimental Medicine indicated that the administration of CBD and its modified derivatives significantly suppressed chronic inflammatory and neuropathic pain in rodents (8).

A study published in Neurotherapeutics in 2015 examined CBD as a potential treatment for anxiety disorders (9).

In a 2018 review of existing studies published in Frontiers in Immunology, the authors concluded that CBD has anti-stress effects, which may reduce depression related to stress (10). 

The authors of a 2019 study published in Clinical Therapeutics found that the topical administration of CBD ointment improved the quality of life in individuals with skin disorders, especially those that are linked to inflammation (11). 

How CBD Oil Works to Help Support Thyroid Health

The endocrine system is a series of glands in the body that produce and secrete hormones for a wide range of functions

These hormones control many different body processes, including respiration, metabolism, reproduction, sensory perception, growth, and movement (12).

Research published by the Polish Society of Endocrinology in 2018 suggests interrelations between the endocannabinoid system (ECS) and the activity of the endocrine system (13). 

The ECS, a communication network vital to overall well-being and health, is responsible for regulating balance in many bodily functions, including thyroid function.

To understand how CBD works to help with thyroid health, it is essential that one understands how the ECS works. 

The therapeutic effects of cannabinoids, such as CBD, are realized by their interaction with the body’s ECS and its specialized cannabinoid receptors. 

Scientists in a study published in the European Journal of Endocrinology found that there are functional CB1 receptors on the thyroid of animal models. These CB1 receptors modulate the release of thyroid hormones triiodothyronine (T3) and thyroxine (T4) (14). 

Each type of thyroid hormone plays an important role in the regulation of body weight, energy levels, internal temperature, skin, hair, and nail growth (15). 

Cannabinoid receptors have also been found within the hypothalamic paraventricular nucleus (PVN). The PVN is an area of the brain that sends signals to the pituitary gland nearby that then releases different types of stimulating hormones that travel in the bloodstream to organs such as the thyroid, gonads, and adrenal glands regulating these organs’ activities (16).

Meanwhile, CBD acts indirectly against cannabinoid agonists, which are substances that bind to a receptor and cause the same action as the substances that typically attach to the receptor.

CBD also interacts with several other receptors in the body, such as the 5-HT1A receptor, which is linked to serotonin, a neurotransmitter found to be a contributor to feelings of well-being. It is through this interaction that these cannabinoids promote healing and balance (17). 

The Pros and Cons of CBD Oil for Thyroid Health

 The Pros 

  • Studies mentioned previously demonstrate CBD’s therapeutic benefits in helping alleviate symptoms of thyroid disorders, such as pain, depression, dry skin, inflammation, and anxiety.  
  • CBD is non-addictive, says Nora Volkow, director of the National Institute on Drug Abuse (NIDA) in a 2015 article (26). This characteristic makes CBD safe for daily intake (18). 
  • CBD “is generally well tolerated with a good safety profile,” as the World Health Organization (WHO) stated in a critical review (19). 
  • CBD oil may be purchased without a prescription in locations where they are legally available.

The Cons

  • Studies are too limited to determine whether or not CBD is an effective treatment for conditions other than the ones approved by the U.S. Food and Drug Administration (FDA).
  • As with the use of any natural chemical compound, there are risks involved in using CBD. According to the Mayo Clinic, possible side effects include drowsiness, dry mouth, diarrhea, fatigue, and reduced appetite (20).
  • CBD has been shown to interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research revealed (21). Consult with a doctor experienced in cannabis use before starting a CBD regimen or combining it with current prescription thyroid medications.
  • Dr. Doris Trauner, professor of neurosciences and pediatrics at the University of California San Diego School of Medicine and a physician at San Diego’s Rady Children’s Hospital, cautions that CBD products marketed online and in dispensaries are mostly unregulated (22).

The lack of regulation makes it difficult to determine whether the CBD gummies, tinctures, patches, balms, and gelcaps contain what the product label claims.

A 2107 review published in the Journal of the American Medical Association revealed labeling inaccuracies among CBD products. Some products had less CBD than stated, while others had more (23).

How CBD Oil Compares to Alternative Treatments for Thyroid Disorders

According to the American Thyroid Association (ATA), people with thyroid disease choose complementary and alternative medicine (CAM) to help them cope with the side effects of medication and treatments, including dry mouth, fatigue, weight gain, and mental fogginess.

People with thyroid disorders also use CAM to ease the stress and anxiety of medication and treatments or worries about having a lifelong diagnosis (24).

Adjusting lifestyle habits that reduce stress, strengthen immunity, and prevent inflammation may help promote thyroid health.

  • Physical activities like exercise improve the ability to sleep, which in turn reduces stress, says the Anxiety and Depression Association of America (ADAA) (25). The ATA, meanwhile, suggests Pilates, yoga, and massage reduce stress (26).  
  • Improve overall immunity to fight environmental toxins. Maintaining a diet that includes plenty of vegetables and fruits, as well as taking steps to avoid infection, such as frequent washing of hands and cooking meats thoroughly, also helps strengthen immunity.
  • Consume more anti-inflammatory foods like berries, fatty fish, broccoli, avocados, turmeric, and olive oil. Many of the causes of thyroid conditions are associated with autoimmunity and inflammation. 

CBD oil may help with the lifestyle adjustments mentioned, as it has been shown to alleviate stress, enhance immunity, and reduce inflammation.

    • A 2019 research in The Permanente Journal suggests that CBD helps with anxiety and sleep problems (27). 
    • Published in Frontiers in Immunology, a 2017 study showed that phytocannabinoids deeply influence the immune functions of the body (28).
    • Data from a 2018 study demonstrated CBD’s anti-inflammatory property (29). The results of the said review, which focused on pain and inflammation treatment, were published in Molecules

How to Choose the Right CBD for Thyroid Health

Studies cited previously show that CBD is not the only cannabinoid found in cannabis that can help promote thyroid health. Hence, when choosing a CBD product, opt for one that contains full-spectrum CBD oil.

Full-spectrum CBD oil contains all phytonutrients from hemp, including trace amounts of THC, terpenes, flavonoids, amino acids, and essential oils. These compounds work together to intensify the therapeutic benefits of each cannabinoid, resulting in the “entourage effect”.

Those with allergies to THC may opt to use broad-spectrum CBD oil, which is like full-spectrum CBD but without the THC that makes the user high.

However, regardless of the form of CBD product of choice, careful consideration must still be employed in selecting the best CBD oil to help with the immune system, inflammation, pain, and anxiety.

The following factors are essential to ensure the safety and reliability of the CBD products purchased:

      1. Research on the exact legal stipulations applicable to CBD in the area where it would be bought and used.
      2. Purchase only high-quality CBD products from legitimate and reliable brands. The majority of companies that manufacture the best CBD oil products grow their hemp from their own farm, or they purchase from licensed hemp producers.
      3. Research product reviews before buying from an online store. When purchasing from a physical store or dispensary, check whether the store is authorized by the government to sell CBD.
      4. One important thing to look for in CBD products is certification codes. Several certification authorities approve certain products only after some thorough screening tests. 
      5. Compare company claims about their products’ potency with that of the third-party lab reports. Look for a certificate of analysis for every product purchased.
      6. Consulting with a trusted medical professional experienced in CBD use is ideal before one purchases his or her first bottle of CBD. 

CBD Dosage for Thyroid Health

There is no recommended CBD dosage specific for thyroid disorders or any other diseases. 

According to an article written by Peter Grinspoon, MD, on Harvard Health in August 2019, experts do not know the most effective therapeutic dose of CBD for any particular medical condition (30).  

Without sufficient high-quality evidence in human studies, effective doses cannot be determined. Also, Grinspoon says given that CBD is currently mostly available as an unregulated supplement, it is difficult to know what the consumers are getting. 

Grinspoon’s advice to those looking to try and purchase CBD products is to talk with their doctor to make sure that taking CBD would not cause adverse interactions with other medications that are currently taken.

In a 2017 study, researchers said that chronic CBD use and large doses of up to 1500 mg a day had been repeatedly shown to be well tolerated by humans (31).  

While CBD is considered generally safe, as the 2011 review in the Current Drug Safety Journal suggests, the long-term effects are yet to be examined further (32). 

How to Take CBD Oil for Thyroid Health

There are different ways to take CBD oil to manage symptoms commonly associated with thyroid disorders, such as pain, depression, anxiety, dry skin, and inflammation. 

The delivery method an individual chooses for taking CBD depends on one’s preference and lifestyle.

CBD oil capsules and edibles, such as brownies, gummies, and lozenges, are a convenient and straightforward way to take CBD oil, especially for beginners.

This format is easy to work into a routine, and the dose is consistent. Depending on the metabolism of an individual, the effects can last between 6 and 12 hours. Thus, one dose is probably all that is needed during the day.

CBD oil tinctures or drops are a practical option for those who seek fast results and maximum dosage control.

Tinctures and drops may be administered sublingually (under the tongue), through which the CBD oil is absorbed directly into the bloodstream. 

Place the desired quantity of drops under the tongue using a dropper, and then let the CBD oil stay in place for at least 60 seconds. Once 60 seconds have passed, swallow the CBD oil.

Sublingual application allows for results to be experienced within 30 to 60 minutes after its use, and the effects can be felt for 4 to 6 hours.

In a 2010 review, published in the International Journal of Pharmacy and Pharmaceutical Sciences, researchers found that peak blood levels of most substances given sublingually are achieved in 10 to 15 minutes, which is faster than when those same drugs are ingested orally (33).

Topicals, like CBD creams, lotions, and patches may be applied to a target area on the skin to address dryness and other skin problems.

Look for keywords on the product labels that indicate that the product uses nano technology, encapsulation, or micellization of CBD. These words indicate that their solution can carry CBD through the dermal layers, rather than just staying on the surface of the skin.

Vaping CBD is also a preferred method for some people. However, vaping may cause lung problems (34). Thus, smoking medical cannabis or medical marijuana may not be an option for others.

The Thyroid and Its Functions

The thyroid is the small butterfly-shaped gland found near the throat. The thyroid gland releases thyroid hormones, like thyroxine (T4) and , triiodothyronine (T3) that regulate the way the body uses energy. 

The thyroid plays an essential role in regulating body weight, body temperature, muscle strength, and even mood (35).

The thyroid also controls metabolism and impacts the nervous system, digestive tract, cardiovascular system, appetite, hair, skin, and nail growth.

In addition, thyroid activity influences heart rate, muscle functions, and brain development, particularly during infancy.

Thyroid Disorders

The thyroid is sensitive to deficiencies in nutrients like iodine, zinc, and selenium, as well as specific environmental contaminants, which can cause it to over function or under function (36). 

Also, the immune system can start attacking the thyroid gland, resulting in autoimmune thyroid conditions, such as Hashimoto’s thyroiditis and Graves’ disease.

Thyroid problems include the following (37):

      • Thyroid nodules, which are small lumps that may cause excessive hormone production
      • Hyperthyroidism-excess thyroid hormone production
      • Hypothyroidism-low levels of thyroid hormone production
      • Goiter, which is a swelling of the thyroid
      • Thyroid storm, which is a rare type of hyperthyroidism
      • Thyroid cancer

When thyroid hormone release is too much or too little, the results can be damaging to organ functions and can impact one’s health and well-being.

It can be challenging to detect and identify a specific disorder as thyroid conditions can cause several problems related to bodily functions.

However, specific tests are available to check for thyroid imbalances. These procedures include biopsies and imaging scans, such as ultrasound and iodine scans. Blood tests that check for healthy levels of T3, T4, and thyroid-stimulating hormone (TSH) can also assess thyroid imbalances.

A TSH is a blood test that measures the amount of thyroxine (T4) that the thyroid is being signaled to make.

Graves’ Disease (Hyperthyroidism)

Graves’ disease is named after Dr. Robert J. Graves, who first described it in a patient in 1835.

Graves’ disease is a form of autoimmune thyroid disease that causes hyperthyroidism, which is a condition when the thyroid gland generates too much thyroid hormones. Graves’ disease is usually the underlying cause of hyperthyroidism.

Typical symptoms of this thyroid disorder include goiter, fast and irregular heartbeat, diarrhea, irritability or nervousness, muscle weakness or tiredness, trembling hands, trouble sleeping, and weight loss (38). 

Hashimoto’s Thyroiditis (Hypothyroidism)

Also known as chronic lymphocytic thyroiditis or Hashimoto thyroiditis, Hashimoto’s disease is a common cause of hypothyroid symptoms. Most patients are middle-aged women, although the disease can affect anyone at any age (39).

This autoimmune thyroid disorder, which was first described by the Japanese physician Hakaru Hashimoto in 1912, triggers the immune system to attack and reduce thyroid function, impeding its hormone production. 

As symptoms are mild, one may not be able to recognize that he or she has this disease. These symptoms include constipation, dry skin, fatigue, intolerance to cold temperatures, irregular menstrual cycles, weight gain, hair loss, changes in body temperature, and muscle aches, tenderness, and stiffness (40).

Levothyroxine is a thyroid hormone used to treat hypothyroidism. It is also used with radioactive iodine therapy and surgery to treat thyroid cancer (41). 

Levothyroxine works by replacing thyroid hormones usually produced by the body.

Without thyroid hormones, the body cannot function properly, which may result in slow growth, slow speech, lack of energy, thick skin, increased sensitivity to cold, muscle and joint pain, eye problems, and depression, among other problems.

When taken correctly, levothyroxine reverses these symptoms and eventually treats underactive thyroid issues (42).

The Thyroid Antibodies Test

A thyroid antibody test is used to diagnose autoimmune disorders of the thyroid. This test measures the level of thyroid antibodies in the blood (43).

A doctor who suspects that an individual has symptoms of a thyroid problem, which may be caused by Hashimoto disease or Grave’s disease, may recommend this test. 

Conclusion

Due to its properties, CBD (cannabidiol) allows individuals an alternative option for treating symptoms of various conditions, including thyroid disorders.

A properly adjusted dose of thyroid hormone is essential in dealing with hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid). Adequate nutrition and a healthy lifestyle can lead to a reduction in symptoms.

CBD oil may also help treat these symptoms and assist the body in regulating its functions. However, CBD for thyroid conditions is an area that still necessitates more research.

A consultation with a doctor is excellent advice to those interested in trying CBD. Making changes to one’s health care regimen without the supervision of a trusted medical professional is not recommended. Doctors also have to be informed if one is already taking thyroid medication or any other prescription medications. 


    1. Lakiotaki E, Giaginis C, Tolia M, et al. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions. Biomed Res Int. 2015;2015:839403. doi:10.1155/2015/839403.
    2. Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121–1134. doi:10.1084/jem.20120242;  Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Published 2018 Sep 21. doi:10.3389/fimmu.2018.02009; Palmieri B et al. A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. Clin Ter. 2019 Mar-Apr;170(2):e93-e99. doi: 10.7417/CT.2019.2116. DOI: 10.7417/CT.2019.2116.
    3. ECHO. (2017, Sept 13). Can CBD Help with Thyroid Disorders? Retrieved from https://echoconnection.org/can-cbd-help-thyroid-disorders/.
    4. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017;2(1):139–154. Published 2017 Jun 1. DOI:10.1089/can.2016.0034.
    5. .ECHO. (2017, Sept 13). Can CBD Help with Thyroid Disorders? Retrieved from https://echoconnection.org/can-cbd-help-thyroid-disorders/.
    6. Lakiotaki E, Giaginis C, Tolia M, et al. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions. Biomed Res Int. 2015;2015:839403. doi:10.1155/2015/839403.
    7. ECHO. op. cit.
    8. Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121–1134. doi:10.1084/jem.20120242.
    9. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825–836. doi:10.1007/s13311-015-0387-1. 
    10. Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Published 2018 Sep 21. doi:10.3389/fimmu.2018.02009.
    11. Palmieri B et al. A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. Clin Ter. 2019 Mar-Apr;170(2):e93-e99. doi: 10.7417/CT.2019.2116. DOI: 10.7417/CT.2019.2116.
    12. Hormone Health Network. The Endocrine System. Retrieved from https://www.hormone.org/what-is-endocrinology/the-endocrine-system.
    13. Borowska M et al. The effects of cannabinoids on the endocrine system. Endokrynol Pol. 2018;69(6):705-719. doi: 10.5603/EP.a2018.0072. DOI: 10.5603/EP.a2018.0072.
    14. Porcella A et al. Evidence for functional CB1 cannabinoid receptor expressed in the rat thyroid. Eur J Endocrinol. 2002 Aug;147(2):255-61. DOI: 10.1530/eje.0.1470255.
    15. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/thyroid-hormones.
    16. Deli L, Wittmann G, Kalló I, et al. Type 1 cannabinoid receptor-containing axons innervate hypophysiotropic thyrotropin-releasing hormone-synthesizing neurons. Endocrinology. 2009;150(1):98–103. doi:10.1210/en.2008-0330.
    17. ECHO. (2017, March 29). What Are the Differences Between CBD and THC? Retrieved from https://echoconnection.org/differences-cbd-thc/.
    18. Nora Volkow. NIDA. Researching Marijuana for Therapeutic Purposes: The Potential Promise of Cannabidiol (CBD). National Institute on Drug Abuse website. https://www.drugabuse.gov/about-nida/noras-blog/2015/07/researching-marijuana-therapeutic-purposes-potential-promise-cannabidiol-cbd. July 20, 2015. Accessed January 31, 2020.
    19. Expert Committee on Drug Dependence Fortieth Meeting. Cannabidiol (CBD) Critical Review Report. June 2018.
    20. Bauer, B. (2018, Dec 20). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700.
    21. Iffland K, Grotenhermen F. op. cit.
    22. Peachman, RB. (2019, Feb 26). Can CBD Help Your Child? Retrieved from https://www.consumerreports.org/cbd/can-cbd-help-your-child/.
    23. Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909.
    24. The American Thyroid Association. Complementary and Alternative Medicine in Thyroid Disease (CAM). Retrieved from https://www.thyroid.org/thyroid-disease-cam/.
    25. The Anxiety and Depression Association of America. Physical Activity Reduces Stress. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-st.
    26. The American Thyroid Association. op. cit.
    27. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18–041. doi:10.7812/TPP/18-041.
    28. Oláh A, Szekanecz Z, Bíró T. Targeting Cannabinoid Signaling in the Immune System: “High”-ly Exciting Questions, Possibilities, and Challenges. Front Immunol. 2017;8:1487. Published 2017 Nov 10. doi:10.3389/fimmu.2017.01487.
    29. Bruni N, Della Pepa C, Oliaro-Bosso S, Pessione E, Gastaldi D, Dosio F. Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules. 2018;23(10):2478. Published 2018 Sep 27. doi:10.3390/molecules23102478.
    30. Grinspoon, P. (2018, Aug 24). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476.
    31. Iffland K, Grotenhermen F. op. cit.
    32. Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011 Sep 1;6(4):237-49.
    33. Narang, N. and Sharma, J. (2010, Dec 08). Sublingual Mucosa as A Route for Systemic Drug Delivery. https://innovareacademics.in/journal/ijpps/Vol3Suppl2/1092.pdf.
    34. Shmerling, R. (2019, Dec 10). Can vaping damage your lungs? What we do (and don’t) know. https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
    35. MedlinePlus. (2020, Feb 26). Thyroid Antibodies. Retrieved from https://medlineplus.gov/lab-tests/thyroid-antibodies/
    36. Mederi Center. Natural Strategies to Maximize Thyroid Function (Part 2 of 3). Retrieved from https://medericenter.org/the-mederi-blog/natural-strategies-to-maximize-thyroid-function-part-2-of-3.html
    37. MedlinePlus. (2018, June 13). Thyroid Diseases. Retrieved from https://medlineplus.gov/thyroiddiseases.html 
    38. NIDDK. (2017, Sept). Graves’ Disease. Retrieved from https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease#symptoms.
    39. Mayo Clinic. (2017, Nov. 8). Hashimoto’s disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855.
    40. Ibid. 
    41. MedlinePlus. (2019, Feb 15). Levothyroxine. Retrieved from https://medlineplus.gov/druginfo/meds/a682461.html.
    42. Ibid. 
    43. MedlinePlus. (2020, Feb 26). Thyroid Antibodies. op. cit.
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