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3 Thyroidbrain axis pathophysiology and neurological manifestations The major mechanistic routes linking thyroid dysfunction to neuropsychiatric manifestations are summarized in Figure 2, highlighting disrupted hormone transport/activation in the brain, neurotransmitter imbalance, oxidative stressneuroinflammation, and bloodbrain barrier vulnerability
The evidence for meaningful additional benefit from niacinamide inclusion is limited, but like glycine, it adds minimal cost and no significant risk
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Exposure to direct sunlight or bright artificial light should be avoided, as this can lead to degradation of the cyanocobalamin component and potentially affect the semaglutide as well
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