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A 2022 systematic review and meta-analysis of 18 randomized trials including 883 hypothyroid patients and evaluating outcomes like depression, fatigue, pain, anxiety, and anger, found no statistically significant advantage of combined LT4+LT3 therapy over LT4 monotherapy on any of these psychological endpoints (42)
Meja-Guzmn JE, Belmont-Hernndez RA, Chvez-Tapia NC, Uribe M, Nuo-Lmbarri N (2025) Metabolic-dysfunction-associated steatotic liver disease: molecular mechanisms, clinical implications, and emerging therapeutic strategies
doi: 10.1016/j.micpath.2018.07.006 79 OCallaghanA.SinderenD
In addition, ginkgolic acids and related alkylphenols, naturally present in ginkgo leaves, are strongly allergenic and cytotoxic
