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(PubMed) Walker JG, Mackinnon AJ, Batterham P, et al

Since the body cannot distinguish between endogenous and exogenous T4, both are utilized equally

Additionally, excessive iron can inhibit IRPs in cells, then regulating the increased expression of ferritin and Fpn1 to enhance the storage capacity and iron output capacity for the increased iron pool (Thirupathi and Chang, 2019

Levels naturally decline with age, especially after 40, and faster with stress, poor sleep, alcohol, and hormonal changes

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Initially, patients have a thyrotoxic phase, later passing through euthyroidism to hypothyroidism and, finally, return to euthyroidism