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For patients with hypothyroidism who are not candidates for weight loss injections or prefer alternative approaches, evidence-based lifestyle interventions remain foundational

Antioxidants, such as vitamin C, vitamin E, carotenoids, selenium, zinc, polyphenols, coenzyme Q10, and probiotics, play vital roles in mitigating the negative effects of oxidative stress on adrenal hormone balance

In recreational athletes, supraphysiological GH doses are often used either alone or in combination with other doping substances (140), and studies have shown that GH improves anaerobic sprint capacity, but not strength and endurance (141), and increases GH, IGF-I and fasting insulin levels (142, 143) mimicking those seen in acromegaly patients ( Table 1 )

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