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However, it may be considered in selected patients with persistent symptoms despite adequate LT4 dosing and normal TSH, provided that alternative explanations for their complaints have been excluded (5)

Other possible causes include endometriosis, abdominal or pelvic surgery, pelvic inflammatory disease, other abdominal or pelvic infections, and previous tubal pregnancy (a dangerous condition in which the fertilized oocyte is implanted into the wall of a fallopian tube)

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It is reef-safe, cruelty-free, and can help with dry skin, oily

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