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We hypothesize that reduced CPT-I activity may contribute to persistent fatigue in these congenital hypothyroid patients, even after levothyroxine therapy, which alone may be insufficient to fully address the downstream metabolic consequences of TPO and TSHR gene mutations present in this cohort

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When the body is in a caloric deficit, whether through dietary changes, increased activity, or medication support, it may draw on both fat stores and lean tissue for energy

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