How could individuals be apparently euthyroid but still have thyroid difficulties?

Deiodinases are selenoproteins. Deiodinases both activate and inactivate thyroid hormones. T3 is the active thyroid hormone. Deficiencies in selenium could lead to decreased activation of T3 by deiodinase I but also decreased inactivation of T3 by deiodinase III whereby individuals would appear to be euthyroid though thyroid hormone homeostasis would be upset. Dysregulation of CTH (cystathionine gamma-lyase), which metabolizes L-seleonomethionine the food form of selenium so selenium can be used to synthesize selenoproteins, could result in dysregulation of DIO1 and DIOIII.

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