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These challenges reflect the inherent complexity of the gut-thyroid axis and the multifactorial nature of hypothyroidism pathogenesis

et al (2019) Resistin induces breast cancer cells epithelial to mesenchymal transition (EMT) and stemness through both adenylyl cyclase-associated protein 1 (CAP1)-dependent and CAP1-independent mechanisms

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However, there are many medical conditions that affect the disposition of low Vd drugs in a patient (e.g., nonsteroidal anti-inflammatory drugs and aminoglycosides), and these drugs do require dosage adjustment because of their narrow therapeutic index