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This helps explain why identical twins can have differing disease patterns

[1] [4] Signs and symptoms Symptoms of an underactive thyroid (hypothyroidism) due to Hashimoto's include: Weight gain Hair loss (or thinning) Fatigue Sensitivity to cold Constipation Joint pain and muscle pain Excessive or prolonged menstrual bleeding Depression Causes There are many risk factors and potential causes for thyroid disease

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These are important context points that any clinically responsible provider will explain before therapy

The Journal of Clinical Endocrinology and Metabolism, 81(12), 43384341

This makes it less likely to cause systemic side effects like water retention, insulin resistance, or abnormal growth of tissues