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Randomized trials in Graves disease have shown slight biochemical increases in thyroid hormone levels, but no discernible decrease in relapse rates or long-term clinical benefit

Most bacterial species in a healthy human microbiota belong to the genera Bacteroidetes and Firmicutes (232), whereas Actinobacteria , Proteobacteria , Fusobacteria , and Cyanobacteria , are less abundant (233)

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It is difficult at this stage to establish a causal sequence of events that underlie these observations

Acknowledgements The authors would like to thank Kayoko Nishimura for expert input on the manuscript

From here, imagine a triangle with this first injection as the first point in the triangle