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The silence is almost certainly deliberate

Although 25 selenoproteins are tissue-specific finetuned in Se deficiency (85) and deiodinase is a highly conserved selenoprotein, the content activity of deiodinase also decreases in severe Se deficiency, when the body synthesizes significantly less T3 and the inhibitory effect on TSH is diminished

Clinicians should be alert to this possibility when evaluating patients presenting with unexplained hypoglycemia who report GLP-1 agonist use, especially if obtained from non-pharmacy sources or online

Pulsatile GH secretion persists during continuous CJC-1295 stimulation StatPearls (NCBI Bookshelf) Brinkman JE et al

A lack of improvement in self-management strategies due to fatigue may include procrastination and emotional imbalance