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Mechanistically, selenium deficiency may exacerbate thyroid-related neurological dysfunction through three pathways: impaired deiodinase activity, weakened antioxidant defense, and disrupted selenium transport (134136)

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Another criticism of use of a provocation test to judge net retention is the lack of a standard protocol, and laboratory reference ranges or guidance for interpretation of results [100]

According to a study published in Frontiers in Pharmacology, intramuscular administration of vitamin B12 produces a faster increase in serum levels compared to oral routes, although both methods are effective in restoring normal cobalamin levels in patients with deficiency