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Luquet, S., Perez, F

In urea cycle which rids harmful compounds, Citrulline plays an important role by removing ammonia

Laboratory evaluation typically shows elevated TSH, low free thyroxine (fT4), and increased TPOAb titers, while thyroid ultrasound reveals diffuse hypoechogenicity and heterogeneous parenchymal texture

This allows sufficient time for one medication to leave the system and reduces the risk of exacerbated side effects