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Surgery is indicated in almost all patients with moderate to severe CTS The gold standard test is nerve conduction studies The diagnosis of CTS should be based on history, physical examination, and results of electrophysiological studies The patient with mild symptoms of CTS can be managed with conservative treatment, particularly local injection of steroids

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The problem arises when this antioxidant defense is overwhelmed or depleted: *Excess HO damages thyroid follicular cells, triggering inflammation and immune activation *Oxidized thyroid proteins become neoantigens - foreign-looking molecules that the immune system attacks, initiating or amplifying autoimmune thyroid disease *Lipid peroxidation in thyroid cell membranes disrupts hormone synthesis and cellular integrity *Chronic oxidative stress accelerates thyroid cell apoptosis and fibrosis - the hallmarks of Hashimoto's progression A landmark review published in Antioxidants (MDPI, 2021) - "The Influence of Oxidative Stress on Thyroid Diseases" - confirmed that decreased glutathione levels appear to be a distinctive parameter related to the activation and development of oxidative stress in Hashimoto's thyroiditis, and that antioxidant interventions represent a promising therapeutic avenue for autoimmune thyroid conditions