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Additional in vitro and in vivo studies are required to investigate the mechanism of this effect and the potential use of Myo, alone or in combination with selenomethionine, as a novel clinical treatment for the general management of autoimmune thyroiditis and thyroid nodules ( Table 1 )

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Adjusting protocols based on results When to extend protocol Extend if : Making progress but not complete (60-70% healed, goal is 90%) Results plateaued but could improve with more time No side effects, tolerating well Can afford extension How to extend : Add 4-8 weeks to original timeline May need to order more supplies Continue same doses unless adjusting Example : Planned 8 weeks BPC-157 , at week 8 injury 70% healed