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Hypothyroidism Has 3 types: primary (caused by the thyroid gland and induces a compensatory TSH increase), secondary (caused by pituitary disorders and results in decreased release of TSH and T3/T4 levels), and tertiary hypothyroidism (caused by hypothalamic disorders), resulting in decreased levels of TRH, TSH, and T3/T4 (Shahid et al

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Following exertion, patients experience reduced mental and physical stamina, accompanied by accelerated muscle and cognitive fatigue (15–17)