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![Global view on the pathogenesis of benign thyroid disease based on historical, experimental, biochemical and genetic data, identifying the role of magnesium, selenium, coenzyme Q10 and iron in the context of the unfolded protein response and protein quali](https://image.oaes.cc/7f2e1ad2-c1a7-4693-8e97-13470247a765/3671.fig.1.jpg)
Figure 1. The Index Case showing combined deficiencies of magnesium, selenium, and CoQ10. Thyroid sonography was done using 2 different systems: SIEMENS Antares in 2008 (A, B) and GE LOGIQ E9 in 2019 (C, D). In 2009, the thyroid showed diminished echogenicity and hyperperfusion as seen in color mode. The images C and D demonstrate the improvement of thyroid morphology together with a normalization of perfusion. These changes disappeared after combined supplementation was started. Currently the patient does not require any thyroid medication