fig1

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