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Disrupted peripheral neurogenic signaling pathways between the liver and the brain axis, coupled with perturbed central neurotransmission within the brain, in tandem with disease-related or disease-associated factors, such as complications, treatments, and severity, as well as alcohol use, metabolic syndrome, and malignancy, collectively contribute toward clinical fatigue (10)

Daylight intensity and air humidity were maintained at 10,000 Lux and 70%, respectively

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doi: 10.4103/iju.IJU_15_17 72 BaratiENikzadHKarimianM

These data make sense in light of the fact that this medication is the gold standard in care for the management of hypothyroidism