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Furthermore, B cells can further differentiate into plasma cells and continuously produce autoantibodies (Vinuesa et al., 2016), which can mediate the complement-dependent thyroid cell killing process and further aggravate thyroid injury

So if you have never been in that kind of environment but have high levels of gliotoxins in your urine test (more about this below), then think candida overgrowth

Moreover the implications for diabetic stability and obesity management are not trivial if the medication is ceased

(4) This may lead to elevated levels of plasma growth hormone and insulin-like growth factor 1 (IGF-1)