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Although some trials documented GET related fatigue improvement [165, 166], recent findings associated GET with symptom exacerbation, marked by increased fatigue, pain, and PEM in a significant proportion of patients [167]

3.1.1 The role of Se in GD A large number of studies have now confirmed Se deficiency as a risk factor for GD in areas with adequate soil Se levels ( Based on the damage to thyroid cells caused by low Se level, researchers have raised the possibility that Se supplementation may be beneficial in GD and have conducted a series of clinical studies ( Although the current findings are ambiguous and evidence from clinical trials does not favor the use of Se as a routine treatment option in GD, nor does the use of Se supplementation affect the remission and recurrence rates of GD ( 3.1.2 The role of Se in GO Current studies suggest that fibroblasts are distributed in the posterior globular connective tissue and ocular myofilament