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this chronic low-grade inflammation activates the hypothalamic-pituitary-adrenal axis, elevating cortisol levels, which promotes visceral fat storage and impairs insulin sensitivity

People with GI conditions (such as chronic diarrhea, celiac disease, Crohn's disease, and ulcerative colitis) or who have had procedures like gastric bypass surgery that impair nutrient absorption are also at greater risk

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However, even if you are getting adequate thyroid hormone and the body is absorbing it, there are factors that may lead to abnormal lab results, and steps you can take that will ensure accuracy