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& Sheldrick, R

Primary Autoimmune These are by far the most common causes in the developed world Autoimmune lymphocytic thyroiditis of which there are two man types: Hashimoto thyroiditis Atrophic thyroiditis Congenital Defects in hormone synthesis usually be due to: Iodine deficiency, Antithyroid drugs (e.g

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To meet the diagnostic criteria for cEDS, a person must meet: Major criterion 1 AND major criterion 2 OR Major criterion 1 AND three or more minor criteria Major Criteria Skin hyperextensibility and atrophic scarring Generalized joint hypermobility Minor Criteria Easy bruising Soft, doughy skin Skin fragility (or traumatic splitting) Molluscoid pseudotumors Subcutaneous spheroids Hernia (or history thereof) Epicanthal folds Complications of joint hypermobility (e.g., sprains, dislocations/subluxations, pain, flexible flatfoot) Family history of a first-degree relative who meets clinical criteria Genetic testing is used to see if a person has a genetic variant that causes vEDS

Evidence base for dosing: Primarily animal infusion studies and invitro concentration work (no standardized, FDArecognized human protocol) Core research theme: Anabolism / nitrogen retention, growth signaling, tissueresponse modeling Dosing & Reconstitution Standard Approach (Preclinical context) Standard Approach Important reality: For des(13) IGF1, the clearest dosing in the peerreviewed record is from animal studies, commonly delivered via continuous infusion (osmotic minipump) rather than intermittent injections

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