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The treatment was 1,000 g of cyanocobalamin (n=54), 1,000 g of cyanocobalamin plus 400 g of folate (n=51), and a placebo (n=57)

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The study found that some microbiota, such as Lactobacillus , Bifidobacterium and Helicobacter pylori , can induce thyroid autoimmunity by through molecular simulation, because some bacterial proteins have structural homology with human thyroid globulin (hTg)and thyroid peroxidase (TPO), and can selectively bind human TPO and Tg antibodies, and compete with natural antigens to bind autoantibodies [69, 70]