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Foundational work should include translational trials that pair GLP-1RA therapy with deep immunophenotyping (Th1/Th17/Treg balance, inflammasome activity), adipokine profiling (leptin, adiponectin), and gut-barrier/microbiome readouts, alongside thyroid-specific endpoints (Thyroid Peroxidase Antibodies (TPOAb)/Thyroglobulin Antibodies (TgAb)/TRAb trajectories, ultrasound echogenicity and volume, Doppler vascularity, and patient-reported outcomes) [1,3,9,22]

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