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Sleep optimization strategies: Target 7-9 hours in a dark, cool room (65-68F) Avoid blue light 90 minutes before bed Consistent sleep/wake schedule, including weekends Limit alcohol it severely disrupts REM sleep and glucose regulation Cortisol and GLP-1 Resistance Chronic stress elevates cortisol, which has a bidirectional negative relationship with GLP-1

4 Mechanisms of dysbiosis on GERD Ecological dysbiosis is an abnormal state of the microbial ecosystem in the host (39)

Still, a family history of MTC may be present in some people with hypothyroidism, independent of the condition

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