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supervised exercise can strengthen periarticular muscles and reduce joint loading Topical NSAIDs (e.g., topical diclofenac) as a preferred first-line pharmacological option for localised joint pain, particularly in older adults where systemic NSAID use carries greater risk Paracetamol is not routinely recommended by NICE for osteoarthritis-type pain but may be considered for short-term use if other options are unsuitable or not tolerated [15] [16] Cold or warm compresses for symptomatic relief If oral NSAIDs are considered necessary, they should be used at the lowest effective dose for the shortest possible duration, on medical advice, and with gastroprotection (a proton pump inhibitor) as recommended by NICE

Other toxins like heavy metals, such as mercury from dental fillings, can impair conversion of T4 to T3. 22 High exposure to these toxins, coupled with impaired detoxification due to poor diet, nutrient depletion from chronic stress, and genetic factors, may give them the opportunity to disrupt thyroid function

Research has concentrated on its reported influence on telomerase activation, circadian rhythm regulation via melatonin pathways, antioxidant defence, and neuroendocrine modulation

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