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Thyroid hormones increase ROS release in the mitochondrial respiratory chain ( Figure 1 ) ( 5.1 Thyroid dysfunctions and OxS 5.1.1 Hypothyroidism Even in its subclinical form, hypothyroidism reduces antioxidant system activity, which promotes OxS, causing oxidative damage and altered lipid metabolism in thyroid cells ( 5.1.2 Hyperthyroidism ROS generation is increased by hyperthyroidism ( 5.2 Thyroid disorders and OxS 5.2.1 Nodular goitre OxS promotes thyroid cell proliferation ( Additionally, rare loss-of-function germline mutations of Kelch-like ECH-associated protein 1 (KEAP1) could be detected in nodular goitre leading to Nrf2 pathway activation that favours transcription of cytoprotective and antioxidant enzymes (93)

doi: 10.1177/1178646920936279 46 LongoNFrigeniMPasqualiM