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Oral treatment generally requires four to six weeks before noticeable improvements occur , and compliance is essential for success

After six months, the 20 HT patients who followed a low-carbohydrate diet showed a significant reduction of thyroid water content as well as decrease of both anti-TPO and anti-Tg autoantibodies compared to HT patients who had followed a normal diet [195]

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Despite the pivotal role of mutant HTT in triggering and driving HD, growing evidence indicates that its symptomatic expression is significantly influenced by environmental factors [136, 137], such that even monozygotic twins bearing the same number of CAG repeats may show considerable differences in the age of onset and nature of their HD symptoms [138, 139]