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Gene editing can introduce point mutations to specifically modify O-GlcNAcylation sites [60], Nanobodies can be fused with engineered OGT or splitOGA to install or remove O-GlcNAc on target proteins within living cells [196]

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Thus, if a patient with a normal TSH presents with symptoms consistent with hypothyroidism, including fatigue, weight gain, depression, cold extremities, muscle aches, headaches, decreased libido, weakness, cold intolerance, water retention or PMS, a combination of both clinical and laboratory assessment should be used to determine the likely overall thyroid status and if a therapeutic trial of straight T3 or a T4/T3 combination is indicated