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At the same time, probiotics can also promote the secretion of digestive fluids (gastric juice, bile and pancreatic juice), enhance the activity of digestive enzymes such as amylase and lipase, optimize the process of food decomposition and absorption, and indirectly relieve the digestive dysfunction of hypothyroid patients ( 4.2 Prebiotics as critical modulators of gut-thyroid homeostasis Prebiotics, indigestible dietary fibers that selectively stimulate the growth and activity of beneficial gut bacteria, serve as essential adjuncts to probiotic therapy and independently contribute to hypothyroidism management ( Bifidobacteria and Lactobacillus , while inhibiting the growth of harmful bacteria such as Clostridium and Escherichia coli (Wang K