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For most patients eating 1200+ calories daily with moderate protein intake, endogenous carnitine synthesis is sufficient

Toxic Doses of Selenium Selenium has a narrow therapeutic index, and doses of under 100 mcg per day may not be sufficient for improving Hashimotos symptoms and markers, while doses in excess of 800 mcg per day can be toxic

Biochemical Society transactions 10 , 7879 (1982)

Effect of Penicillium bilaiae on the solubility and uptake of P and micronutrients from soil by wheat

These risks have been studied extensively, monitored, and are manageable through dose escalation protocols and patient education