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The three main factors are: (1) the unresolved causes of DPN

2014 Aug;3(4):557-67

M1-polarized macrophages secrete ferroptosis-inducing factors that act on neighboring cells and efficiently eliminate post-ferroptotic necrotic cells through phagocytosis

It has been observed in vitro experiments that DsbA causes non-native disulfide bond formation in proteins having multiple disulfide bonds (Hirudin, BPTI) (Wunderlich and Glockshuber 1993

If you are indeed deficient in nutrients such as selenium , zinc , and B12 , check out the linked articles on each of them to learn about what you can eat and how you can supplement, to get more of these important thyroid-supportive nutrients and optimize your levels