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This deficiency is so common that I recommend using B12 for almost all hypothyroid patients regardless of what your labs show

10.1155/2020/7308386 190 XuJ

Red meat, particularly beef, stands out as a notable dietary source

A recent systematic review of studies done in adults showed that azathioprine monotherapy maintained prolonged remission in 83% of patients after achieving remission on a combination of prednisolone and azathioprine for a period of more than 1 year [92]

Considering that several boys remained on a low/reduced dose (200 mg/kg/day) of carnitine after the initial increase, lower dosing may reduce unfavorable side effects without sacrificing behavioral benefit