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NAC's mechanism is to act on the inflammation-and-oxidative-stress end of that loop, with the downstream effects on insulin and androgens being the part of the story that the trial evidence has not fully caught up to

The disease is characterised by autoimmune destruction of thyroid follicular cells through immune-mediated processes

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This oxidative stress can lead to cellular damage if not adequately managed

This requirement is mediated by a network of cellular pathways that control protein synthesis, folding, trafficking, aggregation and degradation (Powers et al, 2009)

Plantas Med 9(1):8092 Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo W-S (2018) A meta-analysis of the clinical use of curcumin for irritable bowel syndrome (IBS)