TPO and thyroiditis: We next assessed a range of potential confounding factors that could lead to increased variability in DNA methylation levels, including cellular heterogeneity and differences in cell purification efficiency (as quantified by FACS), age of twins at both disease diagnosis and sample collection, medication use (statins and thyroxine), as well as presence of other autoimmune diseases (thyroiditis, as characterized by thyroid peroxidase autoantibodies).