By William W. Chin MD, Paul M. Yen MD (auth.), Lewis E. Braverman MD (eds.)
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Additional info for Diseases of the Thyroid
J Cell Bioi 1995;131:791-805. 37. Zhou Y, Samson M, Francon J, Blondeau J-P. Thyroid hormone concentrative uptake in rat erythrocytes. Involvement of the tryptophan transport system T in countertransport of tri-iodothyronine and aromatic amino acids. Biochem J 1992;281:81-86. 38. Yan Z, Hinkle PM. C, pituitary cells. J Bioi Chern 1993;268:20,179-20,184. 39. Prasad PD, Leibach FH, Mahesh VB, Ganapathy V. Relationship between thyroid hormone transport and neutral amino acid transport in JAR human choriocarcinoma cells.
The nongenomic effect of T3 on cardiac Na+ channels has been confirmed by Dudley and Baumgarten (8). The latter investigators showed that the hormonal effect must occur at or near the extracellular face of the Na + channel, since application ofT 3 to the cytoplasmic face of the patches was ineffective. It should be emphasized that a variety of other factors, including second messenger pathways, also influence channel gating (8). The relevance of these Na + channel observations to the acute effects of thyroid hormone on the human heart in the setting of cardiopulmonary bypass surgery (27) is speculative.
The causes are the same for both subclinical hypothyroidism and symptomatic hypothyroidism; these are listed in Table 4 and are considered further below. Subclinical hypothyroidism may progress to overt hypothyroidism with autoimmune thyroid disease a known risk factor for this progression. Prospective studies have shown that patients with subclinical hypothyroidism and positive anti-TPO antibody titers may progress to frank hypothyroidism at a rate as high as 10%/yr, depending on the population studied (41,42).