It is well-known that important cardiovascular and metabolic changes occur secondary to lower levels of serum TH; decreased response to alpha-1 stimulation increases systemic vascular resistance, decreased nitric oxide availability reduces vasodilation resulting in endothelial dysfunction, and altered lipid metabolism creates increased levels of circulating low-density lipoproteins all of which can lead to higher rates of CHD and DM [8,11,21-25]. The gene discussed is PSMA6; the disease is endothelial dysfunction.