How cholesterol varies among us

[helvella]

There has been quite a lot of discussion about cholesterol recently. Sometimes it looks as if anyone who is hypothyroid will have high cholesterol (however measured). Also, that this high cholesterol will remain high in many of us.

Thought I’d point out that it is perfectly possible to have low cholesterol, and what would generally be regarded as “good” lipids results, while on levothyroxine (only). These were my results from a test done a few months ago. Despite me probably consuming more butter than ever. And being overweight.

 Test ……………………………………… Healthy Level   My result

 Total cholesterol ………………………… 5 or below    3.0

 HDL (good cholesterol) ……………… 1 or above    1.2

 LDL (bad cholesterol) ………………… 3 or below    1.5

 Non-HDL (bad cholesterol) ………… 4 or below    1.8

 Triglycerides ……………………………… 2.3 or below    0.7

 Cholesterol/HDL ratio ……………… Above 6 is high risk  2.50

Note that my cholesterol could be regarded as hypocholesterolaemic (basically, too low). And HDL is only just in range (it varies a bit but 1.2 seems just OK for men and on the border for women).

I suspect that the reasons for our levels might just be more complicated than “just” diet and thyroid – each of which already has plenty of complexity in themselves. This is not to suggest that thyroid issues are not vitally important - they are - low thyroid hormone levels will see cholesterol rise.

But we are all different and whilst mine might be on the floor, yours might stay in the clouds.

[greygoose]

Diet has very little to do with cholesterol levels. I have hypocholesterolemia. When I was first diagnosed, my cholesterol was just 0.1 over the top of the range - didn't stop my GP shouting at me about 'clogging up my arteries', though. Not a very intellegent person...

Now, my cholesterol is just too low. But, I consume a hell of a lot of butter, cheese, cream, all the things they tell you not to eat. Doesn't raise my cholesterol one iota. I was worried that it meant there was something wrong with my liver, as that's where the cholesterol is made. But, apparently not. All tests came back fine - and as much as I hate 'fine', I don't have the numbers to hand, so I'm not going to elaborate.

Just seems that some people are just made that way. Well, you got to catch a break somewhere, haven't you!

[helvella in reply to greygoose]

One of the ironies is that I had dry skin when hypothyroid. Elbows that had uncomfortable hard skin. Almost obsessive use of hand-creams because my hands so often felt horribly dry.

You get the impression that we'd have cholesterol almost pouring from our skin. But it felt like the opposite.

Mostly resolved now.

[greygoose in reply to helvella]

I've never made the connection between cholesterol levels and dry skin. FT3 levels and dry skin, yes. That's my first symptom when my dose is off.

[TSH110 in reply to greygoose]

Well that’s interesting. I suffer quite a bit with dry skin. I had to get a blood test today at the surgery I’ve always had lovely nurses there but this one had no small talk whatsoever no good morning no smile the sort of person that makes your heart sink into your boots . Nevertheless, I thought I’d see if she might fill up my phial for my full thyroid panel which the nhs do not bother to do and would reveal my free T3 status & its tiny. She said she did not do that even though I explained I could not get the blood out and would pay the surgery to do it - I wondered what exactly her job was then if not pulling blood out of people all day long, as if it were any skin off her nose to pull out a few drops more but would rather I took more unpaid time off work to go into another medical environment increasing CV19 risk get another wretched needle into me and pay through the nose for it to be done. Is the NHS even remotely bothered about our health? After all the suffering I have gone through at their hands. Not one iota if you ask me. As for that nurse - god preserve us - not a drop of the milk of human kindness in her

[greygoose in reply to TSH110]

Yes, I've met nurses like that. In general, they are lovely, but you get the odd one... It's such a shame.

[TSH110 in reply to greygoose]

Indeed, I think, in my experience anyway, it is rare to get one like that. I'd hate to be like that doing my job. Having pleasant interaction with others is one of life's joys

[greygoose in reply to TSH110]

Well, perhaps she was having an off-day. Had a headache or something. We never know what's going on in other people's lives.

[TSH110 in reply to greygoose]

That is so true, it just seemed such a small ask. It's helvella 's downward plank method next monday first thing when I'm on holiday see if that causes my digits to transform from stone (that's what it is like trying to get blood out of them with a spiggot) to flesh with a blood supply. I often wonder how they cope on such a meagre allowance, perhaps that is the cause of my really horrid nails.

[greygoose in reply to TSH110]

What's the 'downward plank method'?

[helvella in reply to greygoose]

If you can't get blood out of your fingertip!

Lie on a horizontal surface and let your arms hang down.

The ideal might be a massage table. Lie face down looking through the hole at the head end. Let your arms hang down. With the collection vial on the floor directly below you, use the finger pricker and hold your hand over the vial. Blood is likely to rush out compared to other techniques. Don't neglect to do the other things - drink some water, make sure you are warm, get the blood moving by doing at least a few brisks steps.

[TSH110 in reply to helvella]

I ran up six flights of stairs, after a hard interval workout, drank lots of water starting the night before, had a hot shower, clenched my fist, stroked my arm and whatever else was advised, I could not even extract a single drop with three stabs at different fingers in exactly the place shown on the diagrams, what did come out immediately clotted. Hoping gravity as per your method might be the secret weapon needed. Why would this happen I wonder. I know when I gave blood they had to get the head vampire sorry nurse to get the cannula in and get anything out of me. It was agony and I was there about twice as long as anyone else. I had serious untreated thyroid disease at that juncture so can understand why my blood volume might have been compromised then but why now? After all that the blood was useless to them because I had very high malaria antibodies after 40 years and no known recurrence.

Thanks for the details of the method you suggested will be useful to refer to on Monday

[greygoose in reply to helvella]

Wow! That conjures up a few weird images! Thank you for the explanation.

[TSH110 in reply to helvella]

It worked 😊 Thanks helvella!

[TSH110 in reply to helvella]

Oh dear the sample was no good they could get thyroid hormones and b12 but they said the blood cells exploded haemolotised or something similar so the rest of the panel could not be determined. Would being horizontal have caused that to happen? They are quite adamant to stay upright as you stab for blood. It was still a struggle to collect enough I had to use a second spigot but I thought I’d succeeded when I got enough to slightly exceed the line . They thought I had massaged my finger too much. Perhaps I was a bit heavy handed....

[helvella in reply to TSH110]

Drat. That is not good, is it?

The whole point of the approach is to avoid the need to squidge your finger. Just let gravity work for you.

[TSH110 in reply to helvella]

I’m afraid after an initial promising flow it rapidly started to slow and clot so I had to do something to get it going again - I ought to be a prime candidate for a stroke, brain haemorrhage or heart attack with that thick soup coursing through my veins. Mmm those are popular grim reaper options in my family come to think of it. Would aspirin interfere with the results? It might thin it down a bit I suppose. At least lying flat was not the cause of the explosive blood cells.

[helvella in reply to TSH110]

Sorry - I have read so many things about aspirin - but still feel utterly ignorant.

[Zazbag in reply to greygoose]

How come you eat dairy with Hashimoto's?

[greygoose in reply to Zazbag]

Because cutting out dairy with Hashi's is not obligatory. You only do it if it makes you feel better. Same with gluten. I tried it, it didn't make any difference, so I started eating it again.

[Zazbag in reply to greygoose]

I remember reading that even if you feel no difference, dairy increases your antibodies. Dairy never caused me any issues but I cut it out 100% because of reading that.

[greygoose in reply to Zazbag]

Well, what if it does increase your antibodies? Although I doubt it. The antibody level is no sort of indication of anything. Your Hashi's isn't worse because your antibodies are higher. And, it's not any better if your antibodies go down. It doesn't make much difference to you at all. A lot of codswallop is written on the subject of antibodies, you know.

[Zazbag in reply to greygoose]

You say that but I seriously doubt that antibodies don't mean anything.

[greygoose in reply to Zazbag]

They are used as a blood test indication that you have Hashi's. Their job is to clean up after an immune system attack. When the thyroid is attacked, and the cells breached, certain quantities of Thyroid Peroxidas and Thyroglobulin are released and leak into the blood. The Thyroid Peroxidas antibodies and the Thyroglobulin antibodies come along and engulf them, and take them away to be destroyed. Therefore, it's often after an attack that the antibodies are at their highest.

Besides, you said above: I remember reading that even if you feel no difference, dairy increases your antibodies. Right? So, that would mean that if the antibodies were bad, and eating dairy increases their number, by stopping eating dairy, the antibodies should decrease, and therefore you should feel the difference, you should feel better.

On the other hand, if you don't feel any difference, one can conclude that the antibodies weren't having any effect on you in the first place. Don't you think?

[Zazbag in reply to greygoose]

You're thinking of antibodies differently to the way I am. If antibodies are a sign that your immune system has destroyed your thyroid, then logically speaking the concentration of antibodies should directly correlate to the degree of damage that has been done. Since the more damage = the more thyroglobulin/thyroid peroxidase in your bloodstream = the more thyroglobulin/thyroid peroxidase antibodies in your bloodstream to clean them up. So I think it is perfectly reasonable to expect that your antibody titres are directly related to your thyroid status and that lowering them can only be a good thing. To me, lowering them implies that you have reduced the amount of damage being done to your thyroid and therefore your immune system needs fewer antibodies as there is less thyroid tissue in the bloodstream to be cleaned up. I know they're not the source of the thyroid damage but they're a biomarker for that damage and are directly related to it.

[helvella in reply to Zazbag]

As the amount of thyroid tissue reduces, we expect the numbers of antibodies to reduce. End result being no thyroid - and no antibodies.

Antibodies are not a sign that your immune system has destroyed your thyroid. They are a sign that there has, recently, been thyroid damage resulting in the spillage of thyroglobulin and/or thyroid peroxidase. Why, we even see people with antibodies to just one of those substances which rather suggests that there is not an obvious and simple relationship between antibody levels and the amount of damage sustained.

[Zazbag in reply to helvella]

*Is destroying

[greygoose in reply to Zazbag]

logically speaking the concentration of antibodies should directly correlate to the degree of damage that has been done.

No, not at all, they fluctuate all the time, they're just highest after an attack. It's the TSH that gives an indication of how much damage has been done.

lowering them can only be a good thing.

But, lowering them wouldn't lower the number or intensity of the attacks. They would still go on regardless. 20% of Hashi's sufferers never even hav elevated antibodies, so that goes to show that they don't indicate very much.

To me, lowering them implies that you have reduced the amount of damage being done to your thyroid

No, not at all. If they lowered naturally - as they do, with time - yes, it would indicate that. But, lowering them artifically wouldn't indicate anything at all.

they're a biomarker for that damage and are directly related to it.

No, they fluctuate too much for that to be true.

[Zazbag in reply to greygoose]

You are speaking as though you know all of this as a fact which makes me curious as to where you have learned this information?

TSH fluctuates constantly too.

[greygoose in reply to Zazbag]

TSH fluctuates during the day. It's highest early morning, and drops throughout the day. It doesn't fluctuate randomly like antibodies.

"The important thing to understand here is that the amount of antibodies don’t necessarily directly correspond to how severe the Hashimoto’s is.

There are many reasons for this, but one simple way to look at it is this: The amount of destruction that is done by the army (the immune system) depends on the strength and number of the soldiers.

As I said earlier, the antibodies are really like the CIA or some intelligence gathering part of the army. The front line soldiers are the killers. If you have lots of soldiers and they are all revved up and ready to dance, then you get more destruction.

If your army is weak and there aren’t that many soldiers, then the CIA tells them to kill, kill, kill, but they can only do so much damage.

On the other hand, even if there are only a few CIA agents and there is a large, aggressive army, you will still have massive destruction (and loss of thyroid function).

Where am I going with all this? The amount of destruction, which really is the cause of how crappy you feel, depends on the strength and number of soldiers, not on the number of CIA agents in the field.

This is why antibodies are not a good measure of progress and often don’t correspond with how well people feel."

hashimotoshealing.com/under...

That's just one source. There are many others.

Just out of curiosity, why are y you so aggressive? You give the impression that me not being dairy-free is a personel insult.

[Zazbag in reply to greygoose]

I was curious about your personal choice, and then I was explaining my rationale for why I have chosen differently. There's nothing personal about it and certainly no aggression intended, although the way you write does sometimes come across as patronising.

[greygoose in reply to Zazbag]

Sorry if it comes across as patronising, but, as I said this morning, there's no way of knowing how much someone knows if they don't tell you. I don't want to tell people things they already know, but you can't always avoid it. You asked me questions, I answered them to the best of my ability, using what I intended as a flat, impersonal tone.

[Zazbag in reply to greygoose]

I would really like to see something solid in the scientific literature to back up what you are stating as fact, rather than a random website.

[greygoose in reply to Zazbag]

Well, at the risk of being patronising, you could do your own research if you're interested. What do you mean by 'randome website'? Aren't they all pretty random?

[Zazbag in reply to greygoose]

My job is literally to read medical literature and write about it. So I am perfectly capable of understanding these topics. I just prefer to see solid evidence rather than speculation or personal hypotheses.

[greygoose in reply to Zazbag]

I wouldn't have said that the article was 'speculation or personal hypotheses. He give references to his sources at the end. Why don't you check out some of them? If your job is reading medical literature, then you should know where to find the information you want. I'm just a humble actor/English teacher, you should be teaching me! lol

[greygoose in reply to Zazbag]

Oh, and while we're on that subject, where did you read that eating dairy increases antibodies? And where did it say that antibodies were harmful? I would like to read that.

[Zazbag in reply to greygoose]

I responded, but I realised that I really don't want to get into an argument, so I deleted my posts. I just wanted to learn more. None of this was necessary.

[greygoose in reply to Zazbag]

I read before you deleted them. The argument is of your making, I was just answering your questions. And I agree, it wasn't necessary. You didn't like the answers, not my fault.

[Zazbag in reply to greygoose]

It really seems like you wish to have an argument but unfortunately you will have to look elsewhere for it.

[TSH110]

Apparently I was told I have high levels of “good” cholesterol but low of bad and the nurse didn’t know what to make of it. I thought I had read high levels correlate with lower incidence of heart attack. I get the impression it may well be of importance but the medics have got it all wrong. I just thought re my results - oh well so what? Bit like the nurse.

[greygoose in reply to TSH110]

Actually, there's no such thing as 'good' and 'bad' cholesterol. There's just cholesterol, and none of it causes heart attacks. Big Pharma invented the good/bad bit to scare people into taking statins.

[helvella in reply to greygoose]

Totally agree.

They (almost) never admit that HDL and LDL are lipoproteins - carrier molecules - not cholesterol itself.

[greygoose in reply to helvella]

Exactly.

[TSH110 in reply to helvella]

So what exactly is cholesterol and how do those two carrier proteins relate to it?

[helvella in reply to TSH110]

Wiki article on cholesterol isn't too bad as a basic description

en.wikipedia.org/wiki/Chole...

I don't entirely agree with everything they say, but a reasonable enough basic explanation of LDL and HDL.

heart.org/en/health-topics/...

Always, always, always question what you read. Far too many vested interests and utter ignorance.

[TSH110 in reply to helvella]

Thanks, I'll check it out. I've read Dr M Kendrick's opinion of it - he's probably pretty near to the truth, although I don't always accord with his views, he's dealt with it in some considerable detail and it sounded convincing to me.

[humanbean]

As someone who comes from a family in which the paternal side almost all die of heart attacks and the maternal side almost all die of strokes (although occasionally they swapped cause of death) I really sucked up the nonsense about cholesterol and eating fat during the 80s and 90s.

I avoided fat in my diet and didn't eat as much protein as I should have (bad for the kidneys allegedly but I don't believe that now either) with the result that I was always hungry and always fat (because most of my diet came from carbs and I loved sugar and carbs because I was always hungry). And once I went through menopause my muscles disappeared practically overnight.

Luckily these disasters happened before anyone wanted to prescribe me statins (in 2012 or 2013 as far as I remember), because if I'd been offered them 10 years earlier I would have accepted the prescription and taken them.

Everything about my cholesterol and my lipoproteins is high - the total (over 8), the HDL, the LDL, the non-HDL. But my triglycerides are always in range (with one exception in approx 10 years), so I'll just cross my fingers and hope for the best.

If I took statins and had side effects I would be fobbed off and gaslighted by doctors like I have been for every other serious health problem I've ever had since I was a teenager. So I'm glad I never took them when I didn't know any better.

[TSH110 in reply to humanbean]

Luckily my diastolic is too low for those things to be proffered to me, wouldn't touch them with a bargepole. I was into all that carbo loading nonsense when I did a lot of running mind you I was still like a whippet no matter how many bowls of pasta I scoffed! I think I must have been hyperthroid back then I was always on the go with so much energy it used to drive my nuts. I was always running, cycling, swimming, playing badminton trying to dissipate it.

Sorry about your family. A lot of mine on both sides die of heart attacks and some strokes and brain haemorrhages. Cancer is the other biggie, but I guess you have to die of something. I just try my best to be healthy and not think too much about the grim reaper - I have already dodged the scythe, so on borrowed time as it is. I find that rather pleasing.

[humanbean in reply to TSH110]

I've always felt hypothyroid, going back as far as I remember. I'm not sure if I was hypo as a child - I suspect I was. But another issue I have is almost constant low levels of iron and ferritin, and the symptoms of that can be confused with the symptoms of hypothyroidism. Luckily, of course, I can now control my own iron-related testing and supplementing, which makes life easier.

[TSH110 in reply to humanbean]

I think it likely you were. I wonder if you can get a very mild form from your mother if she is hypothyroid I think I read some of the thyroid antibodies can cross the placenta. Glad you have been able to sort out the iron and ferritin imbalance I bet that makes a big difference to how you feel.

[humanbean in reply to TSH110]

My mother was one of those women who was very short, and was also very skinny until middle age. She ate hardly anything, and was often (or always?) low in iron/ferritin or actually anaemic. I would expect her to have been very low in many nutrients during her adult life. She developed hypothyroidism and rheumatoid arthritis both of which were diagnosed in her 50s.

A time machine would be nice - I could change everything!

[TSH110 in reply to humanbean]

But you'd not be you if you got into that time machine and changed everything. I am sanguine about it all I suppose, perhaps every life lived has its very difficult bits. Its been an interesting journey in my case I don't think I would change it even if I could. Mind you I am getting some pretty awful random electric shock like pains at the mo which are very scary no idea what is causing them also dreadful pains in left side of chest just under the ribs there is a ton of stuff in there that could be causing it so my next part of the journey might be one I am not so keen to take. I might hop in that time machine after all! It wouldn't be so bad if you could be euthanised if the pain got too unbearable. What's good enough for my dogs is good enough for me in that department. I don't have to take them to Switzerland when it is kinder to pts. I suppose you could use the time machine to omit the horrid bits and light speed on to oblivion at warp factor 9.

[Zazbag]

Yeah I'm not really sure if it has an effect but I heard from several people that it does and wanted to be cautious as I was desperate to feel better and willing to try anything.

[TSH110]

I got cetraben the doc suggested it - it works really well and I had very dusty shins! It’s worth a go. Don’t get any reaction from it either everything else gives my boils. The cream is the best they do other cetraben products as well. It should improve if you are properly optimised on your meds

[TSH110]

Not much space to stab because of my triple ear piercing both sides - is there much blood in there? I might have to get a venous draw my blood tests at the quack never fail like these have. I was with Thriva