My cholesterol results are not good but I don't fully understand them. Could someone explain the good and bad cholesterol results? Thank you

[DACG]

! LIPID FRAC W/O LDLC TG - (LC1242) - Abnormal - Contact Patient

! Serum cholesterol 6.1mmol/L. 0.00 - 5.00mmol/L

Serum cholesterol/HDL ratio 4.4

Serum HDL cholesterol level 1.4mmol/L 1.00 - 4.00mmol/L

Se non HDL cholesterol level 4.7mmol/L

[SlowDragon Administrator]

High cholesterol is linked to being under medicated for your hypothyroidism nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Suggest you get FULL thyroid and vitamin testing done

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine

What vitamin supplements are you currently taking

When were thyroid and vitamins last tested

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto’s?

Ask GP to test thyroid and vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[DACG in reply to SlowDragon]

Thank you Slow Dragon. Very informative! I do have an underactive thyroid and I just had a test at the same time as the cholesterol test but not as detailed as required. I will discuss. your suggestions with my GP. Thank you again.

[SlowDragon Administrator in reply to DACG]

NHS frequently only tests TSH

What were your results?

[DACG in reply to SlowDragon]

My (incomplete according to you) thyroid results are:

Thyroid function test - (LC1242) - Normal - No Action

Serum TSH level 1.59 mU/L 0.30 - 4.20mU/L

Serum free T4 level 18.5 pmol/L 12.00 - 22.00pmol/L

Also in answer to your other questions I generally get the same levothyroxine tablets. I take 50mg three times a week and 75mg 4 times a week.

I take Vitamin D but have to admit to being rather erratic in taking it depending on whether it is summertime or not.

[SlowDragon Administrator in reply to DACG]

So you have no idea how good, or bad Ft3 result is

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Is this how you do test?

Unless very petite you may need dose increase

First step is to get full thyroid and vitamin testing done

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[DACG in reply to SlowDragon]

Thank you again Slow Dragon. You are a wonder to take the time and trouble to answer my queries. I greatly appreciate it. I will relay all this to my GP and cross my fingers he takes it all on board!

[SlowDragon Administrator in reply to DACG]

NHS rarely tests Ft3 (unless TSH is below bottom of range)

You will have to test privately via NHS private test at monitor my health - £26.10

But you might/should get GP to test vitamins