Interesting article by Malcolm Kendrick: Assessing cardiovascular disease looking beyond cholesterol

[TSH110]

journals.lww.com/co-endocri...

I dont agree with all his opinions but having read his blog

drmalcolmkendrick.org/

I do agree his evidence is compelling on this topic.

I wonder how it might relate to cardiovascular disease and hypothyroidism

[SeasideSusie Remembering]

TSH110

You appear to have copied/pasted his whole blog post. This may breach copyright.

Our forum guidelines state

16. Do not breach copyright rules by placing documents onto Thyroid UK unless you have permission from the author of the document. You can, however, post excerpts with links to the full text of the document.

So to be on the safe side it would be best if you amend your post, just write a brief summary and link to his blog post.

[TSH110 in reply to SeasideSusie]

He says he wants it spread far and wide so I can’t think he’d be disappointed it’s here lock stock and barrel it was an email alert. He’s really into open access if you read the commentary. But if it is a breech I’ll remove it.

He does say:

I hope that the readers [of this blog] can make as much noise about it as possible and share it as widely as possible.

It’s now been removed.

The blog can be found here:

drmalcolmkendrick.org

[Marymary7]

What I don’t understand is when you are told your triglycerides are too high, where does that fit in with the cholesterol hypothesis? Not me, this was a friend.

[TSH110 in reply to Marymary7]

Sorry I have no idea. He’s just saying it’s blood clots damaging the arteries that are the cause, not high cholesterol clogging arteries

[diogenes Remembering in reply to Marymary7]

Actually, you can marry his "clot" idea with cholesterol and triglycerides. If high levels of these have greater effect when clots form, they could act by coating the clots and forming larger vessel blockage more quickly. I wouldn't write the fat side of the theorem out of the picture completely.

[TSH110 in reply to diogenes]

I think he claimed there was no mechanism in nature that could allow cholesterol to clog up blood vessels. The blog is huge and I read that bit a very long time ago so it’s now somewhat vague to me. I think veins were involved as some sort of example…oh dear the failings of the ageing mind. It seemed a very good argument he presented at the time.

[Ukie]

Thank you, well worth a read of the full article (when not feeling too brain-foggy!)

[arTistapple]

Thank you for this TSH110. I too wonder how it might relate to cardiovascular disease and hypothyroidism. I have had that axis of High Cholesterol/cusp of type 2 diabetes/HBP/chronic kidney disease/obesity for many years. HA 2002. No-one thought to check for hypothyroidism in all those years. However my arteries were pretty clear at time of HA. Now that I realise how much inflammation has to do with hypothyroidism, I kind of think my ‘old perception’ of high cholesterol being more like a bandaid running around my system, attempting to cover up areas of blood vessels damaged by that inflammation is even more likely than I thought. I always worry about people glibly taking statins for just this reason (I decided myself not to imbibe) especially people who have already had heart events and possibly have a whole lot of cardiovascular scarring. LOW cholesterol means less running about in our bodies repairing the damage ‘naturally’ as nature intended and in fact rather than protecting the system, it is much more likely to be damaging it further. Anyway my thinking is it’s why hypothyroidism contributes to heart disease, the inflammation created by hypothyroidism creates and exacerbates any damage. The body has no option but to UP the cholesterol to first aid it, leading to pressure from medics to lower cholesterol. I think I am not entirely alone in thinking this but unlike you I can’t quote any papers. I hope this makes sense.

[TSH110 in reply to arTistapple]

I did wonder if it alters the viscosity of the blood because of decreased blood volume and this might play a roll. But I might be talking junk….or maybe not:

pubmed.ncbi.nlm.nih.gov/183...

[Icicles in reply to arTistapple]

I was diagnosed with cold acting agglutinin and then ectopic beats. Neither apparently warrant anything more than ‘don’t get too cold’ or ‘it’s very common’ from the doctor. My fluid retention appears to be off the scale so I can lose a kilo of weight overnight if I take a diuretic. I’m interested to read your comments and will check out the article. Thank you for sharing TSH110 and arTistapple

[TSH110 in reply to Icicles]

As if its being very common is some sort of solace because every aunt and her uncle has it. I’ve never heard if it before so it can’t be that common and it sounds awful. Gaslighting or what?

[Icicles in reply to TSH110]

To be fair the cold acting agglutinin is rare and that attracted the ‘don’t get too cold’ comment. It’s the ectopic beats which are very common. But it’s no help and I’m afraid of both.

[TSH110 in reply to Icicles]

I hope your not in GB this winter then! It’s going to be hard not to get cold. Extra heart beats must be alarming, it was bad enough getting heart pains thinking I was about to croak from a heart attack. They stopped on NDT. I wonder if it helps cold acting agglutinin.

[arTistapple in reply to Icicles]

Never heard of it so looked it up. It definitely fits the very issues we are discussing in an ‘out there’ sort of a way. That is, to me! I saw my varicose veins today for the first time in quite a few weeks, such is my loss of water/bloating. I love my skinny ankles but I could do without the varicose veins.

[TSH110 in reply to arTistapple]

I view them like wrinkles and white hair - a badge of honour that I’ve lived! Mine are spidery flat things but no doubt they will eventually take on a life of their own and rise up and become 3D 🤣🤣🤣

[arTistapple in reply to TSH110]

Oh I have pretty much the full range. Flat spidery. Big fat obtrusive ones. Ones that look like bruises. Lovely.

[TSH110 in reply to arTistapple]

Wisdom comes at a cost 🤣🤣🤣

[arTistapple]

Well that would also make sense. Hypothyroids don’t deal with hydration very well. So much of our water can be trapped and inaccessible within our mucin, which in itself is waxy viscous fatty substance. Hypothyroids often complain of not only dryness but thicker saliva, chronic coughs which produce a small amount of thickish sputum, thickened earwax etc. It’s as if the whole system is deprived of proper hydration whilst at the same time holding on to water where it is adding to our discomfort. It follows on that the blood itself will be affected also. I suppose I was thinking holistically and that the body would feasibly attempt to right itself but really that does not exclude viscosity of blood.

[TSH110 in reply to arTistapple]

Seems hypothyroidism not only increases blood viscosity it also deforms red blood cells and changes sedimentation rates, so it basically creates chaos in the blood circulatory system.

[Icicles in reply to arTistapple]

I agree with your list of hydration related symptoms. My nose runs at the mere sight of some food, and toothbrushing, yet I am as dry as a bone. I have tens of hot flushes a day and wake in the night unable to swallow an inexplicable amount of sticky saliva. And then cold acting agglutinin is a condition where my blood thickens on cooling, so much so that it doesn’t survive outside my body long enough before thickening to useless. The blood service asked me politely to stop bothering them to give blood haha!

[arTistapple in reply to Icicles]

Yes icicles. I have already been told they can’t take mine for a number of reasons. NOW I might have to go and get it taken anyway as I might have haemachromatosis (spotted by Greygoose from my results). More tests to confirm. Gosh it does just go on does it not?

[arTistapple]

Hypothyroidism is a disease of many parts. It’s classically ‘holistic’ although I have difficulty imagining any illness which does not reach into all parts, one way or another. There are not many illnesses I am sure which have quite the cluttered symptom picture as hypothyroidism. However apparently it is easy to treat. Ha! What is it? Only 300 symptoms and counting.

[TSH110 in reply to arTistapple]

I have found it’s very easy to treat by self medicating on NDT! If you just replace what’s missing chances are it will help sort it out - there’s nothing complicated about that but we are led round the Levothyroxine garden path and NDT is effectively banned.

[arTistapple]

NDT I only know the basics. I have spent time getting my head around T3. I am taking one step at a time. I am hoping it will be easy to treat from here. Every day is a school day - as my sister says. Without recent blood tests and not having seen me, the local endo has advised more levo by letter to my GP, although there has been no improvement since 50mcg dosage. Getting T3 is difficult enough but NDT feels like another step into the unknown; especially when it seems even more difficult to acquire. I am pinning things on T3 at least for the moment. However it makes sense (again) that although NDT is not the same balance of T4 and T3 allegedly needed, the higher T3 content could be very useful for particular patients.

[TSH110 in reply to arTistapple]

I don’t believe that old trollop that pig NDT’s proportions make it useless for humans it’s just nonsense. First off there is no actually magic human proportion in the first place it’s dynamic it varies from person the person and is changing all day long to meet daily demands on the body. Some do have similar proportions to pigs and some do not and I’m sure there’s a lot of similar variations in pigs themselves, so that’s one piece of nonsense dealt with. Also I believe the body takes what it needs and gets rid of any excess or how could the dynamic system we all had when our thyroid worked properly actually function? It wouldn’t be very dynamic if we were stuck with too much or too little would it? We’d vacillate between a state of hypo and hyper even with a perfectly functioning thyroid, which clearly does not happen. It only happens when it isn’t functioning properly and there isn’t enough thyroid hormones for it to work correctly. If the proportions are not ideal but are adequate in themselves I am sure the body can sort it all out perfectly easily as long as the dose is right for you. I soon felt perfectly well again on NDT after decades of suffering from an undiagnosed thyroid disorder and feeling dreadful on Levothyroxine. So whatever a pig makes in its NDT suits me right down to the ground. Don’t believe all the scare mongering clap trap you hear about NDT, if current research is acted upon it once again will be the front line treatment for hypothyroidism. I say bring it on. Getting hold of it is a nightmare I do agree but dosing T3 with T4 is such a faff by comparison to NDT where you just need to reach the right number of grains I don’t get it, but I keeps endocrinologists, researchers and drug companies in filthy lucre I suppose fussing and faffing and reinventing the NDT wheel

[arTistapple in reply to TSH110]

I hear you. It’s only someone in your position, who has the experience to express it. I am a Jonny come lately but I take great heart from what you say. I would hate to be let down again by T3 but I value that NDT is around and may become useful to me. I have struggled for years and I do want this to be over. I am sick of the view from the couch and yet be unable to sleep at night because I have done nothing useful all day. I agree too with the faffing. The easier the better. Thank you for our discussion today.

[TSH110 in reply to arTistapple]

Well I hope you get the T3 to add to T4 because it should improve things. 50mcg is only a starter dose of Levothyroxine few people would recover on that minuscule amount, perhaps you just need more of it. To feel well the TSH should be between 0.2 and 0.5 and free4 and free T3 in the top third if their ranges (same with T3 and T4) if you haven’t got those numbers they haven’t optimised your Levothyroxine dose. There is a formula for body weight and dose I think it’s 1.6 kg /10mcg levo but it tends to give numbers on the low side. I was about 10 stone and I was given 125/120 alternate days any more I was crazy and on that amount I was miserable and felt awful. I had poor conversion of T4 to T3 so very low T3, I think below the range even when TSH was at 0.25ish small wonder I felt like pants. I’m glad I found out about NDT and got support here. Oddly my close relatives on Levothyroxine feel really well on it, that’s how I knew something was wrong I was nothing like them even after two years. Just goes to show we are all different even in the same family. It made me wonder if an increase in dose of Levothyroxine until you get optimum numbers might be what you need to aim for first and if that’s no good t3.