I was diagnosed as hypo in 2019 following a routine blood test. I had no symptoms that I was aware of and noticed no changes after TSH and T4 values were normalised with 75mcg Levothyroxine.
Test results in 2019 were
TSH 22.9 (0.4 - 4.0)
T4 8.6 (9 - 25)
Subsequent readings vary but average 2 and 17 respectively (T4 not al always tested).
During the same period my total cholesterol has climbed from 5.4 to 7.3.
There is research suggesting that TSH levels directly relate to cholesterol levels and so should be close to the lower limit. See academic.oup.com/jcem/artic...
I am wondering if it would be worth asking to up my levo to 100mcg to se if cholesterol reduced.
Statins have been prescribed but I am not keen to take them.
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Jasper79
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Many, many posts about cholesterol on here, if you do a search. All the info you need - type in 'cholesterol' or 'statins'.
However, I would just that that cholesterol levels are not directly linked to TSH. They are linked to FT3 - which is rarely even tested! Cholesterol is made in the liver, and the liver strives to keep levels stable. But, when T3 is low, the body cannot process cholesterol correctly, and it tends to build up in the blood.
noticed no changes after TSH and T4 values were normalised with 75mcg Levothyroxine.
Unfortunately, although your TSH and FT4 are now in-range, they are not normal. A 'normal' (euthyroid) TSH is around 1. 2 is too high, especially for someone on thyroid hormone replacement.
Your FT4 is 50% through the rang, which is a good euthyroid level, but hypos usually need it higher than that - around 75% - to feel well.
So, given your high TSH, your FT3 is more than likely too low, which would explain your high cholesterol.
So, yes, it is worth asking for an increase in dose - something that should have been done automatically if your doctor knew anything about thyroid. But, it would also be worth getting private testing to get a better picture of your thyroid status:
Be aware that even slightly low thyroid hormone levels and/or slightly elevated TSH levels alone can cause cholesterol levels to be raised. 5
ref below
5.
Wang F, Tan Y, Wang C, et al. Thyroid-Stimulating Hormone Levels within the Reference Range Are Associated with Serum Lipid Profiles Independent of Thyroid Hormones. The Journal of Clinical Endocrinology & Metabolism. Published online August 2012:2724-2731. doi:10.1210/jc.2012-1133
It also says : If you have an underactive thyroid (hypothyroidism ) your thyroid isn’t producing enough hormones, particularly the T3 hormone (which stimulates the breakdown of cholesterol (lipolysis) and increases the number of LDL receptors ) and so your body can’t break down and remove LDL cholesterol properly. This can lead to a build-up of LDL in the circulatory system.3
TSH is a pituitary hormone. It has two jobs and two jobs only:
a) it stimulates the thyroid to make more hormone when the pituitary senses that they're getting low
b) it stimulates the deiodinases that convert T4 to T3.
I have never read any research that proves it does anything else.
I have to say that I'm not always in agreement with everything that is said on that site. I think that statement is the result of poor understanding of thyroid. If T3 is low, the TSH should be high (but it isn't always!). But it is the low T3 that affects cholesterol levels, not the TSH itself.
They also state that:
High cholesterol (hypercholesterolemia) is often caused by poor diet. Eating too many foods that are rich in LDL (the bad cholesterol)
LDL is not cholesterol. It is the protein carrier that transports cholesterol round in the blood to where it is needed. And there is no such thing as good or bad cholesterol. There is just cholesterol and your body needs it.
Cholesterol levels have little to nothing to do with diet. And certainly not with fatty foods. Fat and cholesterol are two different substances and do not magically turn into each other when eaten. Fatty foods may - or may not - also contain high levels of cholesterol, but the more you ingest, the less the liver makes, and vice versa. If I were you, I would forget that entire page and research Dr Malcolm Kendrick.
Most people when adequately treated on levothyroxine will always have TSH below 2 and frequently around or below 1
Most important results always Ft3 followed by Ft4
ALWAYS test thyroid levels early morning, ideally just before 9am, only drink water between waking and test and (most importantly) last dose levothyroxine 24 hours before test
ESSENTIAL to test vitamin D, folate, B12 and ferritin at least annually
Being under medicated on inadequate dose levothyroxine likely to result in low vitamin levels
Do you know if your hypothyroidism is autoimmune, usually diagnosed by high thyroid antibodies?
Add most recent results and ranges
Or get new test results via GP or privately
List of private testing options and money off codes
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.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Comprehensive list of references for needing LOW TSH on levothyroxine
I loose weight when undermedicated (no appetite), which has led the odd doctor to believe that I am not undermedicated since I am so slim. Hypothyroidism seems to be associated with weight gain, which was the case for me before diagnosis. Strangely enough, after starting on Levo this was reversed. All those things to figure out!
Same here. And with a TSH of 12, being put on statins, I was in excruciating pain. Every muscle in my body hurt and it took many months after stopping the statins to get back to normal.
Good for you! It was during a time when I trusted doctors 200% and did everything they told me, to a tee. Would (I hope) not happen again now. Then I was blissfully uninformed. Did not see the value of getting information since "the doctor was the specialist with all the good medical education" and I have no such fabulous medical background. Standing up to doctors still is difficult, but it would not have entered my mind then for sure. I had to pay the price for my approach more than once. That's how I learned. Maybe now I'm even too suspicious.
my t3 is 5.3 and has been over 6 where the range is 3.1-6.6 - my cholesterol is 8 something. It has never give down despite starting hypothyroidism treatment of Levo and lio.
I have the same problem but mine is my genetic cholesterol not the stuff I eat. I’m not takin the statins either as they block ALL STATIN production and it’s there for a reason especially in your brain
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