We keep hearing of doctors who deny that cholesterol levels are linked to hypothyroidism. The comments on forum often say something like “they used to use cholesterol as an indicator of thyroid levels”. However, rarely has this actually been complemented by a link, a quote, of an actual example.
I found this case report, one of nine in the paper, when I was looking for something else. It was published in the British Medical Journal in 1950.
In addition to the specific cholesterol issue, some may find interest in what was happening around the time thyroxine started to become available.
ORAL THYROXINE IN TREATMENT OF
MYXOEDEMA
BY
F. DUDLEY HART, M.D., F.R.C.P.
Assistant Physician, Westminster Hospital; Lecturer in
Applied Pharmacology, Westminster Medical School
AND
N. F. MACLAGAN, D.Sc., M.D., M.R.C.P.
Professor of Chemical Pathology in University of London
at Westminster Medical School; Chemical Pathologist to
Westminster Hospital
Case 2 (See Fig. 2)
A married woman aged 63 was diagnosed as a case of myxoedema in 1936, and treated with dried thyroid extract.
1946, after ten years' treatment, she ceased to attend. After eighteen months there was a gradual return of symptoms.
On examination typical myxoedema was noted. Her blood pressure was 170/100. Renal function was 64% of normal.
The initial B.M.R. was -21%, and serum cholesterol 437 mg. per 100 ml.
Treatment.-
DL-thyroxine 1 mg. daily was given. Within a week she began to feel better and lost weight. In a fortnight her voice had almost returned to normal. Serum cholesterol dropped to 205 mg., and urea clearance rose to 81% of normal.
Improvement was in every way satisfactory. Thyroxine was increased to 1.4 mg. a day. Her only disability was that the hair continued to fall out. Her energy was still slightly sub-
normal. Thyroxine was increased to 1.8 mg. a day. One month later she stated that she had stopped "falling about” and was now entirely steady on her feet, although her gait had always been unsteady since the onset of myxoedema. Her hair was now falling out much less. Treatment was changed to DL-sodium thyroxine 1 mg. a day, then reduced to 0.6 mg. after two months. Two months later treatment was changed to L-sodium thyroxine (0.3 mg. a day).
Comment.-
Improvement was entirely satisfactory when on 1 mg. of DL-thyroxine sodium. Her B.M.R. rose to +22% and serum cholesterol dropped to 206 mg. On the reduced dosage she continues to be well. She appears to be at her best when the cholesterol reading is slightly raised and the B.M.R. is within the normal range. The only time the cholesterol figure has been within normal limits was when other symptoms suggested that dosage was excessive. She has been on L-thyroxine sodium for four months. Her present dose is 0.2 mg. a day. The observation period was one year five months.
europepmc.org/backend/ptpmc...
Explanatory notes:
B.M.R. - Basal Metabolic Rate
DL-thyroxine-sodium - a mixture of L-thyroxine (which we widely call levothyroxine) and D-thyroxine which is no longer used. D-thyroxine is not the form found in our bodies. It required much higher doses and was eventually recognised as causing heart issues. Which is why we now only see L-thyroxine. It also partly explains the doses quoted appearing much higher than we see today. It is also possible that the less exacting purity of the product, and issues about how it was delivered, also affected requirements.
I thought this might be a useful snippet for passing on to anyone who claims there is no connection. Thought they might make an asinine suggestion such as that there used to be a connection then but there isn't now.
Especially with the typography of 75 years ago. 
Cholesterol Trending High / Graves and on Levo
Lab Results
Myxoedema or Cushings???
