High cholesterol and underactive thyroid

[Turquoisenona]

Hi. Since my total thyroidectomy in 2020 due to Grave's Disease my cholesterol has been creeping up. After a blood test last week my doctor wants a telephone consultation to discuss elevated serum lipids. I don't know how high they have got as she wouldn't give me any results until I have spoken to the doctor (1st available telephone consultation 29th May!). My query is can anyone help me better understand the connection between an underactive thyroid and high cholesterol levels. I want to use the month before I speak to the doctor to better understand it all. Also if I am offered statins what are peoples opinions as I have heard bad things about them. Thank you

[greygoose]

Cholesterol is made in the liver - because the body needs it! In a healthy body, the liver will regulate the amount of cholesterol it makes by making less when you consume more and vice versa. It is then transported round the body, in HDL and LDL protein carriers, to where it is needed for regeneration and repair work. However, when T3 is low, as in hypothyroidism, the body cannot process cholesterol correctly, and those protein carriers tend to build up in the blood. And when you have a blood test, it's those carrier that are counted, not the cholesterol itself.

So, if your cholesterol is on the rise, one assumes your FT3 level is dropping. Raise the FT3 and the cholesterol level will drop.

Statins are not only not necessary, but not recommended for women or those with hypothyroidism. When you're hypo, side-effects of statins tend to be worse. So, if it were me, I would say a very firm 'no' to statins and insist on correct treatment and testing for my hypothyroidism.

[greygoose in reply to greygoose]

If you want to know more about cholesterol and statins, check out Dr Malcom Kendrick's blog and books. Unfortunately, he doesn't mention the thyroid connection but is full of information about the mechanics of the whole thing. He is very anti-statin, too.

[Marz in reply to greygoose]

One of his Blogs - Stop Treating Thyroid Patients like Children - I think it's called 🥰

[pennyannie]

Hey there again :

There is a definitive link between hypothyroidism and high cholesterol but without seeing some current blood tests detailing your Free T3 and your Free T4 and knowing what thyroid hormone replacement you are taking it's all a guess -

but presume you are dealing with too low a level T3 -

You might like to read the link below nhs.uk/conditions/statins/c...

in particular the paragraph for an underactive thyroid - suggesting that optimal treatment for the hypothyroidism should be the first priority -

and then in my words - ' as if optimally medicated on thyroid hormone replacement - the high cholesterol may well ' right itself ' -

[Turquoisenona in reply to pennyannie]

I have added my latest results. My t3 is now the highest it has been since the thyroidectomy

Results

[SlowDragon Administrator in reply to Turquoisenona]

How much levothyroxine are you taking

Do you always get same brand of levothyroxine at each prescription

What vitamin supplements are you taking

When were vitamin D, folate, ferritin and B12 last tested

Free T4 (fT4) 18.7 pmol/L (12 - 22) 

Ft4 67.0% through range

Free T3 (fT3) 5.2 pmol/L (3.1 - 6.8) 

Ft3 only 56.8% through range

[Turquoisenona in reply to SlowDragon]

I am taking 100mcg of Levo and 10mcg of T3 daily plus an extra 75mcg of Levo on a Saturday. It has been Accord Levo for ages but noticed my last box was Mercury. Have only been taking the Mercury a few days though so too early to see if a difference. I took on a swim 10k in March challenge which I finished but caught 2 awful colds almost back to back (probably from the swimming pool ) and haven't fully recovered since so maybe I need to up my vitamins a bit. I will have a look for my last vit d results etc. I do feel low like you do when your thyroid levels are low and have my very painful dry cracked heel back.

[Turquoisenona in reply to Turquoisenona]

From September last year

Result

[Turquoisenona in reply to SlowDragon]

From September last year

Result

[Turquoisenona in reply to SlowDragon]

September 2024

Result

[SlowDragon Administrator in reply to Turquoisenona]

vitamin D looks good

No top of range on folate

B12 too low

Ferritin too low

What vitamin supplements are you taking

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

healthunlocked.com/thyroidu...

[Turquoisenona in reply to SlowDragon]

This is what I am taking

Vitamins

[SlowDragon Administrator in reply to Turquoisenona]

So add a separate B12 as well for a while to boost B12 levels

Retest again in 2-3 months

If B12 then high experiment with reducing separate B12 to alternate days…..or just twice a week

Then check levels again in a further 2-3 months

Meanwhile working on improving low ferritin by increasing iron rich foods

[Turquoisenona in reply to SlowDragon]

Probably lower now too as have had exceptionally heavy periods

[SlowDragon Administrator in reply to Turquoisenona]

Small increase in levothyroxine might help reduce heaviness of periods

And improving iron/ferritin levels too

Ask GP to check you for fibroids

fibroidfree.com/fibroids/hy....

Also ask they test oestrogen and progesterone and testosterone levels

[Turquoisenona in reply to SlowDragon]

They have said they won't test sex hormone levels as they fluctuate so I don't think I will get anywhere there. I have had a few ultrasound scans in the last few years so I guess fibroids would have shown up?

[SlowDragon Administrator in reply to Turquoisenona]

Will tag Regenallotment . She may know more about testing for fibroids

Sex hormones and HRT - will tag Buddy195

[Regenallotment Ambassador in reply to Turquoisenona]

Yes fibroids show up on ultrasound, anything from 1-2cm upwards. But it’s imprecise, they thought mine came into the uterus lining and hoped to remove them with hysteroscopy but no, after laparoscopy they are now sure they are in the uterine wall, which didn’t show up on MRI either. If it’s unclear it could be adenomyosis which is often described as ‘bulky’ uterus.

As SD says heavy bleeding can be improved with Levo dose increases. When I’ve been slightly over replaced my cycle stretched to 40-50 days when under it can be 19-21.

[Buddy195 Administrator in reply to Turquoisenona]

You can always look to test sex hormones privately, if you are able. Levels do fluctuate, but at least you would have a ‘baseline’ of where they are at now. You could always ask another GP at your surgery- some are more willing to test than others!

[Turquoisenona in reply to SlowDragon]

Currently taking vitamin d (although have stopped taking religiously as the nicer weather comes in...is this right? Plus b vits as recommended on here. Again have slipped in my routine a bit and not taking daily.

[pennyannie in reply to Turquoisenona]

Ok - so your T3 is now the highest it has ever been since your thyroidectomy -

and your T3 now is at around 57% with your T4 coming in at just under 70% -

How do you feel now, much improved, or still with symptoms of hypothyroidism ?

What medication are you taking ?

We generally suggest ' optimal ' T3 being around 70% with a T4 coming in at around 75/80% through the range when taking synthetic thyroid hormone replacement -

The cholesterol would have been built up over months - so logically it will be a slow reduction back down the scale as your optimise your thyroid hormone replacement.

[Turquoisenona in reply to pennyannie]

I have felt better. Tired a lot at the moment but still recovering from a few back to back colds so could just be that. Plus I am almost 51 so probably getting near menopause. What I have noticed lately is that my weight has shot up! Normally I can do the keto diet for 4/5 weeks and loose a stone but I tried to do this a month or so ago and it just didn't work at all which is very odd.

[SlowDragon Administrator in reply to Turquoisenona]

Low iron/ferritin makes weight loss harder

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 3-5 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Meanwhile

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week. Increase the amount of red meat you eat, other foods include pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Vegetarian option

healthunlocked.com/thyroidu...

epigenetics-international.c...

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

excellent info from Seasidesusie (much missed) explaining why iron panel is necessary

Good iron but low ferritin

-healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

And low iron and weight

healthunlocked.com/thyroidu...

[Turquoisenona in reply to SlowDragon]

Thank you for all of this. Really appreciated. I will look into it all.

[pennyannie in reply to Turquoisenona]

Everywhere I researched suggested that ferritin needed to be over 70 for any thyroid hormone replacement to work well -

so can only concur with all that has been written since I was last here :

Diets are not recommended - and you need good ' clean ' nourishment with your fair share of good fats for thyroid hormones to work well within the body.

Optimal conversion of T4 into T3 can be compromised by inflammation, antibodies, non optimal levels of the core strength vitamins and minerals - ferritin folate, B12 and vitamin D -

and down regulation is also impacted by any physiological stress, emotional or physical, depression, dieting and ageing - T4 to T3 conversion is reduced and T4 will be preferentially converted to reverse T3 and reduces metabolism-

nahypothyroidism.org/login/

Graves is an Auto Immune disease and can wax and wane throughout your life and generally triggered by stress and anxiety - Graves carries both Blocking and Stimulating antibodies and I think after treatment even with just non evasive AT drugs our ' optimal ' blood tests may need to be with a higher T3 to what is ' considered ' normal.

I found the most well rounded of all I researched on Graves - though around 10 years after my diagnosis and RAI thyroid ablation - that of Elaine Moore - books and now archived website -

web.archive.org/web/2024122...

[Staffsgirl]

Another excellent read is The Great Cholesterol Myth by Bowden and Sinatra. ( One is a cardiologist, the other a nutritionist.)

[buddy99]

I'm sure there will be a lot of answers here for you. My short advice would be: As long as your thyroid hormones are not optimized and you don't feel as great as you can possibly feel, statins are an absolute no-no. They caused me excruciating muscle pain and weakness, that lasted long after I stopped taking the statins. They lasted for a longer period of time than I had taken statins even. Never in my life would I ever take them again. I'm convinced that they did lasting, irreversible damage to my body. They are a quick fix for doctors, but they fix nothing for the patient as far as I'm concerned. As most of the time, doctors are treating numbers and don't bother about the patient.