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January 03, 2023 8 min read

High cholesterol is often thought of as a diet-related problem, but did you know that there could be a connection between high cholesterol and your thyroid? If you have high cholesterol, it's possible that your thyroid has something to do with it.

In this article, we'll explore the link between these two health issues and discuss how they affect each other, as well as ways you can manage both conditions simultaneously.

What is the thyroid gland?

Your thyroid gland is a butterfly-shaped gland in your neck. This gland produces important hormones, such as thyroxine (T4) and triiodothyronine (T3), that controls your metabolism or the process your body converts food into energy. These hormones play a vital role in maintaining the proper functioning of the heart, brain, and other organs. In other words, they keep your body running smoothly.

Who tells the thyroid to produce and release hormones? 

The pituitary gland, a pea-sized gland at the base of your brain, produces thyroid-stimulating hormone (TSH). As its name suggests, this hormone stimulates your thyroid gland to produce more hormones. Your pituitary produces more TSH when it detects that your thyroid hormone levels are low. And when your thyroid hormone levels are high, it stops or slows the release of TSH.

What is hypothyroidism?

Hypothyroidism, also known as underactive thyroid, is a condition in which your thyroid reduces thyroid hormone production. This means that there isn't enough thyroid hormone in your bloodstream, causing your metabolism to slow down. When this happens, your entire body feels sluggish. You feel exhausted all the time, gain weight, and even have elevated cholesterol levels. Some other symptoms of hypothyroidism include sensitivity to cold, dry skin, muscle weakness, and constipation.

Hypothyroidism can be divided into two grades: overt and subclinical hypothyroidism. Overt hypothyroidism is when you have increased TSH and decreased T4 levels, and you usually have clear symptoms. Subclinical hypothyroidism, on the other hand, doesn't always cause clear symptoms. It's usually characterized by elevated TSH but normal T4 levels.

What is the connection between hypothyroidism and cholesterol?

What is cholesterol?

Cholesterol can often get a bad rap, but it's actually essential for keeping you healthy. In fact, it's a vital component of your body.

According to the American Heart Association (AHA), cholesterol is a waxy substance that your body uses to make hormones and build cells, among other important functions. Cholesterol is not harmful to our health. It's a fundamental fat required to make hormones, vitamin D, and substances that help us digest food. That means we can't function without it.

Your liver produces all of the cholesterol your body requires; this is known as blood cholesterol. However, cholesterol is also found in foods like meat and full-fat dairy. Food sources of cholesterol are called dietary cholesterol.

There are two types of cholesterol:

  • Low-density lipoprotein (LDL) cholesterol is also known as the "bad" cholesterol because having too much of it can cause your arteries to narrow and harden, which is bad for your heart. Keeping LDL levels low - ideally under 100 milligrams per deciliter (mg/dL) - is important.

  • High-density lipoprotein (HDL) cholesterol is often called "good" cholesterol. Having high levels of HDL can lower your risk of heart disease and stroke. It plays an important role in carrying bad cholesterol back to your liver, where it's flushed away from your body. The normal HDL level is at least 50 mg/dL in men and 50 mg/dL in women.

Why is cholesterol considered dangerous?

Cholesterol is a vital component of your body, but having too much of it in your blood is not good for your health. High cholesterol can combine with other substances in your blood to form a thick and hard deposit, sometimes called plaque, inside your arteries. This plaque can stick to the walls of your arteries, narrowing them and making them less flexible. Moreover, if you have significant plaque buildup, an area of plaque can rupture. Thus, your blood flow will be reduced or even blocked completely, leading to conditions like cardiovascular disease and chronic kidney disease.

The only way to know for sure if you have high cholesterol is by taking a simple blood test. A total cholesterol level of under 200 mg/dL is considered ideal. Anything above 240 mg/dL is high, while anything between 200 and 239 mg/dL is borderline.

High cholesterol can be caused by your diet, particularly if you consume foods high in saturated fats, such as red meat and butter. However, certain health conditions, like thyroid dysfunction, may be to blame in some cases. Too much or too little thyroid hormone can cause your cholesterol levels to fluctuate.

Can hypothyroidism cause high cholesterol?

The answer is a definitive yes; hypothyroidism or even subclinical hypothyroidism is a contributing factor to high cholesterol. In fact, before reliable blood thyroid hormones and TSH tests were developed, cholesterol levels were part of the diagnosis of hypothyroidism.

Studies have shown that up to 13% of people who have high blood cholesterol also have hypothyroidism. Another research has also reported that your thyroid function and cholesterol levels are inversely correlated. Thus, managing thyroid hormone with thyroid hormone replacement may help you control your cholesterol levels.

How does low thyroid hormone cause cholesterol problems?

Thyroid hormones assist your liver in getting rid of excess cholesterol from your body. That's why when your thyroid hormone levels are low, your liver cannot break down and remove less LDL cholesterol than usual. As a result, you may have high LDL and total cholesterol levels. Eventually, LDL cholesterol can build up in your blood.

Interestingly, your cholesterol can rise even when your thyroid hormone levels aren't very low. Even subclinical hypothyroidism can cause you to have higher-than-average LDL cholesterol levels. A study found that elevated TSH levels alone can cause a rise in cholesterol despite normal thyroid hormone levels.

Aside from helping your liver eliminate excess cholesterol, thyroid hormones are also essential in steroidogenesis - the conversion of cholesterol into bile salts and steroid hormones. Therefore, not having enough thyroid hormone can slow this conversion, leading to a rise in total cholesterol levels.

The thyroid hormone regulates cholesterol synthesis in the liver. TSH can stimulate an enzyme called HMG CoA reductase, which helps produce cholesterol. When there is more of this enzyme, the production of cholesterol in your liver will increase. This essentially means that hypothyroidism can lead to the production of cholesterol since the condition increases your TSH levels. Lastly, hypothyroidism can also affect lipid metabolism, which is the process by which your body breaks down and uses fats.

How are high cholesterol and thyroid problems tested?

Of course, hypothyroidism doesn't always mean you have high cholesterol, and vice versa. Still, if you experience symptoms of hypothyroidism and your cholesterol levels are high, it's a good idea to talk to your doctor.

Your doctor will likely order blood tests and thyroid function testing to determine your TSH and T4 levels. High TSH and low T4 levels indicate that you have an underactive thyroid. In some cases, your doctor or laboratory technician may test your blood cholesterol levels from the same blood sample.

How do I treat high cholesterol and hypothyroidism?

If your high cholesterol is caused by hypothyroidism, you need to take thyroid hormone replacement therapy. This type of medicine is designed to help restore the missing thyroid hormones from your body, which will get your cholesterol levels back on track. Your doctor will monitor both your thyroid and cholesterol levels.

There are several types of thyroid hormone replacement medications. These include:

  • Levothyroxine (a synthetic version of T4) - this is the standard treatment for hypothyroidism, so your doctor will likely prescribe it for you. Synthroid, Levoxyl, Levothroid, Unithroid, and Tirosint are levothyroxine.

  • Natural desiccated thyroid (NDT) - this is natural thyroid medication made of porcine thyroid glands. It consists of T4 and T3 thyroid hormones. Some of the most common NDT brands are Armour Thyroid, WP Thyroid, and VitaliThy.

  • Liothyronine (a synthetic version of T3) - this is usually used in combination with levothyroxine. One of the most well-known liothyronine is Cytomel.

Although levothyroxine is the most common, most hypothyroid patients prefer NDT because it offers better relief of symptoms. In fact, since NDT contains T3, it can often lower your cholesterol levels more dramatically than T3-only medications. You can usually ask your doctor to prescribe NDT like Armour Thyroid for you. But if the medication is hard to find or if your doctor refuses to prescribe it for you, there's always an alternative option.

One of them is VitaliThy, a natural desiccated thyroid you can buy online. Although it's recognized as an NDT supplement, it consists of Thyroid (USP), just like Armour Thyroid. To top it off, it's free of common allergens like lactose, gluten, eggs, shellfish, and fish. This means that you don't have to worry about getting an allergic reaction.

Cholesterol-lowering drugs

When your thyroid hormone levels are only a little out of range, you may not need thyroid hormone replacement medication. Your doctor may prescribe a statin or another cholesterol-lowering medication instead. These may include simvastatin (Zocor), rosuvastatin calcium (Crestor), and atorvastatin (Lipitor).

What other ways can I lower my cholesterol if I have hypothyroidism?

Whether you have overt or subclinical hypothyroidism, sometimes taking thyroid hormone replacement medication alone is not enough to lower your cholesterol. So to support your medication, your doctor may recommend you do the following activities:

Lose weight

Since excess weight contributes to inflammation and metabolic problems, losing weight might actually help you lower your cholesterol levels. You don't have to lose a lot of weight. Even scaling back 10 pounds can cut your LDL cholesterol by up to 8% if you are overweight.

Get regular exercise

Exercise can help clear lipids like LDL from your bloodstream. Make sure not to overdo it, though. Excessive exercise will only put unnecessary stress on your body, which is not great for your thyroid function. If you rarely exercise before, it's a good idea to start slowly. You can begin by walking to increase your activity level. It's important to find an activity that you enjoy so you can consistently do it. Even as little as 2 and a half hours per week can help you a lot.

Eat a heart-healthy diet

If you haven't been paying attention to what you eat, it's probably time you start adjusting your diet. Try to cut down on fatty food, especially food that is high in saturated fat, like butter, lard, meat pies, cakes, cream cheese, cheddar, and ghee. Instead, you can consider adding more sweet ripe fruits, dairy, and meats that are low in polyunsaturated fatty acids (PUFA).

Quit smoking

Smoking damages the thyroid and raises the possibility of health issues. Plus, quitting smoking can really improve your HDL or good cholesterol levels.

Take your thyroid medication the right way

It's important that you take your thyroid medication properly. To ensure complete absorption, take it at the same time every day on an empty stomach. Ideally, 30 minutes before or four hours after a meal and at least two to four hours apart from any iron or calcium-containing supplements.

How to quickly lower cholesterol levels?

It's common for medical insurers to use certain health markers, such as cholesterol levels, to determine the cost of healthcare coverage. This is because high cholesterol levels increase cardiovascular risk factors. Therefore, some insurers may charge higher premiums for people with high cholesterol levels.

Due to this reason, some people take synthetic T3 like Cytomel a few days before the test to dramatically lower their cholesterol. While taking Cytomel itself is safe, you shouldn't do it just for the purpose of tampering with your test results.

It's true that after a few days of healthier living and taking medication, cholesterol drops gradually rather than abruptly. But if you get proper treatment and adjust your lifestyle as soon as you find out that you have hypothyroidism and high cholesterol, you should be able to have normal levels before your next health test with your insurer!

Conclusion: the connection between hypothyroidism and high cholesterol

Hypothyroidism and high cholesterol have a strong connection in many ways. Taking the right steps to properly manage your hypothyroidism is one of the best ways to bring down your cholesterol levels. That's why it's important that you take the right type of thyroid medication.

Although almost every doctor prescribes levothyroxine, natural desiccated thyroid, whether it is prescription medication like Armour Thyroid or an NDT supplement like VitaliThy, are more preferred. Plus, this type of medication can help lower your cholesterol more dramatically than T4-only medications.

It's important to remember that taking thyroid medication is just one part of the equation - making healthy lifestyle changes such as getting regular exercise and eating heart-healthy foods can also help!

Wojciech Majda
Wojciech Majda

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