Is Thyroid And Cholesterol Related
Even people with mildly low thyroid levels, called subclinical hypothyroidism, can have higher than normal LDL cholesterol. A 2012 study found that high TSH levels alone can directly raise cholesterol levels, even if thyroid hormone levels arent low. Hyperthyroidism has the opposite effect on cholesterol.
How Does The Thyroid Cause Cholesterol Problems
Your body needs thyroid hormones to make cholesterol and to get rid of the cholesterol it doesnt need. When thyroid hormone levels are low , your body doesnt break down and remove LDL cholesterol as efficiently as usual. LDL cholesterol can then build up in your blood.
Thyroid hormone levels dont have to be very low to increase cholesterol. Even people with mildly low thyroid levels, called subclinical hypothyroidism, can have higher than normal LDL cholesterol. A 2012 study found that high TSH levels alone can directly raise cholesterol levels, even if thyroid hormone levels arent low.
Hyperthyroidism has the opposite effect on cholesterol. It causes cholesterol levels to drop to abnormally low levels.
You might have an underactive thyroid gland if you notice these symptoms:
- weight gain
Can An Underactive Thyroid Cause High Cholesterol
Thyroid hormones, primarily T3, play an essential role in helping the liver process and remove excess cholesterol from the body.
When the body does not produce enough thyroid hormones, the liver cannot process as much cholesterol as usual. An underactive thyroid means that the body removes less LDL cholesterol from the blood. This can lead to high levels of LDL and total cholesterol.
According to studies, up to
may lead to adverse health conditions.
However, complications arising from cholesterol levels being too low are less common than those resulting from levels being too high.
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The Terrible Triad What Is The Role Of Vitamin D In Subclinical Hypothyroidism And Cardiovascular Risk
A September 2021 paper looked at how vitamin D deficiency and autoimmune thyroid diseases may play a role in cardiovascular disease.
The role of thyroid hormones in the cardiovascular system, through several direct and indirect effects is recognized. Even very small modification in thyroid hormone levels may adversely affect the cardiovascular system, whereas thyroid hormones benefit the cardiovascular system and improve the prognosis.
There is also evidence of vitamin D effects on cardiometabolic disease , renin-angiotensin-aldosterone system , nitric oxide, oxidative stress, and inflammatory response), as well as an association between vitamin D deficiency and autoimmune thyroid diseases or cancer, and a relationship between vitamin D concentration and titers of antibodies and thyroid autoimmunity replacement.
Interestingly, experimental data indicate a direct effect of vitamin D on Type 2 deiodinase expression causing subsequential peripheral conversion of T4 into T3. However, the functional links among thyroid hormones, vitamin D and the cardiovascular system, and clinical effects of coexisting abnormalities in this new troublesome triad, have not yet been reviewed.
Review Of The Thyroid System
Remember, the thyroid has a huge part in regulating our metabolism. The thyroid gland receives its instructions via a hormone secreted by the pituitary gland. This causes the thyroid to release several other hormones that will affect the rest of the body. There are three important hormones that we will review below.
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Overt And Subclinical Hyperthyroidism
The incidence of hyperthyroidism is lower compared with hypothyroidism in the general population. Similarly, a decreased prevalence of hyperthyroidism is evident in hyperlipidemic patients, since only 3 out of the 248 patients in our study had thyrotoxicosis .
Despite the increased activity of the HMG-CoA reductase, levels of TC, LDL-C, ApoB and Lp tend to decrease in patients with clinical or subclinical hyperthyroidism. This is due to increased LDL receptor gene expression resulting in enhanced LDL receptor-mediated catabolism of LDL particles . Moreover, no difference in LDL subfraction distribution has been observed between subclinical or overt hyperthyroid versus euthyroid subjects . Furthermore, hyperthyroidism results in enhanced LDL oxidability, which is related to FT4 levels .
A decrease in HDL-C levels is also observed in hyperthyroidism, due to increased CETP-mediated transfer of cholesteryl esters from HDL to VLDL and increased HL-mediated catabolism of HDL2 . Triglyceride levels remain unchanged. On the other hand, no changes in blood pressure , Lp or hsCRP levels have been described in hyperthyroid patients. However, an increase in factor X activity has been observed in subclinical hyperthyroidism patients, indicating a hypercoagulable state . Therapy of clinical hyperthyroidism results in restoration of those alterations of lipid metabolism , while the effects of treatment of subclinical hyperthyroidism subjects are not yet clear .
Hypothyroidism And High Triglycerides
Triglycerides are often misunderstood but can be a very telling sign of thyroid and metabolic dysfunction.
When you consume carbohydrates, they are first and foremost metabolized and used for energy production.
What carbohydrates are not required for energy production are then stored in the liver in the form of glycogen.
Think of glycogen as your fuel reserves that are stored and used between meals and during the night when youre not eating anything.
Your liver needs usable thyroid hormone along with other nutrients in order to store and release glycogen.
Keep in mind that this client is using T3 properly.
Carbohydrates that arent used for energy or stored in the liver as glycogen are then converted into the storage form of fatty acids known as triglycerides.
Whats interesting is that the subjects triglycerides are extremely elevated, above 400.
While triglycerides themselves arent necessarily dangerous, they can help explain the underlying dysfunctions that are the real problem.
In this case, its a sign of impaired oxidative metabolism, potential insulin resistance, and likely issues with the liver storing and releasing glycogen.
In other words, if you cant metabolize carbohydrates or store them in your liver, then your body has no choice but to store them as triglycerides.
The elevated cortisol does come into play here as well.
Cortisols primary function is to break down muscle tissue protein and convert it into glucose/carbohydrate.
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High Cholesterol By Itself Is A Warning Sign Of Hypothyroidism
Your thyroid gland is one of the primary controllers of cholesterol in your body.
What does this mean?
When there is a problem in your thyroid gland it will manifest as a problem in your cholesterol level.
The bigger the problem in your thyroid the bigger the change in your cholesterol.
Thyroid hormone, specifically the most powerful thyroid hormone T3, regulates an enzyme known as HMG-CoA reductase .
This is the SAME enzyme that medications like statins, like Lipitor, interfere with.
But thyroid hormone doesn’t just stop there.
It also regulates HDL metabolism, LPL, VLDL, and triglyceride metabolism.
You don’t have to know the specifics but you should know that changes in your thyroid can dramatically impact your cholesterol at many levels.
Several studies have shown that an abnormal TSH, even in the upper level of what is considered “normal”, increases the risk that you will have high cholesterol.
What does this mean for you?
If you have high cholesterol the FIRST thing that you should look at is your thyroid level as the primary CAUSE of that problem.
Does it mean that your thyroid is always the cause of high cholesterol levels?
Not necessarily, but you can’t just assume that it isn’t.
Every patient with high cholesterol should undergo screening for low thyroid the CORRECT way .
If your doctor hasn’t done that, and you are currently taking a medication for high cholesterol, you should go back immediately and get tested.
Helping Yourself Beyond Medication
As Ive said the 2014 study indicated that levothyroxine had a positive effect on cholesterol but not in 25% of cases. A more recent study in 2018 suggested that doses of Levothyroxine which normalised the thyroid function did not always normalise serum LDL and total cholesterol levels.
Patients are always strongly advised to actively seek ways of lowering the risks of high cholesterol and of trying to address the condition. This means:
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Underactive Or Overactive Thyroid
The thyroid can produce too little or too many hormones sometimes.
A condition in which your thyroid is underactive is called hypothyroidism. When the thyroid is underactive, your whole body feels like its slowing down. You become tired, sluggish, cold, and achy.
You might get an underactive thyroid if you have the following conditions:
- Hashimotos thyroiditis, an autoimmune disease in which the body attacks and destroys the thyroid gland
- thyroid inflammation
Other factors that can result in an underactive thyroid include:
- removal of all or part of an overactive thyroid
- radiation for cancer or an overactive thyroid
- certain medications, such as lithium, interferon alpha, and interleukin 2
- damage to the pituitary gland from a tumor, radiation, or surgery
Hyperthyroidism is a condition that occurs when you have an overactive thyroid. When your thyroid is overactive, your body kicks into fast gear. Your heart rate speeds up, and you feel nervous and shaky.
You might get hyperthyroidism if you have:
- Graves disease, an immune system disorder that runs in families
- toxic nodular goiter, which involves lumps or nodules on the thyroid
- thyroid inflammation
Association Between Thyroid Disease & Cholesterol
Association between thyroid disease and cholesterol
The composition and transport of cholesterol is severely disrupted with thyroid dysfunction. As discussed above, cholesterol is mostly synthesized in the liver. In order to ensure proper functioning, this process is heavily regulated by thyroid hormones. Thyroid-stimulating hormone increases the activity of an enzyme called HMG CoA reductase, which helps control the rate of cholesterol synthesis. Because you have increased TSH with hypothyroidism, the amount of cholesterol produced in the liver is increased. This is then taken out into the bloodstream via VLDL cholesterol.
VLDL travels in the bloodstream until it encounters an enzyme called lipoprotein lipase . T3 stimulates LPL to break down the VLDL, turning it into low-density lipoprotein , once the majority of triglycerides are removed. With hypothyroidism, there isnt enough T3, which will increase the amount of VLDL in the bloodstream as there wont be enough LPL enzymes available.
The VLDL-turned-LDL cholesterol circulates in the blood until it finds cells that have LDL receptors. Once it binds to the cell, the LDL is used for cell membrane maintenance or converted to other steroid hormones to be used elsewhere in the body. T3 increases the number of LDL receptors, which reduces the total amount of LDL cholesterol in the bloodstream. With hypothyroidism, the number of LDL receptors will be reduced, increasing the amount of LDL in the bloodstream.
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Prescription Treatments For Cholesterol
If your LDL cholesterol is still too high, your doctor may recommend adding a prescription drug to lower the LDL. There are three popular categories of cholesterol-lowering drugs.
Statin drugs, which lower LDL and triglycerides, and slightly raise HDL. Statins include:
Statin drugs have a number of risks and side effects, including memory loss, confusion, high blood sugar, type 2 diabetes, muscle pain and weakness, insomnia, headache, digestive problems, muscle inflammation and damage , and the potential to cause kidney failure.
ecause statin drugs can reduce your coenzyme Q10 levels, some experts recommend taking a CoQ10 supplement along with statin drugs to reduce your risk of any muscle-related side effects.
Niacin/vitamin B-based drugs, which lower LDL and raise HDL. These drugs include Niaspan and Nicoar. Side effects include itching, tingling, headaches, and flushing.
Bile acid drugs, which cut down on cholesterol production. These drugs include Colestipol , Cholestyramine , Colesevelam , and Ezetimibe . Side effects include constipation, gas, bloating, nausea, diarrhea, and muscle pain.
How The Thyroid Regulates Lipid Metabolism
Fair warning, this section contains the nitty gritty details of lipid metabolism. If youre not in the mood for a physiology lesson, you can skip on to the next section!
Thyroid hormones regulate cholesterol synthesis
You may have heard that dietary cholesterol doesnt have much impact on blood levels of cholesterol. This is because cholesterol is also synthesized by the liver. This process is tightly regulated by several hormones, including thyroid hormones. TSH increases the expression and activity of an enzyme called HMG CoA reductase, which controls the rate of cholesterol synthesis . This means that hypothyroidism increases the amount of cholesterol produced in the liver. This cholesterol is then packaged with triglycerides into VLDL particles, which are shipped out to the bloodstream.
Thyroid hormones affect lipoprotein lipase
VLDL particles travel through the bloodstream until they reach the small blood vessel beds, where they encounter an enzyme called lipoprotein lipase . This enzyme breaks down the triglycerides in the VLDL particle into fatty acids, which are taken up by adipose, heart, and muscle cells. T3 stimulates LPL to increase this breakdown of triglyceride-rich VLDL . Eventually, the cholesterol content of the lipoprotein becomes higher than the triglyceride content, and these particles become LDL.
Thyroid hormones increase LDL particle uptake
Thyroid hormones affect LDL particle oxidation
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Cholesterol And Your Thyroid
Hypothyroidism can cause levels of total cholesterol, LDL bad cholesterol, and triglycerides to rise. Even subclinical or borderline hypothyroidism can cause high cholesterol. Two Chinese studies, for example, found that having a thyroid stimulating hormone level in the upper end of the reference range makes you more likely to have a high cholesterol level.
If you do not have a diagnosed thyroid problem, high cholesterol levels are supposed to automatically trigger screening for hypothyroidism, according to many medical guidelines. Doctors are also advised to test thyroid function before prescribing any cholesterol-lowering medications. Unfortunately, this does not happen consistently, and many people with undiagnosed hypothyroidism are given cholesterol-lowering medication without any thyroid screening.
The take home message? Its especially important for you to ask your physician to do a comprehensive thyroid evaluation, including, at minimum, a TSH test. If you are borderline or overtly hypothyroid, your next step is thyroid hormone replacement therapy.
Proper thyroid diagnosis and treatment of your hypothyroidism could resolve your high cholesterol and allow you to avoid taking prescription medication. One recent study found that more than 60 percent of people with high cholesterol and untreated hypothyroidism saw their cholesterol levels normalize once hypothyroidism was treated.
Benefits Of Pro Omega
Essential Fatty Acids are nutritional cornerstones of human health. Two major families of fats are comprised under this designation, omegas 3 and 6. They are deemed essential because we need them for proper healthmuch like certain vitamins and mineralsbut cannot produce them on our own. We must therefore consume these fats through diet or supplementation.
Most people associate omega-3s with cardiovascular health, but their benefits go far beyond the heart. The two main omega-3seicosapentaenoic acid and docosahexaenoic acid promote a healthy immune response that is behind the relief of many chronic conditions but that is too often inhibited by poor nutrition. Extensive research has documented the health benefits of EPA and DHA, which include not only a healthy heart, but brain and cognitive function, joint mobility, eye health, pregnancy and lactation, healthy skin and hair, and a normally functioning immune response.
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How Can We Control Cholesterol Levels
Having hypothyroidism is not something we can control, so it may seem unfair that you also have to worry about having high cholesterol and an increased risk for cardiac related disease. Luckily, just as cholesterol is elevated with low thyroid function, once the thyroid is treated with appropriate hormone replacement, the cholesterol levels will likely fall.
Research shows that in 60% of people with a new diagnosis of hypothyroidism and high cholesterol, their elevated cholesterol levels resolve after thyroid function is restored. At least 75% of people who are treated with levothyroxine are able to go without cholesterol-lowering medications within one year after diagnosis.
In some cases, cholesterol levels may remain high, even after treatment with levothyroxine. These patients might try eating a nutrient-rich diet and exercising to reduce cholesterol levels. If this is not enough, cholesterol-lowering medications may need to be started with the supervision of your doctor in order to avoid cardiac disease.
As always, itâs important to discover the root cause before treatment is started. If you have elevated cholesterol on routine laboratory tests, talk to your provider about checking your thyroid function before taking cholesterol-lowering medications. Too many people go years without a clinical or subclinical hypothyroid diagnosis, leading to cardiac and other problems throughout the body.
If Your Thyroid Is Not Being Properly Managed You Are Increasing The Likelihood Of Having A Heart Attack By As Much As 50
The thyroid is a gland located in the middle of your neck. It produces two main hormones. The main hormones include triiodothyronine , which is the active form of thyroid hormone, and thyroxine , which is inactive. Your body Takes T4 and converts into T3.
When the thyroid does not produce enough thyroid hormones, it is underactive, which is called hypothyroidism. Thyroid hormones, especially T3, play an essential role in helping the liver process and remove any excess cholesterol from the body.
When the body does not produce enough thyroid hormones, the liver cannot process as much cholesterol as it should. According to research, up to 13 percent of people with high blood cholesterol also have a problem with their thyroid.
The same research notes that societies, such as the American Association of Clinical Endocrinologists and the American Thyroid Association, recommend that people newly-diagnosed with high cholesterol get tested for an underactive thyroid.
The research also suggests that a persons cholesterol levels may improve once they have received treatment for an underactive thyroid, even if they do not require cholesterol-lowering medications.
Even mildly low thyroid hormone levels can lead to high cholesterol. According to 2012 research, elevated TSH levels can also cause high cholesterol, even if T3 and T4 are not elevated.
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