Thyroid Thursday Episode 34: Does Hypothyroidism Have A Role In Elevated Cholesterol?
A patient recently asked me if her elevated cholesterol was related to her hypothyroid condition. It was a great question and one I thought would be a good topic for a Thyroid Thursday video.
The answer is yes!
But why is hypothyroidism associated with increased cholesterol?
When your TSH goes up it binds to receptors in the liver which increases an enzyme called HMG-CoA reductase. HMG-CoA reductase is the rate limiting enzyme (primary enzyme) involved in cholesterol biosynthesis (production).
So, when your TSH goes up, your liver produces more cholesterol. Increased TSH levels correlate with increased levels of triglycerides, total cholesterol, and LDL-cholesterol. Elevated TSH is associated with lower HDL-cholesterol.
The patient’s follow-up question was, “So what does my statin medication do and should I be taking it?”
Her statin medication was prescribed to lower her cholesterol. Statin medications inhibit the HMG-CoA reductase enzyme that produces cholesterol.
The statin did reduce her cholesterol level. But, the statin did not address the underlying cause of why her cholesterol was elevated.
The second part of her question was should she be taking the statin. That is a question that would get different answers based on the type of doctor asked.
In my opinion, the statin does not address the foundational problem, elevated TSH. Instead, it suppresses cholesterol and all its downstream metabolites and ignores the real issue. Some of those downstream hormones that are inhibited are
- Pregnenalone
- Progesterone
- Cortisol
- Aldosterone
- DHEA
- Testosterone
- Estradiol
- CoQ10
- Bile
Instead of just placing her on a statin, which led to other symptoms, she should have had her thyroid physiology evaluated and addressed. When TSH is elevated for extended periods of times it also increases insulin resistance and leads to diabetes. It triggers chronic low grade inflammation, and reduces vasodilation. Elevated lipids along with these other factors leads to vessel damage, plaquing, vessel narrowing, increased blood pressure, and cardiovascular incidents. This is one of the reasons so many people today on statins who have normal or low cholesterol levels are having cardiovascular incidents like heart attacks.
Statins are prescribed to prevent cardiovascular incidents, yet they may very well just increase the risk since the real problem is never addressed. These same people wind up on a number of other medications to the other factors caused by the elevated TSH and hypothyroid state.
