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Combatting High Cholesterol with Hypothyroidism

How to Deal With Thyroid-Related High Cholesterol

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Updated December 06, 2003

By Mary J. Shomon

Hypothyroidism is frequently associated with elevated levels of cholesterol, and in particular, triglyceride levels. Also, a specific form of high cholesterol that is resistant to cholesterol-lowering drugs can also be a symptom of hypothyroidism.

Cholesterol is a waxy substance that occurs naturally in all parts of the body. Our bodies require cholesterol to function, and use it to produce other hormones and substances such as Vitamin D and bile acids. Too much cholesterol ends up being deposited in the arteries, including coronary arteries, where it can eventually block arteries and cause heart disease.

In some cases, for someone who has elevated cholesterol levels and has not yet been diagnosed, the treatment for hypothyroidism -- thyroid hormone replacement -- can reduce cholesterol levels to normal. But in some cases, the cholesterol levels remain elevated, and cholesterol-lowering treatment is needed in addition to thyroid treatment.

What Are Elevated Levels?

Desirable: Less than 200 mg/dL
Borderline: 200-239 mg/dL
High: 240 mg/dL and above

An HDL-cholesterol level of less than 35 mg/dL is a major risk factor for coronary heart disease. An HDL level of 60 mg/dL or higher is protective.

Source: Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults, NIH, NHLBI, 1993.

Lowering Your Cholesterol

When you need to lower your cholesterol, what are your options? Generally, it's always a good idea to lose some extra weight, and to begin regular exercise. In addition, there are changes in diet, supplements, and prescription medications that can help lower cholesterol. Decisions should be made in conjunction with your practitioner.

Diet

A primary line of attack in lowering cholesterol can be a change in diet. This involves reducing high-cholesterol foods, and emphasizing a more low saturated fat, high-fiber diet. A good book to help you understand how best to eat is Julia Ross' The Diet Cure.

You can introduce foods that specifically lower cholesterol into your diet. These include oatmeal (try the slow-cooking steel cut oatmeals, for best health value, and least sugar) and the special cholesterol lowering margarine spreads -- Take Control, and Benecol -- that can help reduce cholesterol levels. These spreads contain sterols or stanols, which compete with cholesterol in the intestines, and, when taking its place, allow cholesterol to be passed through the system. These products may cut bad LDL cholesterol by as much as 10-15%. One downside, however, is that these products are fairly calorie-dense.

Monounsaturated fats (those found in olive, canola, and peanut oils), and most nuts and polyunsaturated fats (such as safflower, sunflower, corn, soybean, and cottonseed oils) can in some cases reduce LDL-cholesterol levels.

Supplements

Particularly effective for lowering cholesterol are supplements containing phytosterol or beta sitosterol. Optimally, experts recommend you take 1,500 to 3,300 mg per day, divided throughout the day, and taken approximately 30 minutes before meals.

Another option to consider is the herb guggul. Guggul is an ayurvedic herb that can help increase thyroid function, and also to reduce cholesterol levels. If you are going to try guggul, however, you should consult with an experienced Ayurvedic physician or naturopath, because guggul can occasionally raise blood pressure, and should not be taken without a practitioner's guidance.

Some studies have shown a connection between elevated homocysteine levels and elevated cholesterol. Supplemental vitamin B6, B12, and folic acid can also help in lowering homocysteine levels.

Vitamin E is also typically recommended, from 100 to 400 IU per day.

Drugs

As noted earlier, if you make changes in your diet and lifestyle and your LDL-cholesterol level still remains quite high, your doctor may also suggest that you take cholesterol-lowering medications. There are several main types of prescription drugs that can be given for lowering cholesterol -- statins, resins, and probucol.

Statins are considered the primary choice for lowering LDL levels. Statin drugs include lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), atorvastatin (Lipitor), and cerivastatin (Baycor).

Fibrates such as Gemfibrozil (Lopid) or fenofibrate (Tricor) are typically given to lower triglyceride levels.

In some cases, high doses of nicotinic acid, also known as "niacin," are recommended for reducing triglyceride levels and raising HDL. Niacin is available over the counter, but should be taken under the supervision of a physician.

Resins are drugs that bind with bile acids in the digestive tract, forcing the liver to clear cholesterol and thereby reducing LDL. These drugs include cholestyramine (Questran, Questran Light) and colestipol (Colestid).

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