I know that when you read the title of this blog, you thought that I had lost my mind; however, I have not.  Let me tell you about a few of my patients and their outcomes that I think you will find very interesting.  A couple of years ago, I had an initial visit with a 50 year old woman who appeared to be the picture of health.  She was her ideal weight, didn’t take any medications, played tennis 2 hours per day and didn’t look a day over 35 years old.  Not only that, she spent several hours in the gym weekly doing cardio and weight training.  When I looked at her lab results, however, what I observed made me think that she was a heart attack waiting to happen.  Her results were as follows:

  •  Cholesterol – 384 mg/dL (optimal is < 200)
  • LDL – 260 mg/dL (optimal is < 100) – This is known as the “bad cholesterol”
  • HDL – 92 mg/dL (optimal is > 60) – This is known as the “good cholesterol”
  • VLDL – 32 mg/dL (optimal is < 30) – ↑ levels are associated with heart disease
  • Triglycerides – 160 mg/dL (optimal is < 150)

Most people know that having high cholesterol levels is a major risk factor for heart disease.  So, after considering her level of physical fitness and her healthy lifestyle, I thought that this must have been a lab error.  I actually had her go back to the lab to have her lipid panel retested.  Also, I had the lab do what is called a VAP (Vertical Auto Profile) Cholesterol Test which determines whether or not the LDL cholesterol particles are small or large.  This is significant because if the LDL particles a small, they are more likely to cause plaque in the arteries.  If the LDL particles are large, however, they are not likely to cause plaque in the arteries.  I was so convinced that the lab must have initially made a mistake, and I was expecting to see her have a total cholesterol result of under 200 mg/dL.  Unfortunately, I got the repeat results back, and this time her total cholesterol was 418 mg/dL and her LDL cholesterol was now 277 mg/dL.  Even though her LDL particles were large (good), the knee jerk reaction still would have been for me to immediately prescribe a statin (Crestor, Lipitor, Zocor, Mevacor, Pravachol, etc) and send her to a cardiologist.  I just knew in my gut, though, that there must be another reason for her high cholesterol level.

So, using the functional medicine approach that I heavily leverage in my practice, I took an in depth look at her other labs, and what I saw was that her thyroid hormone levels were extremely low meaning that she had hypothyroidism.  It is so tempting for me to go off on another tangent and explain what you really need to know about diagnosing hypothyroidism, but I know you have other things to do and I don’t want to make this too detailed and too long.  Quickly, however, so many of my patients have told me that they have had their thyroid tested and have been told that their thyroid was “normal” despite the fact that they had difficulty losing weight, hair loss, cold hands/cold feet, constipation, dry skin, depression, brain fog and brittle fingernails just to name of few of the symptoms.  Using the evidence-based view in which physicians seek to achieve optimal thyroid function, I have found that many of the untreated or inadequately treated patients benefit from proper doses of thyroid medication.  As you can probably tell, I need to cover assessing thyroid function in a future blog.  Anyway, this woman didn’t have any of the above symptoms at all, but I knew that there must be a link between her low thyroid hormone levels and her high cholesterol levels.  So, I did not prescribe a statin for her; instead I prescribed thyroid hormone for her.  Six weeks later I retested her lipid panel, and her total cholesterol had dropped down to 180 mg/dL.  This was a greater than a 200 point decrease without using a statin. 

Many of the patients that I have seen were already taking statins to lower their cholesterol levels prior to seeing me.  I have now lost count of the number of patients that I have seen who no longer have to take a statin at all, or they are taking a significantly lower dose since their thyroid function was optimized.  For example, some of the patients who were taking Lipitor 40 mg/day are now taking Crestor 5 mg twice weekly.  Most people think that the lower the cholesterol level is, the better.  This, however, isn’t true since we need cholesterol in order to make our reproductive hormones.  Estrogen, progesterone and testosterone are synthesized in the body from the cholesterol molecule.

Please don’t misunderstand me as I am not saying that I am totally against the use of statin medications.  I prescribe them when the functional approach that I use doesn’t yield a satisfactory reduction of the cholesterol levels.  Patients need to realize, however, that there are potential risks with any medication including statin drugs. Though it is somewhat controversial, there is research that shows that statins may lower CoQ10 levels.  CoQ10 is an enzyme that is produced in the body that is responsible for production of energy at the cellular level.  Statins sold in Canada are required to carry a precautionary warning expressly stating that this class of drugs may seriously deplete CoQ10 levels.  In the United States, however, the FDA does not require that drug manufacturers give this same warning.  I believe that this is the reason why many physicians don’t routinely recommend the use of CoQ10.  Interestingly enough, there are  numerous small studies that demonstrate that abnormally low levels of CoQ10 are seen in patients with cancers of the breast, colon, lung, pancreas, lymphomas as well as melanomas.  I have not read any information that reports any downside to giving CoQ10, so my position is that all of my patients who are on statins should be taking a CoQ10 supplement.   Additionally, for those patients who really want to be proactive about their health, I recommend that they take CoQ10 even if they are not taking a statin.   For that reason, my own brand of daily nutritional supplements (Proactive EssentialsPLUS) includes a clinically significant dose of CoQ10. 

Now, I’d like to share a few numbers that you might be interested in. Depending on the source, there are approximately 100 million Americans with high cholesterol and over 12 million Americans with thyroid disease, many of whom are untreated or inadequately treated.  And many of the untreated or inadequately treated have high cholesterol that is a direct result of their thyroid disease.  Another survey showed that 90% of the people surveyed were not even aware of the connection between thyroid disease and high cholesterol. The point here is that you or someone you know may be impacted by this phenomenon, and unfortunately the broader and more conventionally thinking medical community is not focused on this issue for reasons that are beyond the scope of this blog.

In conclusion, I hope you now understand that there is a thyroid-cholesterol connection.  In addition to improved cholesterol levels, the other benefits of achieving optimal thyroid function are increased energy, relief of constipation, weight loss, normal body temperature, decreased brain fog, better memory, avoidance of hair loss and less depression just to name a few.  So, if you have high cholesterol levels, remember to ask your doctor to check your thyroid hormone levels since this just might save you from years of taking statin drugs.