Thyroid Disease Related Conditions The Link Between Thyroid Disease and Cholesterol By Mary Shomon Mary Shomon Facebook LinkedIn Twitter Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution." Learn about our editorial process Updated on November 27, 2021 Medically reviewed by Yasmine S. Ali, MD, MSCI Medically reviewed by Yasmine S. Ali, MD, MSCI Facebook LinkedIn Twitter Yasmine S. Ali, MD, MSCI, is a board-certified preventive cardiologist and lipidologist. Dr. Ali is also an award-winning writer. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Why They're Linked Low Thyroid & High Cholesterol High Thyroid & Low Cholesterol Thyroid Treatment Cholesterol Treatment Lifestyle Changes Thyroid disease and cholesterol levels are closely related. Interactions between these conditions include: High cholesterol (hyperlipidemia) is linked to hypothyroidism (underactive thyroid). A sudden drop in cholesterol can occur with hyperthyroidism (overactive thyroid). Treating thyroid disease can correct cholesterol levels. Cholesterol drugs can affect thyroid disease and its treatments. This article explains why thyroid disease and high cholesterol are linked, the potential problems, and how to manage both conditions at once. What Are Normal Cholesterol Levels? Why Thyroid and Cholesterol Are Linked Thyroid hormones have several jobs, including regulating your body's energy. These hormones also control how your body uses cholesterol and other lipids (fats) and help your liver produce fatty acids, which store energy for you to use later. When thyroid hormones are not at the right levels, these processes can be affected. Getting thyroid hormones in balance helps regulate cholesterol. Verywell / Emily Roberts Low Thyroid & High Cholesterol Thyroid-stimulating hormone (TSH) can be measured with a blood test. Made by a small gland in the brain called the pituitary gland, TSH stimulates your thyroid gland to release thyroid hormones. High TSH levels usually mean you have an underactive thyroid. Symptoms include: FatigueWeight gainSlow heart rate Studies show that people with high TSH levels have much higher total cholesterol and LDL (bad cholesterol) levels than people with normal TSH levels. Heart Disease in Borderline Hypothyroidism Health Risks Untreated hypothyroidism is linked to serious health risks. These include: Heart disease Stroke Blood clots Chronic kidney disease High cholesterol further raises the risk of blood clots, heart disease, and stroke. High Thyroid & Low Cholesterol Excessively low cholesterol can cause health problems. Sometimes, a sudden drop in cholesterol levels can be a sign of an overactive thyroid. If you have hyperthyroidism, your thyroid produces too much T3 and T4, which are thyroid hormones. High levels of these hormones speed up certain processes in your body, leading to: AnxietySudden weight lossRapid heartbeat Graves' disease is an autoimmune condition that causes hyperthyroidism. It sometimes involves an eye disease called orbitopathy. Increased levels of LDL and total cholesterol are risk factors for orbitopathy. Health Risks Without treatment, hyperthyroidism can lead to: Orbitopathy Osteoporosis (brittle bones) Abnormal heart rhythm Stroke or heart attack A potentially life-threatening condition called thyroid storm Low cholesterol is associated with an increased risk of: Some cancersMood disordersHeart disease Both conditions are associated with heart disease, possibly compounding the risk. Recap Low thyroid activity is linked to high total and LDL cholesterol. Without treatment, an underactive thyroid could lead to heart disease, stroke, and other health issues.High thyroid activity is linked to low cholesterol. Untreated, an overactive thyroid can lead to brittle bones, abnormal heart rhythm, and more. Thyroid Treatment and Cholesterol You can get effective treatment for underactive or overactive thyroid. Adequate thyroid treatment helps manage your thyroid hormones and may impact your cholesterol as well. Underactive Thyroid Treatment Hypothyroidism is usually treated with the drug Synthroid (levothyroxine), a synthetic form of the hormone T4. This drug often improves thyroid levels and cholesterol levels. A large study of people with hypothyroidism and high cholesterol showed that treating the thyroid problem corrected cholesterol levels 60% of the time. Since levothyroxine doesn't always get cholesterol levels in the ideal range, additional medical treatments may be needed. These include cholesterol-lowering medications such as: Statins, such as Lipitor (atorvastatin) or Crestor (rosuvastatin) Zetia (ezetimibe) PCSK9 inhibitors, such as Repatha (evolocumab) and Praluent (alirocumab) Overactive Thyroid Treatment Treating hyperthyroidism can help raise low cholesterol levels. Possible treatments include: Antithyroid drugs: Medications that lower your thyroid's hormone production Radioiodine therapy: Comes in capsule or liquid form; slowly destroys thyroid cells that produce hormones Surgery: All or part of the thyroid is removed If your entire thyroid gland is removed, you'll need to take thyroid replacement hormones (such as levothyroxine) for the rest of your life. This is sometimes the case with partial removal and radioiodine therapy as well. Recap Treatment with levothyroxine can improve both an underactive thyroid and high cholesterol.An overactive thyroid and low cholesterol can both be improved with medication, radioiodine therapy, or surgery directed at reducing the overproduction of thyroid hormone. Cholesterol Treatments and Thyroid Disease Cholesterol treatments can affect thyroid disease and treatment in several ways. Absorption Drugs classified as bile acid resins may prevent your body from absorbing levothyroxine. They're prescribed for hyperthyroidism and include: Questran (cholestyramine) Colestid (colestipol) Welchol (colesevelam) You should take these drugs at least four hours after taking levothyroxine to avoid this effect. Muscle Pain Muscle pain can be a side effect of statin medications. If you have hypothyroidism, you may be likely to experience this side effect. Muscle Pain and Weakness in Thyroid Disease Hyperthyroidism Symptoms Niacin is a treatment that is sometimes recommended for increasing HDL ("good cholesterol") levels. Its side effects, such as flushing, can closely mimic the symptoms of hyperthyroidism. That might make you think your thyroid treatments aren't working properly. Thyroid Eye Disease A 2018 study found that treating high cholesterol with statin medications reduced the risk of Grave's orbitopathy. Recap Drugs used to lower cholesterol can produce side effects that mimic symptoms of thyroid disease and interfere with thyroid medication absorption. People who have thyroid disease may also be more likely to experience side effects of cholesterol drugs. Lifestyle Changes for Both Conditions Lifestyle changes can help you manage cholesterol and thyroid problems. Your healthcare provider may recommend the following: Diet: An anti-inflammatory diet may lower inflammation from autoimmune thyroid disease and lower cholesterol. Weight loss: If you are overweight, sometimes weight loss can help can lower LDL cholesterol levels and improve thyroid health. Exercise: Regular exercise can improve energy levels if you have hypothyroidism, and may raise your level of good cholesterol. Quitting smoking: Smoking harms the thyroid and increases the risk of health complications. It also adds to the cholesterol-related risk of heart disease and stroke. Summary Thyroid hormones are associated with cholesterol levels. If your cholesterol is high or drops suddenly, you might need to have your thyroid checked. Thyroid treatments may help you reduce your risk of complications such as heart attack and stroke, and they may also help you manage cholesterol. If you are taking a cholesterol-lowering medication, know that it can affect your thyroid disease and treatments. 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Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008 Henning RJ, Johnson GT, Coyle JP, Harbison RD. Acrolein can cause cardiovascular disease: a review. Cardiovasc Toxicol. 2017;17(3):227-236. doi:10.1007/s12012-016-9396-5 By Mary Shomon Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit