Elevated cholesterol after getting TSH to normal ranges

Medical Q&A [Moderated]
1

Hi docs.

I’m a 31 male, 82kg 179cm, lean. I do powerlifting at around 389.06 wilks atm.

5 months ago I started treating my thyroid. My TSH went from 5.938 to 4.880 (37.5 mcg of levo), to 3.592 (75 mcg), to 2.397 (125 mcg, a replacement dose for my weight), and just got result of TSH 0.709 (137.5 mcg). Obviously going back to 125 mcg replacement dose to get TSH a bit closer to 1.7

A lot of hypo symptoms are gone, but some are still present like libido issues and tinnitus. At some point of the treatment (@ 75 mcg) I have noticed that my ability to achieve arm pump in the gym came back (chest and shoulders too), and I never even realized that it was gone, I always thought I was lazy. My numbers and strength went up slightly, and doing stuff like curls and bench became a much smoother and more pleasant experience.
Then 2 weeks later it went back to what it was before - veins and muscles don’t fill up with blood properly, biceps feel weak, and doing curls is painful and unpleasant. I also feel like I’m unable to flex to full potential, muscle always goes weak at around 60-70%, even though my TSH got better.

At first I thought I needed more Levo, but now I think that it wasn’t the issue. I thought maybe something is blocking my blood flow so I did a lipid panel and it came back like this:

Total cholesterol - 237.76 mg/dl *elevated
HDL - 67.27 mg/dl
LDL - 151.55 mg/dl *elevated
VLDL - 14.69
Triglycerides - 72.63 mg/dl
Atherogenic coefficient - 2.53

I’m not sure if high cholesterol runs in my family. I don’t drink/smoke, my daily cholesterol intake does not go above 200 milligrams. However I don’t eat fish or any sea products (very rarely sushi).

Already a doc I know (a friend of mine venereologist/dermatologist) told me that these cholesterol levels are fine and I don’t need to do anything about them, but this is the same doc who told me that my TSH of 5.938 is ok and I don’t need to do anything about it as well, and yet here I am taking full replacement dose.

Tomorrow I will visit endo who is treating my hypo, and I imagine she will prescribe me some statins. I read that they cause muscle pain, especially if muscle is being loaded. So I worry about that. Is it ok to do powerlifting on statins?

Also, do you think these cholesterol levels could cause libido issues and could be causing my muscle problems?

And should I supplement omega-3 (since I hate fish) or psyllium?

Thank you!

2

This would be best handled as a consultation given the specifics of the question. A few points:

  1. A lipid panel in isolation doesn’t really tell the story about heart disease risk. An elevated LDL is not something I would ignore, in general.

  2. TSH values in and of themselves (particularly <10 mIU/L) are somewhat controversial with respect to treating hypothyroidism.

  3. Statins don’t reliably cause muscle pain more than placebo even when training. Resistance training is recommended for nearly all individuals, including those on statins.

  4. I am not going to comment on your libido or “muscle problem” without more information in a 1-on-1 setting other than it is unlikely these are related to cholesterol.

  5. Psyllium husk may be useful in reducing LDL and other atherogenic lipoproteins.

  6. The data on fish oil isn’t great, but you should talk to your doctor about management.

-Jordan

1 Like
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You were right Jordan, my cholesterol was not the issue.

In desperation I did my own bloodwork, checked total blood count and found that I have very elevated levels of eosinophils 3.22 g/litre (35%) lab range is 0.02 - 0.5; and elevated monocytes 1.29 g/l (14%) lab range is 0.1 - 0.9.

I was told to check for parasites and food allergies. While parasites panel and gluten intolerance came back negative - lactose genetics came back as full lactose intolerance.

I’m not sure how is this possible, since dairy is a huge chunk of my diet - cheeses with pasta, 600ml of cow milk per day along with whey protein. Pretty crazy. I did notice bloating if I drank too much milk like over 1 liter per day, so I thought that was my limit. But turns out my body can’t handle any lactose and I find this out at 31 years old…

I was going to check for stomach fungal infections like stomach candida, but I don’t know if it’s relevant anymore. Monocytes don’t seem to be related to lactose intolerance so I’m still on the fence about this.

And I have no idea if eosinophil inflammation and monocytes could be causing my muscle neuropathy for me, along with tinnitus and low libido (at high testosterone and overall perfect sex-related health).

Can I still eat cheeses and whey protein with milk if I start taking lactase pills before every dairy? How long will it take if I go lactose free for my stomach to clear up eosinophils?

Any articles you can direct me to so I can educate myself on this thing? Thank you!