High Cholesterol? It Could Be Your Thyroid.

Cholesterol thyroid

Do you have high cholesterol? You may want to check your thyroid levels!

Earlier this year the U.S. Secretaries of Health and Agriculture joined the American Health Association in stating that dietary cholesterol (the kind we get from eggs and meat products, for example) is no longer a nutrient of concern. After 50 years of guidelines advising to reduce dietary cholesterol, there is simply no good research to suggest that there is a link between the cholesterol we eat and our blood cholesterol levels.

So, if our dietary intake of cholesterol doesn’t affect our levels, what does? While other foods are certainly worth investigating (like sugar!), your thyroid can also play a role.

Hypothyroidism (or low thyroid function) is a very common, but usually unrecognized cause of high cholesterol levels. Low thyroid function affects our ability to produce and metabolize fats in proper levels and can ultimately lead to elevated triglycerides, cholesterol, and LDL (the “bad” cholesterol). There is a clear relationship between thyroid function and cholesterol levels that has been reproduced in many clinical studies.

As thyroid function decreases, cholesterol levels increase

Why is this important?

Well for one, you may be unnecessarily prescribed statins or cholesterol-lowering medication when the root cause is actually your thyroid.

Once thyroid function is addressed and your labs are optimal (TSH, FT3 and FT4), cholesterol levels often return to normal and no further medication is required.

If your latest lab work reveals high cholesterol, have a complete thyroid panel run (NDs can do this!) to rule out low thyroid function, especially if you are experiencing any of the following symptoms:

  • Fatigue
  • Weight gain
  • Constipation
  • Feeling cold
  • Changes in hair, nails and/or skin
  • Brain fog or low mood

If you are already on thyroid medication and are having problems with high cholesterol, you may want to speak with your health professional to ensure that your medication type and dosage is right for you AND that it is resulting in proper levels of thyroid hormones in the body.

Check out my previous blog post here for more information on thyroid lab testing.

Questions? We’re here to help,

Dr. Katie Rothwell, ND

C.V RizosM.S Elisaf, and E.N Liberopoulos Effects of Thyroid Dysfunction on Lipid Profile. Open Cardiovasc Med J. 2011; 5: 76–84. Published online 2011 Feb

Are Low Iron Levels Sabotaging Your Thyroid Hormones?

Low iron thyroid

Iron Basics
Low iron is one of the most common things I see in women who walk through my door. It’s also one of the most common tests we run and we do this by looking at ferritin levels (a measure of iron stores in your body). The normal reference range for ferritin is anywhere from 10-291 ng/mL for women. Most often, if you’re not clinically anemic and your ferritin is within this range, you won’t be alerted to abnormal ferritin levels (even if they as low as 12, for example). However, recent studies show that women have improved energy and feel best with ferritin levels > 50, even if they’re not anemic.

Symptoms of Low Iron
Symptoms of low iron can include fatigue, low energy, hair loss, feeling cold, weak or brittle nails, palpitations or shortness of breath, brain fog and more. Many of these symptoms are also symptoms of low thyroid function or hypothyroidism. If you’ve been previously diagnosed with hypothyroidism and are still experiencing many of these symptoms, take the guess work out and have your ferritin levels checked.

Side note: If you experience heavy menstrual periods, are vegan/vegetarian, or have digestive disorders (such as celiac disease) that affect nutrient absorption, it’s also important to have your ferritin assessed on a regular basis.

The Iron-Thyroid Connection
Women are more likely to have low iron levels and we’re also more likely to have hypothyroidism or Hashimoto’s Disease (Lucky us!). We don’t usually think of iron as being essential to thyroid function, but it is!

Our thyroid needs adequate iron levels to produce the active hormones T4 and T3. If our body is low in iron, the enzyme responsible for this can be reduced in activity up to 50%. Iron is also essential to another key enzyme, which converts T4 into T3. (T3 is our most active thyroid hormone). If you are already on medication for your thyroid (such as Synthroid) having adequate iron levels is still important for converting the medication into active, usable, thyroid hormone.

There’s more: a very common symptom of hypothyroidism is low stomach acid, which decreases our ability to break down foods and absorb nutrients. Thus, a very common symptom of hypothyroidism is (you guessed it) low iron levels!

Low iron –> hypothyroidism –> low iron –> vicious cycle

So What Should My Ferritin Be?
For optimal energy and thyroid function, ferritin levels should be at or above 80 ng/mL. Hair loss or thinning can occur at levels less than 40. Anything below 30 is what I call “scraping the bottom of the iron bucket”. If your ferritin is really low, your thyroid won’t be functioning properly no matter what other medications or supplements you are taking. Most women I test ferritin levels on are somewhere between 20-50, and many are in need of some sort of iron support or supplementation. If you’ve been on iron in the past and have experienced digestive upset, constipation, or nausea, there are better supplements out there that don’t have these unwanted side effects and are more effective in bringing up iron levels.

That said, we also don’t want too much iron, as this can be harmful to the body. So supplement wisely and make sure to re-test your levels on a regular basis.

The Recap: 

  • Many symptoms of iron deficiency and hypothyroidism overlap. What you thought were low thyroid symptoms (such as fatigue and hair loss) could in fact, be due to low iron!
  • Your thyroid requires adequate iron levels for TWO key enzymes that are vital to hormone production and activation.
  • If you have low thyroid function or hypothyroidism, have your ferritin levels assessed and get a copy of the results. Use 80 ng/mL as a guide to optimal levels, although different people feel best at different levels.
  • Ask your Naturopathic Doctor about testing your ferritin levels and if needed, the best iron supplements to increase your levels quickly without causing you digestive upset.

Want more info on the thyroid tests you need? Check out my last blog post here

Take care!

Dr. Katie



Confused about Food Sensitivities? Here’s the Deal…

Food allergies vs. intolerances vs. sensitivities. What’s the difference and why does it matter?

The terms food sensitivities, intolerances and allergies are often confused or (incorrectly) used interchangeably. When Naturopathic Doctors are investigating digestive concerns, we use all three of these terms to determine what might be causing your symptoms and how to best to test for and treat them.


Eggs, dairy, and wheat are three of the most common food sensitivities we see clinically!

Food Allergies
A true food allergy occurs when the immune system responds immediately to a particular food. Common food allergies include peanuts or shellfish. Symptoms can include hives, shortness of breath, or anaphylaxis and typically present within minutes after ingestion. Testing for immediate-type food allergies is typically unnecessary as it is usually readily apparent which food caused the problem. If testing is needed it is done via skin prick or blood testing. Food allergies usually need to be avoided life long, however some children do out grow them over time.

Food Sensitivities
Food sensitivities are also caused by an immune system reaction, but instead of an immediate reaction they cause delayed symptoms which can appear anywhere from hours to days after ingestion. These symptoms can include digestive complaints such as bloating and constipation, as well as non-digestive complaints such as headaches, fatigue, skin concerns, and joint pain. Identifying food sensitivities can be difficult due to the delayed nature of their symptoms. A supervised elimination type diet or specialized blood testing through your naturopathic doctor are the most effective ways to identify food sensitivities. Generally, food sensitivities are avoided or eliminated from the diet for several months and then gradually reintroduced following a gut-healing protocol.

Food Intolerances
Intolerances (unlike allergies and sensitivities) are NOT due to the immune system reacting to food. Instead, they are typically due to the body not being able to properly digest, absorb, or metabolize certain foods. The most common example of this is a lactose intolerance, in which the body does not produce the lactase enzyme. This stops the body from breaking down and digesting lactose or milk products and results in symptoms like bloating, flatulence, cramping, pain and diarrhea. You can reduce the uncomfortable symptoms of food intolerances by supplementing with the enzymes your body is lacking (for example: lactase pills) or avoiding the food all together.

The digestive system (or ‘the gut’ as we fondly refer to it as) is vital to overall health. As many of our patients can attest to, a poorly functioning gut can result in a variety of health concerns and chronic complaints down the line. 

If you’re frustrated with confusing food reactions, random symptoms, and can’t seem to identify what the problem is, it is important to have yourself properly assessed and tested by a qualified professional. You could have an allergy, sensitivity, intolerance, or any combination of the three!

Still have questions? Let us know, we’re here to help!

Dr. Katie

What you need to know about testing women’s hormones

When a woman goes to the doctor and says “I think my hormones are all messed up” she may be given a requisition to test her hormones.  When she’s told that her hormones are fine and brings the results to us, we often ask her to do them again.  Here’s why:

  1. The day of your cycle has everything to do with when you go to the lab.  Hormones vary with your cycle and they peak at different times.
  • Day 3 is when you test estrogen
  • Day 21 (or 7 days before your expected period) is when you test progesterone
  • This means that you need two requisitions
  1. TSH (thyroid hormone) can be tested at any time during your cycle.  If it is a repeat test, go at the same time of day as you went last time as the hormone can vary during the day.
  2. FSH (follicular stimulating hormone) should also be tested on Day3.
  3. Androgens, like testosterone and DHEA are tested to determine if PCOS is an issue.  DHEA and Testosterone can be tested at any point in your cycle.  We want to see free testosterone though as bound testosterone isn’t actively causing symptoms.

Why you should have a physical exam

There seems to be a trend forming amongst some MD’s.  They say that unless you have an indication of a disease, a physical exam is not necessary until the age of 40.

So one of my patients had been off anti depressants for some time and she was feeling like her energy was low and she just wasn’t quite ‘right’.  When she asked her MD for some blood work and a physical he said that it wasn’t needed until she was 40.  He would happily give her a new script for her depression as that was likely why she was feeling low.

While my patient is quite comfortable with the idea that she may need anti-depressants again, she wanted to be sure that it wasn’t something else first, so she came to see me.

After I did a physical exam and routine blood work based on her history (at LifeLabs), we discovered that she is anemic, has low vitamin D status and has low testosterone levels.

This is an example of where naturopathic doctors can fill in the holes our health care system has.

How do you test for PCOS?

Polycystic ovarian syndrome (PCOS) is a complex condition and diagnosis involves a few tests.

Firstly, we want to know how many androgens you have floating through your blood.  These are hormones that are typically higher in men like testosterone and DHEA-s.  These hormones are responsible for the symptoms of:

  • acne
  • hirsutism (coarse hair on your face, abdomen or chest/back)
  • male patterned balding

These hormones are elevated in 50-90% of women with PCOS with or without the symptoms above.

Ask for free testosterone to be checked, not total testosterone.  This is because high insulin is often found in women with PCOS.  When insulin is high, it stops another hormone from working properly, sex-hormone binding globulin.  This hormone usually binds extra testosterone so that it doesn’t cause symptoms.  Total testosterone levels measure both the bound and unbound hormone.  This can result in a normal reading even though you may have too much free testosterone causing symptoms.

Secondly, we want to know if you ovulate and how often.  This can be done by tracking your periods using a basal body chart or having your cycle monitored at a clinic.

Thirdly, we want to know what your ovaries look like.  This can be done via ultrasound.  Polycystic ovaries are not found in all women with PCOS.

If you are not sure if you have PCOS and would like to be assessed, you can book an appointment with one of our doctors online.