Declining oestrogen levels during menopause increase a woman’s risk of developing heart disease. But what most women don’t realise is that hypothyroidism also causes high cholesterol which can result in coronary heart disease.
Menopause and the Risk of Heart Disease
Have you had your cholesterol levels checked recently?
If you’re a woman in your forties, chances are you’ve entered perimenopause, the years in the lead up to menopause when hormone levels, particularly oestrogen, are in decline.
Studies have shown that oestrogen plays a positive role in protecting women against coronary heart disease (CHD) by lowering LDL cholesterol, raising HDL cholesterol and supporting blood vessel walls.
This may explain why women under the age of 55 have a lower risk of developing heart disease than men. But after the menopause women lose the hormonal protection of oestrogen and their risk of developing CHD rises and becomes equal to that of men.
High Cholesterol and Hypothyroidism
I had no worries about my cholesterol levels as I am on bio-identical HRT, which includes oestrogen, and I thought I would be protected.
But my latest blood test results revealed that I have high cholesterol. Here in the UK, patient guidelines suggest aiming for a Total Cholesterol (TC) level of 5.0 mmol/L or less. My TC level is 7.1 mmol/L.
The test results also showed that I am iron deficient (again) and my thyroid is underactive. And to top it all, my blood pressure is high.
I have to admit that this news came as a bit of a shock as I exercise regularly and eat a healthy diet.
My GP thinks that my high cholesterol and high blood pressure are probably a result of my hypothyroidism (underactive thyroid) and I hope she’s right.
The Risk of Hypothyroidism during Perimenopause
Thyroid problems are very common during perimenopause and postmenopause. Approximately 26% of women in or near perimenopause are diagnosed with hypothyroidism. And 20% of women older than forty with high cholesterol levels have underactive thyroids.
There is a direct link between hypothyroidism and heart disease, including a general weakening of the heart muscle and coronary atherosclerosis (furring up of the arteries).
According to Dr Ridha Arem, author of The Thyroid Solution, an underactive thyroid causes or worsens hyper-cholesterolemia, which could result in coronary heart disease (hardening of the arteries of the heart).
The problem is that the symptoms of hypothyroidism are very similar to that of perimenopause and it may be difficult for women to differentiate between them.
Common symptoms of hypothyroidism include:
- Irregular periods
- PMS
- Reduced libido
- Cystitis
- Palpitations
- Muscle aches and pains
- Fatigue
- Weight gain
- Poor memory
- Mood swings
- Depression
- Poor concentration.
There are many more, but any women over the age of forty will be able to tell you that these are also common symptoms of perimenopause. How can you tell them apart?
Hypothyroidism and Brain Fog
This is what happened to me. For months I’ve been complaining of brain fog and fatigue. I’ve been finding it really difficult to concentrate and have been unable to focus on my work and what I want to achieve. Hell, some days I find it difficult to string a coherent sentence together or formulate a clear thought.
For a while I thought it was just another symptom of the menopause – after all, it is meant to affect brain function. But I couldn’t understand why I was taking bio-identical hormones and still experiencing negative menopausal symptoms.
In recent months the one thing that’s changed is that I’ve doubled my oestrogen dosage. Thinking I may be oestrogen dominant I returned to the original low dose and waited for mental clarity to arrive.
I’m still waiting, so that obviously wasn’t it. That’s when I decided it was time to ask my doctor for a blood test to check my thyroid function.
Treatment for Hypothyroidism and High Cholesterol
Research has shown that correcting low-grade hypothyroidism will result in a lowering of both total cholesterol and ‘bad’ LDL cholesterol levels.
My GP has increased my daily thyroxin dose and advised me to cut down on the amount of saturated fat in my diet from meat and dairy products.
It’s only been a week since I increased my thyroxin dosage so I’ve noted a minute improvement in my energy levels. Writing this article has been a real struggle as I’m still finding it difficult to formulate my thoughts in a coherent fashion.
But the more I discover about the link between menopause, hypothyroidism and high cholesterol the more certain I feel that correcting my thyroid function will improve my brain function and reduce my risk of heart disease.
Check Your Cholesterol Levels
If you are a woman in your forties or above I urge you to have your cholesterol levels checked. It’s just a simple blood test. If they’re high it could be a symptom of hypothyroidism.
And if you’re experiencing any of the hypothyroidism symptoms I described above ask your doctor to check your thyroid function as well. Any underlying thyroid problem will only exacerbate your perimenopausal symptoms, so the sooner you get it checked out the better.
If you’re perimenopausal and have an underactive thyroid I’d love to hear how you are coping. Please leave a comment in the box below.
Photo: Thanks to Jo Christian Oterhals on Flickr.com
I am on levothyroine,hrt,Bp tablets and now cholesterol tablets worries about the mix but am on a health kick and exercise regime as I wish to grow old. Worried sick on all these pills x
Hi Sarah. That’s a lot of medication you list there! Great that you’re on a health kick and I hope it helps with your symptoms. Monitor yourself carefully now that you have started cholesterol medication as there could be side-effects. I hope it all goes well.
just being offered anti-depressants even though tsh levels over the top, antibodies over the top (sub-clinical hypothroidism). Would like HRT. Was meant to have cholesterol test but GP (not my usual one I hasten to add but one in practice I’ve not seen & hope not to ever again) forgot to ask lab to check it so just had full blood count.
Been under relentless very heavy “stress” for years – following serious assault, harassment & years of police misconduct & bullying, followed by being defrauded, but hey-ho
Endocrinologist told me years ago that my thyroid results over many years did indeed show a “stress profile” – thyroxine not good idea as am sooooo anxious
Very disillusioned & burnt out
Hi Alice. I’m sorry to hear about your situation. Before you consider taking antidepressants or HRT I would urge you to seek treatment for your hypothyroidism. If your thyroid is not functioning properly it can make you feel very depressed, tired and overwhelmed. As far as I’m aware thyroxine will not make you feel more anxious if you are on the correct dosage. If your thyroid is OVERactive then you can feel tense and hyper. As long as your thyroid is under functioning it will put the rest of your hormonal system under a lot of stress. Also, because of your chronic stress, I suspect your adrenals have taken strain for a long time which can result in feeling burnt out so it may be worth your while to look at what you can do to treat adrenal fatigue. There is a lot of information on the internet. HRT is very useful if your life is being blighted by symptoms like night sweats, mood swings or a dry vagina but from what you say, you have other more pressing problems. Also, the more stressed you are the worse any menopause symptoms are likely to be – it’s a vicious circle. I hope you seek some more help and get the right treatment. Good luck.
Hi .I have had an under active thyroid since the age of 10 ( I am now 41) I believe i am currently perimenopausal and suffering like hell! Most of the time i feel like someone is controlling my body. I feel very weird, forgetful, irritable, depressed, overwhelmed, sad, tired you name it , I feel it and generally find it hard to cope. I have seen a thyroid specialist recently who said my levels were ok but i think the addition of the peri menopause has made my thyroid much much worse. Doc only wants to get me anti- depressants which I have so far resisted taking- although i don’t know for how long, reluctant to give me HRT as I have migraines with aura, so don’t know what to do next. Thought about bio-identical hormones but don’t know where to go for them. Generally life at the moment is extremely hard and unpleasurable.
Hi Julia. I’m really sorry to hear you’re going through such a bad time. I was in a very similar situation a few years ago and it is true that perimenopause can make thyroid symptoms much worse – it’s all part of the same endocrine system. You are right to resist taking antidepressants. Occasionally I have been extremely depressed only to increase my thyroid medication on the advice of my doctor and feel wonderful a couple of weeks later. I also suffer from migraines with an aura and still get about one a month on average. I think the progesterone levels sometimes trigger them. However, I feel an occasional migraine that is usually resolved by taking Maxalt Melt is a small price to pay for feeling generally okay most of the time, apart from the progesterone days.
Speaking from my own experience, I suspect that you would be greatly helped by taking bioidentical hormones at this stage of your life, while your symptoms are severe. Bioidentical hormones are available on the NHS in the form of oestrogen gels and patches such as Oestrogel or Evorel patches, progesterone capsules (Utrogestan), creams (Crinone) or pessaries (Cyclogest), and if you need it and your doctor is prepared to prescribe it, testosterone gel (Testim gel). However, many GPs seem to prefer to prescribe the synthetic HRT made from pregnant mare’s urine (Prempak-C) and this causes horrible side-effects in some women. If your GP is not confident about prescribing you bioidentical HRT, ask him/her for a referral to a menopause clinic at a hospital near you or a Gynae-Endocrine consultant. Bear in mind also, that although your thyroid levels are ok, they may be too low for you to feel well, and it might be worth your while taking to your doctor about increasing your dosage slightly but keeping you within the limits of the normal range. I’m on the cusp but my GP said that if I’m feeling good he’s not worried. I hope that helps, Julia. Let me know how you get on.