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Connection of High Cholesterol and Thyroid Disorders

Hi Dr. Lupo,

I am 46 year old female with strong family history of heart disease.  Recently, while looking for a cause for abdominal pain I was diagnosed with a fatty liver.  I do not drink alcohol, do not have diabetes and as the Gastroenterologist said am not that overweight.  A CT SCAN in May found an enlarged Thryoid, recent ultrasound has revealed:  A diffusely enlarged and heterogeneous gland.  Right lobe measures 4.7 X 1.6 x 1.1cm.  In the right lobe there is a 5mm. cyst and 6mm hopoechoic nodule.  Left lobe measure  On the let the is a 3mm cyst at the upper pole with multiple small hypoechoic nodules ranging in size from 4 to 11mm as well as a 4mm complex cyst.  

My TSH was 0.98 mcIUnit/mL.  I had Thyroid Antibodies run, was simply told they were normal.  The TSH was performed because I am having Night Sweats while taking LoEstrin24 because my periods suddenly became extremely heavy after being practically non-existent.  I am feeling as though there must be a connection with the thyroid and the fatty liver, as I have read that this is often overlooked in people with high cholesterol.  My cholesterol numbers in July were 213, Triglceride 197 (ref 40-180MG), HDL 49, CHOL/HDL 4.3 and LDL 124.6.  I just had a C-Reactive Protein which is 5.9 normal less than 5.  My Internist now wants me to see the Cardiologist about taking a cholesterol lowering med because of the early onset of heart disease on my Father's side and this liver think flipping me out.

I just want to know if further testing should be done on these nodules and perhaps if this isn't contributing to the fatty liver.  What's your opinion? Could this be related?

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The thyroid ultrasound shows only slight enlargement of the left lobe, with normal right lobe dimensions.  The heterogeneity often means hashimoto's, but the thyroid antibodies were normal (usually they are positive in hashi).  The TSH is completely normal, suggesting intact/normal thyroid function w/o need for thyroid treatment at this time.  The nodules are small and with the possible exception of the 11mm nodule, can be monitored over time w/o FNA biopsy at this point.

Low thyroid (hypothyroidism) can increase cholesterol -- but you don't have hypothyroidism.

The pattern is most consistent with insulin resistance with increased triglycerides and non-alcoholic fatty liver.  There may be a family history of diabetes.  The thyroid is not likely contributing to the fatty liver or the cholesterol profile.
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