Dr. Keith Roach: High cholesterol cases should be checked for low thyroid
Dear Dr. Roach: My doctor has put me on atorvastatin 20 mg. I am 71, with high blood pressure, and my HDL (good cholesterol) is in the 30s. My total cholesterol is now good, at around 180.
After some research, I found out that if you have a thyroid condition, you might not need to take cholesterol medication. I am concerned about this, but I find it hard to get in contact with my doctor, since she works only two days a week now. Should I be concerned about this, or just keep taking the medicine? Any info would be appreciated.
Dear A.C.: About 5 percent of all people with high cholesterol have unrecognized low thyroid levels, so everybody should get their thyroid checked before going on cholesterol medication. Sometimes, but not always, treating the underlying thyroid issue corrects the cholesterol issue. Hypothyroidism may have very subtle symptoms, such as fatigue, depressed mood or intolerance of cold temperatures. Treating low thyroid levels can improve symptoms attributed to getting older, as well as prevent the unnecessary expense and possibility of side effects associated with drug treatment of high cholesterol. Of course, some people still will need treatment of high cholesterol, but that doesn’t necessarily mean drug treatment, which should be reserved for people at significant risk for heart disease. However, what “significant’’ means depends on what the patient is concerned about, based on information provided by the doctor.
You definitely should check with your doctor to be sure your thyroid levels were checked, even if you have no symptoms.
Dear Dr. Roach: I’m an overweight woman, 68, who wants to exercise. I’d like to know what type of exercise I can do to help lose weight. I’m allergic to the chemicals in pools, so I can’t swim. Each knee has had a total replacement, leaving me with a limited range of motion, making it impossible to bend my knee enough to ride a bike. I’m not sure what I can do. I was hoping you could help me with that. I can walk half a mile without losing my breath. I live on the second floor and always use the stairs, but only two or three times a day.
What type of exercise do you recommend?
Dear M.W.F.: The best exercise is the exercise you are going to keep up. Based on what you’re telling me, I’d guess walking is going to be your best bet. The more you walk, the stronger you’ll get, and the more you will be able to walk and, I hope, the better you will feel. If walking all the time takes a toll on your new knees, there are other options, including weightlifting, yoga and even chair exercises.
However, losing weight requires changes to diet, as well. They don’t have to be big; often, just making one change can lead to a slow weight loss, such as giving up regular soda for diet or, better yet, water. Many people find that giving up sweets leads to a much easier time losing weight. I suggest you look honestly at your diet and find one thing you know you could do better on to start with.
Email questions to ToYourGoodHealth@med.cornell.edu.