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Timely article. I was just listening to a lecture by cardio-thoracic surgeons and cardiologists and it stunned me to learn that 500 000 women die each year from heart disease, as opposed to 30 000 from breast cancer.

AND if you have had breast cancer your risk of dying from heart disease is higher than dying from breast cancer.

Statuns but also diet and exercise!!

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Interestng facts which I have done research into myself using google scholar and a medical database. There are opposing facts regarding the use of statins for people who require a thyroid medication as well. High cholesterol is common when thyroid levels are too low whereas if hyperthyroid cholesterol levels are lower and plaque in the arteries is not usually present. Much like the use of estrogen in women who require thyroid replacement some studies including those found In JAMA and the New England Journal of Medicine suggest that only pill forms of estrogen (BC pills included) will impact the T4 medication (altering TBG proteins produced in the liver) whereas others state all forms of estrogen (and progesterone has an impact in some studies). The Finnish study contained some interesting facts. Dr. A. Bianco the previous president of the ATA also has presented some information that differs from other specialists regarding medications such as statins and other hormones that women no longer produce after menopause.. No two people of course are the same and the use of estrogen over the age of 65 is frowned upon by many experts, but now some who were associated with NAMS and are now involved with the International Menopause Society are looking at the quality of life for older women and the risks associated with collagen loss (which impacts the heart, muscles, bones etc.) as well as the relationship to thyroid levels. Women's health has taken a back seat for many years. Thanks for posting this information. Statins can cause issues as well for many people, muscle pain joints etc. which are the same issues as low estrogen as well as low thyroid which more women suffer from then men. More medical professionals need more working knowledge about hormone balance in women, including thyroid and what medications can and will impact them. (including myself). Thyroid or estrogen 101 in medical school just does not cut it!!

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Thank you for commenting the relationship of thyroid disease & the impact of potential MHT/HRT has in relationship to thyroid medications. Which is important (I feel) to note, that those of us who have thyroid disorders and who are on HRT, need to have our free T3, free T4, and TSH monitored throughout the course of our continued hormone therapy especially at the 12-wk mark of beginning MHT. As HRT can affect or disrupt the absorption of our thyroid medication. I appreciate your mention of the relationship of high cholesterol & thyroid issues.🩵💙

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I know I have struggled for many years with menopause type issues which are the same as high or low thyroid levels. With almost 20 years experience teaching post secondary students I needed to do my own research as to why I always felt unwell instead of teaching them how to find reliable material. BC pills and estrogen pills will impact thyroid medication as they go through the liver through the digestive process (that is why statins could impact thyroid levels as well lke NSAI meds) anti depressants (certain ones) could also impact thyroid levels. Many doc tors prescribe them to menopausal women becasue of the moods that are experienced. Statins have side effects which can also mimic what thyoid patients experience if on a low or too high of a dose (muscle and joint pain). Then the side effects of estrogen or thyroid medications which need to be a concern.

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It never ceases to amaze me how ignorant some people, even MDs, are. I'm just a ''little-ol' " NP (without an MA) & I've known for decades that CVD kills more women than breast cancer.

And I just don't understand all those fake 'experts' selling fake 'science.'

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I have tried two different statins and, sadly, I have side effects that make life very miserable for me. So now we're going to try ezitimebe?

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I had similar problems and have been on ezetimibe for over a year. My bloodwork showed improvement, and I’ve had no side effects I’m aware of. Just FYI

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Aloha Doc! How might taking red yeast rice & Berberine supplements serve to positively reduce lipid levels in context to statins? I’ve always had terrific cholesterol counts, my HDL being terrific & my LDL being incredibly low. Then meno transition brought an incremental shift in my LDL numbers, while my HDL remained sturdy & high… therefore tipping me closer to an overall risky increase in total cholesterol count. I began taking RYR & Berberine & in a 3-mo time, both my numbers reduced removing me from any significant “risk” for high cholesterol.

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This article is a bit old but curious about your thoughts on this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867901/

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author

It is from 2007 and we have lots of data now so it’s out of date.

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Thanks so much for responding. As you say, there is so much information/ misinformation floating around these days it’s impossible to discern fact from fiction. Would greatly appreciate your assessment of this:

https://m.youtube.com/watch?v=wnl4KFqBbr8

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author

My article specifically answers Haver's claims. She is promoting a statement, not the guidelines. We don't use an opinion piece to make decisions. If she is suggesting otherwise, she is wrong. The AHA recommends statins for women and men. Cardiologists disagree with her, and I have quoted from the guidelines above and interviewed an expert in the area.

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I am struggling with this question myself. I have T2 diabetes but also ADHD and am hypothyroid. My endocrinology PA wanted me to start taking statins at the same time she prescribed Ozempic but I prefer to only add one new medication at a time. The semaglutide controls my blood sugar really well but makes my ADHD meds less effective and makes me more tired. I'm trying to lose weight so I can drop to a lower Ozempic dose and reduce those symptoms. I'm on the fence about adding a medicine that can raise my blood sugar and increase my brain fog symptoms, especially since my cholesterol is pretty low AND I was right at the pre-diabetic/diabetic border when I got diagnosed.

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Thank you for this. I do really appreciate the clear advice not complicated by emotion (which I can get drawn into), and a road map showing the bare bones evidence, rather than reaching for a conclusion that doesn’t have really clear evidence (although it may be something that would benefit from more research). As usual nuance is important.

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I was currently just in with my GP. I have been on 10 mg of Lipitor for about 5 years now (I am almost 52). I asked about HRT, because I want to protect my bones and my heart. She said she wouldn’t put me on them because with my history of high cholesterol she is worried about strokes. Thoughts?

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We don't recommend hormones for the prevention of heart disease. If you read through the hormone therapy guide I think you can find answers to all your questions. Here is the Table of Contents https://vajenda.substack.com/p/gunters-guide-to-the-hormone-menoverse

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Thank you for this. I have a bad family history of heart disease and want to do everything possible to prevent it.

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