The case of the crummy cholesterol: solution

The answer is choice number 1. The doctor was going to prescribe thyroid supplements.

If someone has an underactive thyroid gland ("hypothyroidism"), this can cause a whole host of symptoms, one of which is most certainly constipation. And if the hypothyroidism is bad enough, the skin can turn a yellowish-orangey hue. Hypothyroidism can also cause the cholesterol levels to go up. In fact the highest cholesterol level I've ever seen (17 in S.I. units; 680 in old units) was in someone who had an under functioning thyroid and after he had been on thyroid supplements for six months his cholesterol level came down to 4. And that was without any cholesterol medicine!

The moral of the story? If your cholesterol level is high, although it's probably just "one of those things" (genetic, diabetes, diet, etc) its important to consider other causes such as, in this case, an underactive thyroid.

The most common cause of hypothyroidism in a person with diabetes is a condition called Hashimoto's Thyroiditis. This is caused by antibodies in the blood-stream attacking your own thyroid (what a nasty thing to do!) and interfering with its function. Hypothyroidism is easily detected by a simple blood test (a "TSH level") and equally easily treated by taking a thyroid hormone pill supplement. If untreated (or under-treated), hypothyroidism can cause fatigue, hair loss, weight gain, muscle aching, a feeling of being cold all the time and other symptoms. If treated (with the correct dose of thyroid hormone as verified by testing the TSH level on a blood test), hypothyroidism causes no symptoms whatsoever. More information on thyroid disease.

By the way, this is the format I use in my book (What Your Doctor Really Thinks).

Old cases of the month can be found here.