A high cholesterol result is a number, and it usually has a reason behind it. Before I think about what to do with the number, I want to know what is pushing it up — because an underactive thyroid, a liver under pressure, the gut and shifting hormones can all show up on a lipid panel, and each of those needs something different.
This is not an article about whether to take a statin. That is a decision between you and your GP, and if you are on one, keep taking it. It is about the questions worth asking alongside it, because a lipid result read on its own is half a story.
Could my thyroid be involved?
It is worth ruling out early. An underactive thyroid raises LDL cholesterol and triglycerides and impairs the clearance of fat from the liver — so a sluggish thyroid can sit quietly behind a lipid result that nobody has connected to it.
The catch is how thyroid is usually tested. GP testing often starts and ends with TSH, which can sit in range while other markers tell a different story. A full panel — TSH, free T4, free T3, reverse T3 and antibodies — gives a much more complete picture, and it is what I want to see next to a high cholesterol result.
What does the liver have to do with it?
The liver is where fat is packaged and exported, in the form of VLDL particles, and it needs an essential nutrient called choline to do that. Without enough choline, fat accumulates in the liver instead. There is a gut twist, too: certain gut bacteria consume dietary choline and convert it into a compound called trimethylamine, effectively stealing it before the liver ever gets it.
Where does the gut come in?
What goes on in the intestines is one part of cholesterol that we know matters, and it is the part most people never hear about. There are specific probiotic strains that help support cholesterol — the one I name is Cholecare, by Activated Probiotics, available from The Natural Dispensary.
A word of caution on that. It does not mean you simply take the probiotic and expect your cholesterol to move. It would sit in combination with other supporting supplements, as one part of a plan that is dealing with whatever else is driving the result.
Why does cholesterol change in midlife?
For women, cardiovascular risk rises through the menopause transition as oestrogen's protective effect goes. It does not announce itself, which is why lipids, blood pressure and blood sugar are part of the plan at that stage even when they are not what brought someone in.
For men, testosterone is part of the picture. When it drops, cholesterol or blood sugar that will not come under control is one of the things you might notice — alongside low energy, low mood, brain fog and weight gain around the chest.
Why one number is not the whole picture
Cholesterol is one marker in a wider cardiovascular and metabolic picture, and I would not read it without the rest. Insulin resistance is upstream of a remarkable amount and can develop silently for years before it shows on standard tests, so I want fasting insulin alongside HbA1c. Chronic inflammation sits underneath cardiovascular, cognitive and metabolic decline alike, so I want an inflammatory marker such as CRP as well.
Preparation matters more for lipids than for most markers. Test in the morning, fasted for around twelve hours — and no longer, because an overly long fast raises cortisol and skews your fasting glucose.
So what actually changes it?
Whichever of those drivers turns out to be yours. A thyroid picture gets a thyroid plan. A liver under pressure gets choline and liver support. A blood sugar picture gets blood sugar work, which means eating in the right order, walking after meals, and building muscle. The gut gets its own attention, including the strains above. Doing all of it at once because a number is high is how people end up with a cupboard full of supplements and no idea which one did anything.
Blood sugar swings and stubborn weight usually have a root cause. Book a consultation to find yours.
Book Consultation →Who this is not for
If you have a heart condition, have had a cardiac event, or have been told your cholesterol needs treating urgently, that is with your GP or cardiologist first. We work alongside that care, never instead of it, and nothing here is a reason to change a prescribed medication on your own account.
Common questions
Should I stop my statin?
No. That is a medical decision between you and your GP, and I do not advise for or against it. What I can do is look at the drivers behind your result, and share that picture with your GP if it is useful.
Can a probiotic lower my cholesterol on its own?
I would not expect it to. The strains that support cholesterol are one piece of a plan, sitting alongside everything else that is pushing the number up.
Which tests should I ask for?
A full lipid panel, a full thyroid panel rather than TSH alone, fasting insulin and HbA1c, and CRP. Functional testing is where we can arrange any that your GP has not.
The bottom line
High cholesterol is where the question starts, not where it ends. Look at the thyroid, the liver, the gut and your hormones first, and the number usually makes a lot more sense — and so does what to do about it.
If you have a result in front of you and want to work out what is behind it, bring it to a free 15-minute call and we will see whether a full consultation is the right next step.
This article shares naturopathic and lifestyle guidance for general education and isn't a substitute for personalised medical advice. Always speak to your GP before changing any prescribed medication or if you have an existing health condition.
