Family, Internal Medicine, General Medical Questions/Hashimoto's

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Question
Hello. I am a 26 year old female, and I was diagnosed with hashimoto's  4 years ago. I alternate between 75mcg and 50 mcg of synthroid. My tsh lingered around a 5 while I was strictly on 50mch and recently declined after adding 75mcg. The swelling in my neck seems to be going down.
TSH is a 1.98
Free T4 is 1.1
T3 is 2.9
Antibodies: 168 down from 342
but my lipid panel has also changed...
Total cholesterol: 172
HDL Cholesterol: 34
Triglycerides:192
LDL: 100
Chol/Hdlc Ratio: 5.1
Non HDL: 138
I had a lipid panel done in August and all those results were in normal range. I live a very active lifestyle, I exercise almost everyday, I have a very healthy diet, I take an omega 3 fatty acid supplement 2 times a week, and a multi vitamin 1 time a week. I also have been eating brazil nuts. For the first time in years I feel good. This is the first time I have ever seen my thyroid labs in normal range.
My question is this, do the lipid panel results have anything to do with hashimoto's? And if so, why are some of them out of range despite my lifestyle?
I'd like to add that I smoke about 1-3 cigarettes a day. I realize that this may be contributing to my out of range lipid panels, but I also wonder if this has been reducing my antibodies and thyroid labs. I understand that it is horrible for my health and may be the very reason for some of the problems I have, but I also worry that completely stopping is going raise my tsh and antibodies and I can never go back to the way I used to feel. I feel like if I change one thing I'm going to go back into that dark hole that is hypothyroidism. Your insight is greatly appreciated. Sorry this is so long, thanks so much for your time.

Answer
Danielle,

This is a complex question with many issues.  First TSH should not enter into the picture when managing hypothyroidism.  fT3 and fT4 and even rT3 are the most important and looking and following the TPO antibodies is crucial too.  Smoking while bad for your health in general terms does not have a direct bearing on your lipids.  Would suggest you get advanced lipids besides the basics (Lp(a); sd-LDL-c, ApoB and A-1, and others.)  Thyroid has a big impact on lipid and glycemic control but there are other genetic factors.  Read "Stop the Thyroid Madness, II" and consider getting professional help from those that know the thyroid the best.  www.GetMyThyroidFixed.com is a resource.  

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Yusuf (JP) Saleeby, MD

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Will ONLY answer questions pertaining to Hypothyroidism, Hashimoto's disease and thyroid disorders. I will forward all other questions to the question pool. This forum does not allow for the diagnosis and treatment of illness, so please don't ask questions in that regard.

Experience

Medical School: Medical College of Georgia (Augusta, GA class of 1991) Post Graduate Training: ECU school of Medicine (Greenville, NC) 20 years in Emergency Medicine, Urgent Care and Occupational Medicine (retired 2012). *** Licensed in states of GA, NC, SC and VA. *** Medical Director of Priority Health of SC (www.PriorityHealthSC.com) *** Former Medical Director and Founder of the Saleeby Longevity Institute a clinical practice and research center in integrative (CAM,Allopathic Medicine (1999 to 2004). *** Founder of Vita Sanus, Inc. Manufacturer & Distributer of Vita Sanus Nutraceuticals and Skin Care products (www.vitasanus.com) Sold in 2006. *** Adjunct Professor in Graduate School of Nursing Georgia Southern University (2002-2006). *** Author of "Wonder Herbs: A Guide to Three Adaptogens" available for sale at www.xlibris.com/wonderherbs or signed copies at www.saleeby.net *** Former Medical Director of the Emergency Department at Marlboro Park Hospital, Bennettsville, SC (2006-2010) *** Appointed to Medical Advisory Board for Aerobic & Fitness Association of America (AFAA) 2007-present & Contributing Editor AFAA (American Fitness magazine) 2013-present. *** Appointed to Medical Advisory Board for Beach Body (Product Partners) 2008-present *** Founder and regional director of www.eStatLabs.com an alternative to high priced lab testing sites (DAT). *** Life Extension 5th Edition Book on Prevention and Disease Treatment (contributor on Chapter on Adrenal Fatigue and Stress Management) 2013 5th edition. *** Worked as chief formulator for supplement companies: Vita Sanus Nutraceuticals (Longevity Pack & entire line), SSN's PreGame Formulas for Golf and Tennis, AdapTx Labs' CardioFactor & PreFight, BeachBody's Shakeology consultant, Parhelion Labs' Oviun BioPharma sub-fertility formula ''Fertility Regimen''.

Organizations
South Carolina Urban Search & Rescue Task Force-1 (USAR), former Medical Director/Control. 2010-2012. Founder and developer of http://www.eStatLabs.com Current medical practice: http://www.PriorityHealthSC.com Former member of American Telemedicine Association Former member of A4M and ACAM. Attend regular meetings of AMMG Member in good standing ILADS (www.ILADS.org)

Publications
American Fitness magazine (multiple) Cortlandt Forum Medical Economics DocSaleeby.blogspot.com (blog) JIVE magazine (out of print) Tea Digest Experience (out of print) Authored Books on Adaptogen Herbs (Wonder Herbs: A guide to three adaptogens) 2006 Authored chapter on Stress Management for LEF text book on Prevention of Diseases and Treatments (2013) Authored Chapter 3 in "Stop the Thyroid Madness, II" (2014)

Education/Credentials
Health & Wellness Blogger, Medical Writer. Author of book on Adaptogens. Pioneer in Telehealth, member of ATA. Contributing Editor for American Fitness magazine. Authored Books on Adaptogen Herbs (Wonder Herbs: A guide to three adaptogens) 2006 Authored chapter on Stress Management for Life Extension Foundation LEF text book on Prevention of Diseases and Treatments (2013) Authored Chapter 3 in "Stop the Thyroid Madness, II" (2014)

Awards and Honors
*** co-Author of "Stop the Thyroid Madness, II" (Laughing Grape, 2014) Chapter on NDT/Thyroid. *** Authored chapter in "Life Extension Foundation, 5th Edition book on Prevention and Disease Treatment" Chapter on Stress Management/ Adrenal Fatigue.

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HIPAA prohibits revealing names. Some celebrity clients.

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