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Why Your Cholesterol Is Still High & How to Fix It — Key Takeaways

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Why Your Cholesterol Is Still High & How to Fix It

Jay Feldman Wellness23mAug 24, 2026

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High cholesterol is most likely driven by endotoxin/gut dysbiosis, hypothyroidism (especially T3 deficiency missed by TSH-only testing), or a high-fat/low-carb diet suppressing thyroid conversion — address these root causes before considering any medication.

Key takeaways

High cholesterol was used as a hypothyroidism marker for 100+ years before statins replaced that practice

High cholesterol was used as a hypothyroidism marker for 100+ years before statins replaced that practice

  • 1918 Mayo Clinic paper documented that low thyroid function causes high cholesterol and restoring thyroid function lowers it.
  • 2020 Endocrine Society guidelines still recommend ruling out hypothyroidism before prescribing lipid-lowering drugs.

Normal TSH and taking T4 (Synthroid/levothyroxine) does not confirm adequate active thyroid hormone

Normal TSH and taking T4 (Synthroid/levothyroxine) does not confirm adequate active thyroid hormone

  • TSH reflects pituitary signaling, not cellular T3 levels; poor T4→T3 conversion can exist with a normal TSH.
  • T4 medication requires conversion to T3 to be active; many factors impair this conversion undetected by TSH alone.

Low-carb diets raise cholesterol partly by suppressing T3, not just by increasing fat transport

Low-carb diets raise cholesterol partly by suppressing T3, not just by increasing fat transport

  • T3 activates the StAR protein that moves cholesterol into mitochondria for steroid hormone conversion; low carbs reduce T3.
  • Elevated cortisol/glucagon from fat-reliant metabolism directly inhibits T4→T3 conversion, compounding the effect.

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In this video

  1. 1mintro
  2. 2mthe gut issue that could be driving your cholesterol up
  3. 7mthe forgotten connection between your thyroid and cholesterol
  4. 15mthe diet mistake that increases cholesterol

“High cholesterol is a sign of underlying dysfunction, and we shouldn't ignore it.”

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Ep. 97: How To Properly Test For Thyroid Function (Hypothyroidism Part 3)

A TSH above 2.0 indicates likely hypothyroidism — not the conventional cutoff of 4.0 — and TSH alone is unreliable without also measuring free T3, free T4, and reverse T3, plus tracking waking body temperature (target ≥98.0°F) and resting pulse (target 70–85 bpm).

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Mortality is 2.5x higher in hypothyroid patients treated with levothyroxine than in controls — a finding just published by the speaker — raising urgent questions about whether T4 monotherapy is sufficient or whether the underlying disease drives excess mortality.