45 year old lady. Non cardiac chest pain, body aches and tiredness. Clinically no significant findings. Ecg and echo were normal. Sent for usual blood/urine tests - CBC RFT LFT LIPIDS TSH FBS and Urine routine. #MedTwitter #cardiotwitter

Came back after 2 days with these reports. Severely elevated cholesterol and Triglyceride levels. #Cholesterol doesn't explain her symptoms!

Always check for Thyroid function in people above 30y if it hasn't been tested before. Her Thyroid stimulating Hormone was >150!! - suggestive of severe #hypothyroidism

Started on Thyroxine replacement 100mcg per day. Asked to repeat Lipids and TSH after 6 weeks. Didn't start statins as there was a correctable cause - low thyroid function in this case. #LowMetabolism

After 6 weeks. Lipids almost back to normal. TSH within range.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/

Some cause of reversible secondary hyperlipidemia

https://www.heartuk.org.uk/genetic-conditions/secondary-hyperlipidaemia

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