Varied alterations in lipid parameters are noted in both overt and subclinical hypothyroidism, including elevated total cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein B. A hypothyroid state results in decreased expression of hepatic LDL receptors and reduced activity of cholesterol-α-monooxygenase, which breaks down cholesterol, resulting in decreased LDL clearance.