When most people think about the causes of elevated cholesterol, they think of poor diet, lack of exercise and genetic predisposition. However, for millions of Americans, lack of thyroid hormone could be the culprit.  The thyroid gland produces a hormone that influences every cell, tissue and organ in the body.  In addition to regulating heart rate, growth, and cognition, thyroid hormones also regulate the body’s metabolism.   If the thyroid gland produces too little hormone, metabolism can slow, decreasing the body’s ability to clear cholesterol from the blood stream.  As a result, cholesterol may be deposited in the arteries around the heart, increasing the risk for heart disease.  This is frightening given that more than 13 million Americans have thyroid disease, but more than half of these patients remain undiagnosed.


To combat this lack of awareness, the American Association of Clinical Endocrinologists (AACE) and Fleishman-Hillard (FH) piggybacked the sense of urgency that elevated cholesterol and heart disease exude, to uncover the often-overlooked problem of thyroid disease.  This unique, yet critical, connection was brought to life with the nationwide call to action -- Take Cholesterol By The Neck.  




An AACE survey conducted in August 1999 provided insight into the audience and the situation:

  • Fewer than half the adults who had been diagnosed with high cholesterol had ever been tested for thyroid disease.
  • Even more astounding, nearly ninety percent of survey participants were not aware of the thyroid gland’s impact on cholesterol regulation. 
  • While most adults did not know which organs in the body played a role in the regulation of blood cholesterol levels, the role of the thyroid gland was the least well-known.


In order to clearly establish the relationship between thyroid disease and elevated cholesterol, secondary research was also compiled to build the case:

  • Thyroid disease is the most common secondary cause of high cholesterol.
  • More than 90 percent of patients with overt hypothyroidism (underactive thyroid) have increased cholesterol and/or triglycerides.
  • Average blood cholesterol levels of patients with underactive thyroid are 30 – 50 percent higher than desirable (normal range is 200 mg/dL or less).
  • Once hypothyroidism is treated with thyroid hormone replacement therapy, and the TSH level is returned to normal, the majority of patients show an estimated 20 – 30 percent reduction in cholesterol levels. 





  • Increase the number of people diagnosed with, and treated for, thyroid disorders.
  • Generate awareness, via media coverage, about the role of the thyroid hormone as it relates to cholesterol levels and heart disease, and underscore the role of the endocrinologist.
  • Incite consumers to seek out resources/take action to learn more about the thyroid-cholesterol connection.
  • Strategies
  • Draw a clearly illustrated link between thyroid hormone and elevated cholesterol levels to build a case for increased diagnosis of thyroid disease.
  • Emphasize severity of elevated cholesterol as a long-term complication of thyroid disease.



Public awareness of cholesterol levels has been at an all-time high since the Know Your Number campaign was launched (encouraging consumers to treat cholesterol cases above 200 vs. 220).  F-H and AACE needed to leverage the interest in this topic without being perceived as the “traditional” cholesterol story.  In addition, since the Association wanted to launch the campaign during its Thyroid Awareness Month, we needed to create messages that would break through the clutter and the sleepy connotation “awareness months” hold among media. 



Rolling It Out: Leveraging the latest technological tools, the team utilized a new approach to reach the media via a high-tech, interactive simultaneous web cast/telebriefing.  By offering reporters access to the physicians and full presentation via the Internet and phone lines, they were able to tune into one of the first health stories of the century without even leaving their desks.


More than 30 reporters from top media outlets participated in the thyroid disease and cholesterol web cast/telebriefing, including U.S. News and World Report, MSNBC.com, The Boston Globe, Reuters Health, and Shape.


In addition to the cyber-launch, the physicians fielded one-on-one interviews (deskside briefings) with reporters throughout New York.  Broadcast producers had individual access to the AACE spokespeople through a satellite media tour, and a custom–developed b-roll brought the news home at a grassroots level.


Although launched in January as part of AACE’s Thyroid Awareness Month, coverage was maximized beyond event day with creative tactics that sustained interest among both the media and the general public throughout the entire year.  The “Neck Check” was promoted and distributed via a P.O. box and the AACE web site (www.aace.com), which were listed in all materials.  A mat release carried messages to local audiences via smaller newspapers and hospital newsletters nationwide.  The mat release and a turnkey kit were also mailed to 3,300 AACE members for distribution to local media to continue driving grassroots awareness.


Seize the Day: Quick-thinking, strategic planning and aggressive action enabled the team to seize an opportunity to further extend AACE’s cholesterol-related thyroid messages.  When a study came out unveiling a clearer correlation between thyroid disease and cholesterol levels just one month after the campaign launch, the team quickly pounced on this opportunity to provide AACE’s Take Cholesterol By The Neck materials to reporters as background.  And it worked.  Lauran Neergard at the Associated Press wrote an article about the study in which she mentioned AACE and its related key messages.  To date, this wire article has been placed in numerous newspapers around the country, reaching nearly 10 million Americans.




Increased the number of people diagnosed with and treated for thyroid disorders, according to a 10 percent increase in the number of levothyroxine sodium prescriptions (the medication used to treat thyroid disease) between January 2000 (Thyroid Awareness Month announcement) - March 2000 (post announcement measurement).  This increase in prescriptions of thyroid medication indicates an increase in the number of people learning about, getting tested and then treated for thyroid disorders.


The public has also taken action to learn more about thyroid disease and self-diagnosis.  In the first month after the campaign was launched, there was a 44 percent increase in traffic to the AACE Web site.  In total, the Take Cholesterol By The Neck  pages of the AACE website have recorded nearly 60,000 visitors.  Additionally, more than 230 consumers participated in the web chat!  The vendor said this marked a record for a chat that did not feature a celebrity.  Approximately 140 questions were asked during 60-minute period.


Generated awareness, via more than 80 million media impressions, about the role of the endocrinologist and the thyroid hormone as it relates to cholesterol levels and heart disease.  Penetrated nearly every U.S. state (46 of the 50) via a mass blanketing of broadcast placements.  The air waves were ringing with AACE’s “Take Cholesterol by  the Neck” messages – especially in top media markets like Los Angeles, Chicago, Boston and Dallas.  Also secured print placements in high-profile publications such as Parade, USA Weekend Magazine andWoman’s Day, as well as in leading daily newspapers including: USA Today, The Washington Post; The Boston Globe; and The Miami Herald. 

In this technology age where the Internet dominates, and more and more consumers turn to online sources for information – especially health information – securing online placements is critical.  Our strategic approach to this growing medium helped us to secure placements that not only reached a broad base of consumers, but also targeted women specifically – the population most commonly affected by thyroid disease.  Highlights include placement in Reuters Health, About.com, PlanetRx, HealthCentral and USAWeekendOnline.