The way testosterone acts depends on many factors, such as age, dose, type of therapy, and individual metabolism. Studies show that testosterone can interact with the liver, the main organ that produces and manages cholesterol. Testosterone affects lipid metabolism, which means how the body makes, uses, and clears fats from the blood. The therapy aims to improve energy, sexual health, muscle and bone strength, and overall well-being. It is important to note that these benefits are best documented in men who truly have low testosterone due to medical causes. A healthcare provider can ensure that therapy is improving your health overall – and not unintentionally increasing cardiovascular risk. TRT is available in several forms – gels, injections, and patches – and works by supplementing the body’s natural testosterone to reach healthier, more functional levels. Low testosterone doesn’t just affect energy, mood, and libido – it may also have a significant impact on your cholesterol levels. Regular monitoring is essential to ensure that any changes in hormone levels are matched with appropriate cardiovascular risk management. For men with low testosterone and metabolic syndrome, TRT has been shown in some studies to reduce triglycerides and improve overall cholesterol ratios. TRT has also shown improvements in metabolic health that indirectly benefit cholesterol levels for some men. Your body uses cholesterol to create pregnenolone, a hormone that kickstarts the process of making testosterone and other steroid hormones. Some people who have a family history of high cholesterol can also be at risk for high cholesterol. Learn more about preventing high cholesterol by making healthy eating choices. Your body needs it to perform important jobs, such as making hormones and digesting fatty foods. Further clinical trials of testosterone replacement therapy in men with type 2 diabetes are warranted. The effect of testosterone treatment on HDL-C in clinical trials has been inconsistent. Discover the health benefits of ashwagandha and what role it plays in testosterone in men. Triglycerides are another kind of fat in the blood, and high levels of these can also raise the risk of heart disease. To the contrary, recent literature has raised concern for increased cardiovascular disease in certain groups of men receiving testosterone therapy. Ties between hypogonadism and cardiovascular disease are suggested by observational data, yet therapy with testosterone replacement has not been shown to mitigate that risk. A blood test can measure your cholesterol levels, including HDL. Cholesterol changes caused by therapy might seem small, but even small shifts can matter for someone with blocked arteries or a history of heart attack. Obesity often changes how the body responds to testosterone. As a result, small changes in cholesterol from TRT may not carry the same risk as they would in older adults. Because younger men are usually healthier, their blood vessels are less likely to have plaque buildup or stiffening. In these younger men, therapy often improves overall metabolic health. Newer, larger trials show no major rise in cardiovascular events, which should reassure patients and doctors. Importantly, the interpretive value of these randomized controlled trials remains limited, as these studies were not powered to look at CVD events as an outcome. Therefore, the higher rate of cardiovascular events noted in the TOM trial might be attributable to a poorer baseline cardiometabolic profile among the participants. Further, subjects in the TOM trial had higher baseline BMI, higher triglycerides, and lower HDL than individuals included in the second study. It is notable, however, that these community-dwelling participants had very significantly reduced mobility, a high prevalence of chronic disease, and that they received rather high doses of T in this study. However, it is important to remember that all of these studies, regardless of findings, have methodological weaknesses that limit their interpretive value. The authors further suggested that the Xu meta-analysis may have noted an association because their definition of cardiovascular events was more inclusive than typical restriction to major adverse cardiovascular events. Rather than observational findings, interventional data are required to infer causality between androgen exposure and CVD risk in men.
