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Testosterone and Cholesterol — Will Testosterone Replacement Therapy Raise Your Cholesterol?

One of the more common fears that my patients have is that testosterone replacement therapy (TRT) will harm their heart. Yet when it comes to testosterone and cholesterol, studies seem to indicate that TRT may improve your cholesterol (or, at the very least, not make it worse).

Testosterone and cholesterol are not related the way you think. Scientist looking at clear liquid.

Here’s what you need to keep in mind when it comes to testosterone and cholesterol. Or really, when it comes to testosterone replacement therapy and many of the supposed problems with it:

Testosterone replacement therapy is meant for men and women who have low testosterone.

It seems almost silly to have to say this, but unfortunately, many folks who don’t suffer from diagnosed low testosterone want to use it anyway, as a sort of booster for mood and gym results. Testosterone should never be used this way.

If a medical professional introduces testosterone into the system of someone who has abnormally low levels, if they’re helping their patient’s levels return to normal, to what their body should be producing, it’s unlikely to cause harm. It’s when testosterone levels go far beyond what they should be that we start to see some negative results.

A medical professional who is helping a patient with low testosterone is not introducing some strange, random chemical to the body. They’re not artificially raising testosterone beyond what it should be (which is what people who take steroids to unnaturally gain muscle mass are doing).

Instead, they’re returning unnaturally low levels to normal. This may be why we’ve seen some strange results with testosterone and cholesterol and the heart — because testosterone may have been given to someone who didn’t need it.

So, while some studies have found that testosterone and cholesterol are related and that testosterone may have detrimental effects, very few studies (if any) have found that testosterone replacement therapy for people with legitimately low testosterone is dangerous or harmful, either to the heart, to cholesterol levels, or to any other bodily function.

In fact, most studies have found that TRT is beneficial to the heart for those suffering from low testosterone.

The same can likely be said for cholesterol levels.

Testosterone and Cholesterol — How Does Testosterone Affect Your Heart?

Consider this quote from a Harvard Health article on testosterone and cholesterol:

“Men who receive [testosterone]-deprivation therapy for prostate cancer drop their testosterone levels nearly to zero, and when that happens, their cholesterol levels rise.

“Even within the normal range, men with the lowest testosterone levels tend to have the highest cholesterol levels.

“And when doctors from the Mayo Clinic reviewed 30 trials of testosterone-replacement therapy, they did not find any overall effect of hormone treatment on cholesterol levels, for good or ill.”

You can read the full article here, but the point is this — testosterone replacement therapy is unlikely to have much of an effect on your cholesterol, one way or the other.

In fact, it seems returning testosterone levels to normal may be good for your heart. Several studies seem to indicate that normal levels of testosterone may actually have a protective effect on the heart.

The Truth Is, This Is a Question That’s Still Being Debated

That testosterone and cholesterol are somehow related seems to be clear, but how they are related is probably more nuanced than “less testosterone is bad for my cholesterol,” or “more testosterone is good for my cholesterol.”

A recent study found that testosterone replacement therapy seems to alter one form of cholesterol, HDL, but it’s not clear exactly what that alteration means or how it works.

However, it seems safe to say that if you suffer from low testosterone, your heart may benefit from testosterone replacement therapy.

And, if you suffer from some of the detrimental symptoms of low testosterone, the rest of your body (and your sense of well-being) stands to benefit as well.

Click the button to learn more about those symptoms.

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.


  1. John on 02/24/2017 at 1:58 pm

    I was on TRT for the last 6 years and I had high cholesterol. I recently had a heart attack and my cardiologist said I have to stop TRT because it may cause blood clots. My testosterone is really low now. I have no libido and my facial hair growth has slowed down. Are they any other alternatives? I am at a loss. I am only 42 years old.

    • Augie Galindo on 02/24/2017 at 2:34 pm


      I would definitely recommend seeking a second opinion from a cardiologist who has done more reading up on TRT and it’s potential risk. There are a couple of studies, written about three years ago which definitely do suggest that blood clots could be an issue, but with all bias admitted, they were terrible studies.

      Looking over the entirety of the literature available on TRT, as incomplete as it may be, points toward cardiovascular benefit from normal T levels. Do some digging, and you will find a cardiologist who is well informed on TRT.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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