Sven Wombwell
Article by: Sven Wombwell
Estimated 6 minutes read

Testosterone levels (low T) significantly impact men's health, and when it's low, it affects health and wellness in many ways. It's common for guys with low T to have high cholesterol levels, and studies show a connection. Testosterone replacement therapy (TRT) positively impacts cholesterol, particularly testosterone creams, which lower bad cholesterol more than injections. So how are testosterone and cholesterol linked? 

What Types of Cholesterol Are There?

According to the Centers for Disease Control and Prevention (CDC), there are two types of cholesterol. 

  • Blood cholesterol is made by the body and is a waxy substance vital for good health. It's necessary for making hormones, including testosterone, and helps digest fatty foods. 
  • Dietary cholesterol is in animal products such as poultry, beef, seafood, dairy and eggs. 

Dietary cholesterol can be high in saturated and trans fats and, when ingested, can take you from a healthy cholesterol range to unhealthy levels. 

When cholesterol levels are too high, a buildup in the blood vessels may lead to high blood pressure and cardiovascular disease. Checking cholesterol as you age is crucial to ensure good health. Getting labs done to check your cholesterol levels during your annual physical is a must. The lab work will give you your numbers for:

  • Low-density lipoprotein (LDL) - or “bad” cholesterol- may lead to plaque buildup in the artery walls, known as atherosclerosis. (1) The plaque narrows blood vessels, which can lead to stroke and heart disease.
  • High-density lipoprotein (HDL) is also called “good” cholesterol because it can lower the risks of heart disease and stroke.
  • Triglycerides - fat in the blood used for energy. When you have high levels of triglycerides combined with low HDL or high LDL cholesterol, you may increase the risks of stroke and heart attack.
  • Total cholesterol - is the total cholesterol in the blood based on triglycerides, HDL and LDL.

Cholesterol levels can significantly impact health, so it's essential to understand your numbers and do what you can to prevent cholesterol from getting too high. 

According to a study, (2) there's evidence that low testosterone levels can be related to metabolic syndrome. Factors contributing to metabolic syndrome include high blood pressure, high glucose levels, excess belly fat, and high cholesterol. Metabolic syndrome puts you at a higher risk of diabetes and heart disease and has been associated with low testosterone levels in men.

The study showed that after receiving testosterone replacement therapy (TRT), there was a decrease in total cholesterol, LDL cholesterol and triglycerides with a slight increase in HDL cholesterol, which is considered “good” cholesterol.

Another study (3) observed that while HDL levels decreased with TRT, other factors can also have an effect depending on the individual, such as the dose of hormones received and age.

What Causes High Cholesterol?

According to the Cleveland Clinic (4), while there are no visible symptoms of high cholesterol, there are several risks associated with it, including: 

High blood pressure (hypertension)

Cholesterol plaque can cause arteries to narrow, making it difficult for your heart to pump blood through them, causing blood pressure to increase. While medication can help to lower blood pressure and cholesterol, lifestyle factors can also make a significant difference and include:

  • Diet. Reducing sodium intake, eliminating unhealthy fats such as saturated and trans fat, and ditching sugar and processed foods can have a positive effect.
  • Exercise. Not getting enough physical activity can raise cholesterol, so to keep it in check, move more and sit less.
  • Smoking. Smoking increases the risks of heart disease and cardiovascular disease.
  • Stress. Long-term stress raises cortisol levels which can increase cholesterol levels.
  • Alcohol. Drinking alcohol contributes to a variety of health issues and raises cholesterol.

Low testosterone and high cholesterol have several similar causes, like poor diet, visceral fat, stress, lack of exercise and too much alcohol.

Thyroid Disorders

Thyroid hormones alter how the body processes fat, and the following common conditions affect this process differently.  

  • Hyperthyroidism is when the body makes too much thyroid hormone. Some medications control this condition, which, if left untreated, may raise LDL, HDL, and total cholesterol levels.
  • Hypothyroidism is when the body makes too little thyroid hormone. Hypothyroidism may cause high cholesterol; medication like bioidentical thyroid can control it. Low testosterone, high cholesterol and low thyroid are all linked. By optimizing testosterone and thyroid hormones, you can help alleviate associated health issues.


Lupus causes high LDL cholesterol and triglycerides and lowers HDL cholesterol levels. In addition, as an autoimmune disease, lupus keeps your body in a state of chronic inflammation, which puts you at a higher risk for coronary artery disease.

Chronic kidney disease (CKD)

CKD puts you at risk of coronary artery disease because it can cause you to have more triglycerides (fat) in your blood and can cause plaque to build up quickly. It also may lower HDL (good) cholesterol. 

Polycystic ovary syndrome (PCOS)

Those with PCOS can have high LDL and low HDL cholesterol and a higher risk of heart disease due to high blood pressure and diabetes. 


Type 1 and type 2 diabetes put you at greater risk for low levels of HDL cholesterol and high levels of LDL and triglycerides, putting you at a greater risk of coronary artery disease.

What is Considered High Cholesterol?

According to Johns Hopkins Medicine (5), cholesterol levels can depend on a variety of factors such as health history and age, but generally, the ranges for total cholesterol in adults are:

  • Normal: Less than 200 mg/dL
  • Borderline high: 200 to 239 mg/dL
  • High: At or above 240 mg/dL

LDL Cholesterol numbers for adults:

  • Optimal: (If you have heart disease and diabetes) less than 100 mg/dL
  • Near-optimal: 100 to 129 mg/dL
  • Borderline high: 130 to 159 mg/dL
  • High: 160 to 189 mg/dL
  • Very high: 190 mg/dL or higher

HDL cholesterol numbers for adults:

  • Levels should be above 40 mg/dL
  • Heart protection: 60 mg/dL or above

Since HDL is good and lowers the risk of heart disease, you want higher numbers. 60 mg/dL or above offers the best protection against heart disease.

Conclusion Testosterone and Cholesterol Are Connected

Many studies show that while there is an association between cholesterol and testosterone, the depth of that relationship has been challenging to determine. However, many men experience both low testosterone and high cholesterol at the same time. 

Testosterone replacement therapy can lower LDL cholesterol numbers. Along with lifestyle changes in diet, exercise, smoking, and drinking habits, positive changes can occur. 

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