Testosterone and Cholesterol (Is There a Connection?)

Cholesterol is connected with testosterone in two different ways. There seems to be mutual support - cholesterol is necessary for testosterone synthesis, while testosterone may impact cholesterol levels.

Cholesterol is an essential fatty (lipid) substance produced naturally in the liver, which circulates the body.

Total cholesterol is comprised of two types:

• Low-density lipoprotein cholesterol (LDL) - the ‘bad cholesterol’
• High-density lipoprotein cholesterol (HDL) - the ‘good cholesterol’

Nevertheless, this fat-like substance is necessary for many cell processes and body functions (synthesis of vitamin D, fat-dissolving bile, and hormones, etc.) [1].

Cholesterol plays an important part in testosterone synthesis. It gets transferred from the blood into the part of the testicles responsible for T-production (Leydig cells - where 95% of endogenous testosterone is produced in males), and acts as the building block of the male hormone [2].

And that’s what many veteran gym-goers know - you need to eat those fats to get proper cholesterol production and secure stable testosterone levels (high-cholesterol diet).

Still, you should watch the amount and the different types of dietary fat you consume since they could ramp up cholesterol production beyond healthy levels, which can cause severe heart disease.

More on that later.

First, let’s talk about what most bodybuilders probably don’t know about the cholesterol-testosterone connection.

A 2013 study showed that men with testosterone deficiency on testosterone replacement therapy (TRT) showed a significant decrease in previously high cholesterol (serum cholesterol levels) over the course of the 5-year study [3].

A bit older study from 1996 evaluated the effects of increasing testosterone levels on cholesterol.

The study showed that reversing low testosterone levels lead to a significant cholesterol decrease.

Male participants went from an average of 225 mg/dl of total cholesterol to 118 mg/dl [4].

Another study revealed that men undergoing low testosterone treatment experienced a decrease in their cholesterol (HDL cholesterol) [5].

So, to fully understand and prove these correlations, more research is needed as the mechanism through which high or low testosterone levels affect cholesterol isn’t entirely clear.

Nevertheless, you should ensure that your serum testosterone and cholesterol levels are within normal ranges, as disbalance could lead to many health problems.

High cholesterol levels can affect health negatively as the buildup of too much cholesterol in the blood (particularly LDL type) may lead to atherosclerosis.

Atherosclerosis is a cardiovascular disease that may lead to heart attack or stroke [6].

High LDL cholesterol, known as ‘bad’ cholesterol, may lead to the formation of plaque inside the arterial walls which slowly builds up and bulges into the artery.

When that happens, the artery narrows and blood flow decreases, elevating blood pressure.

If a plaque in the coronary artery bursts, a blood clot forms, most likely leading to a heart attack.

The counterpart of total cholesterol, HDL cholesterol, usually has a much more benign effect as it takes LDL cholesterol and other fats (like triglycerides) from your blood to the liver to be broken down.

The most important thing here is that there are ways to lower your LDL cholesterol levels and increase HDL levels, keeping the total cholesterol in the safe zone and decreasing the risk of heart disease.

To lower LDL cholesterol, you should avoid processed food since it’s usually full of trans-fats which may significantly increase its levels [7].

You should include sources of omega-3 fats (nuts and fish), and fiber-rich foods, as fiber (mostly soluble) will absorb bile acids and remove some of the cholesterol in bile.

You should also use spices like cinnamon, ginger, garlic, black pepper, coriander, or curcumin, as they may have an LDL-lowering effect [8].

Lastly, have more veggies in your diet since plant-based foods contain compounds such as sterols and stanols, which are also beneficial for reducing high cholesterol [9].