The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile. An additional 40% of testosterone is metabolized in equal proportions into the 17-ketosteroids androsterone and etiocholanolone via the combined actions of 5α- and 5β-reductases, 3α-hydroxysteroid dehydrogenase, and 17β-HSD, in that order. It is bound 65% to sex hormone-binding globulin (SHBG) and 33% bound weakly to albumin. The plasma protein binding of testosterone is 98.0 to 98.5%, with 1.5 to 2.0% free or unbound. The amount of testosterone synthesized is regulated by the hypothalamic–pituitary–testicular axis (Figure 2). In addition, the amount of testosterone produced by existing Leydig cells is under the control of LH, which regulates the expression of 17β-hydroxysteroid dehydrogenase. The number of Leydig cells in turn is regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH). You want smooth blood flow, so an increase in red blood cells could easily cause stagnation. It’ll cause the red blood cells to overproduce which can, in turn, create a clot in your blood vessels. "If you think about bodybuilders who are doping, they always have injuries and this is why," says McDevitt. Too much estrogen in a male body is not a good thing; it can cause erectile dysfunction, or low libido." "Estrogen is a proliferative hormone, meaning it likes to get cells to grow. Just like it can be too low, your testosterone can also be too high, and that’s equally problematic (8). Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. The content of this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This buildup is a significant concern as it can lead to heart problems and increase the risk of heart attack. Moreover, a diet high in saturated fats, aiming to boost cholesterol, can be a double-edged sword. Instead of focusing solely on cholesterol intake, a well-rounded diet rich in various nutrients is more beneficial for muscle growth and overall health. Further research indicates that reducing cholesterol intake from an average of 633 mg/day to about 342 mg/day over six weeks can decrease serum TT levels in middle-aged men. (Fantus et al., 2020) So, we don’t know if cholesterol per se or other nutrients contribute to increased testosterone. The way a person eats, moves, and takes care of their overall health can strongly affect how testosterone therapy changes cholesterol levels and heart health. On the other hand, improvements in body fat, blood sugar control, and inflammation from testosterone therapy may reduce risks in other ways. In these cases, doctors may recommend testosterone therapy to bring hormone levels back to a healthy range. More people are asking whether this therapy has risks for the heart and blood vessels, especially because cholesterol levels are one of the strongest predictors of heart disease. Because TRT changes hormone levels throughout the body, it is natural to wonder if it also affects LDL, artery health, and long-term heart risks. In these cases, cholesterol and plaque risk must be monitored more closely. Men with metabolic syndrome, diabetes, obesity, or a family history of heart disease may respond differently to TRT. This is not directly related to cholesterol but is important for overall cardiovascular safety. Contact us at if you see an error. Every article is rigorously reviewed by medical experts to ensure accuracy. We source research from peer-reviewed medical journals, top government agencies, leading academic institutions, and respected advocacy groups.
