T Nation

Familial Hypercholesterolemia (High Cholesterol) and TRT

Just curious if anyone on these pages has high cholesterol (genetic - FH), and is on TRT. If so, are you on a statin?

I am not on TRT, but may go that route (meeting with doctor Friday). However, I don’t meet with my lipid specialists for a few more weeks. I won’t be making any quick decision, however I’m just curious to know if any of you do have high cholesterol and are on TRT, and if so, has that made your treatment any different?

LDL 175, HDL 38, Triglycerides 74.

Thanks in advance.

Some have seen lipids improve on TRT. You do not want to block estrogen though, if that’s even a consideration.

1 Like

Definitely would not use an AI, would rather sit at my current levels than go on TRT if i needed an AI. I have heard some report lipid improvement; however I’m not sure I’ve heard anyone with actual FH have any improvement.

Legitimate replacement can exert a beneficial impact… it did for me (LDL dropped from like 130 to 110) whether that’s the same regarding FH I’m unsure, I don’t think any data exists. You’ve got baseline labs (TT of 1100, lowish SHBG and high FT) so given you’re symptomatic at 550ng/dl, it might be worth a trial, I’d suggest keeping a very close eye on you’re lipids if you go down this route though

1 Like

Appreciate it man. I guess although a small sample size, the lack of responses would indicate it’s not by any means common. Would explain why my searches have popped up very little on the web.

Will definitely keep you posted along the way, with whatever I end up deciding to do.

Just keep in mind that on higher T doses a drop in HDL by around 20% is frequently observed.

What do you think that dose is? I suspect some supplement TRT with AAS cycles (and I know some do), but do you think this is an issue at physiological levels?

We are talking 100-200mg weekly for this individual (though literature indicates even 200mg is enough to exert a slight HDL suppression according to literature)

It appears to be very individual. At 200 mg per week HDL decreased by about 15% in most men.

I will keep a close eye on my HDL, hopefully doesn’t drop much. I do believe I will end up on a statin due to my small particle size LDL being so high.

I want to see what my calcium score is before making any decisions on this topic. Hopefully get my cholesterol controlled and then will consider TRT.

I appreciate all the advice and info guys!

Interestingly this appears to be induced in as few as 1-2 shots… so the effect is fairly immediate

250mg for me however appears to have zero effect on my HDL… but that’s just me… some can even take winny like Zeek (a guy on here) keep his HDL in the 30s on like 50mg daily (most would dip down to like… 4)

What’s even more interesting is that this effect doesn’t appear to be directly correlated with an increase in dosage… ie 600mg induces a depression in HDL by about 20-25% if I recall correctly, not 45%

I’m interested to see what conclusions you come to. My brother is in the same boat, though I lucked out and somehow missed getting the bad Gene from our father. Sorry I don’t have anything useful to add other than my interest in the conversation. Good luck

Are you already on a statin? I dont think 213 total merits any action. Ive heard anything under 200 is generally considered detrimental.

I am not on a traditional statin, although red yeast rice is a “natural statin” essentially (at least my understanding).

My LDL was 268 / HDL 40 my entire life. 4 year ago i started red yeast rice, niacin , fish oil and krill oil. It lowered it to what it is now, but won’t go lower. The alarming part is my other numbers. Small particle LDL is massively high risk, and APO is above high risk.

Glad you got lucky! My brother and sister both do not have it, but my father and I do!

In what way is under 200 detrimental? Curious because I was around 150 last time I checked.

I think he meant “not detrimental”. I want your lipids so badly.

1 Like

I did not. I will have to dig up what I read but 200 was the sweet spot.

I will try to find where I read it dextermorgan.

So 4 years ago you started taking care of yourself and your cholesterol dropped? LOL. But seriously you say it won’t go down any further but what is your lifestyle like? If you have another post here by all means link to it if you don’t want to type again.

And yeah small particle LDL is the big one along with APO.