Hey guys, not sure if anyone remembers my old post, but not long ago I was considering TRT. My numbers weren’t terrible (TT 500 / FT 14.5), but I didn’t feel my best at all. My TT was 900-1100 in my 20s, and I’ve felt the drop in the last few years.
Anyhow, long story short. I needed to get my Familial Hypercholesterolemia in check before even considering TRT. I have got my cholesterol in check with the use of a statin, but the statin looks to have lowered my TT/FT as well. My diet hasn’t been as flawless as usual, and with gyms closed I’ve been stuck doing stuff at home, but still seems like a hefty drop just for the slight changes in my fitness routine.
TT is now 386 (290-911) / Free T is now 7.4 (8.7-25.1).
I really don’t mind, as I had wanted to get on TRT anyway. However I’m purely curious if anyone else has had this happen with statin use - or maybe this can be a heads up for anyone starting a statin and help someone else.
I did not start statins until after I started TRT (low dose 10mg Atorvastatin). There was a definite increase in cholesterol and negative balance of lipids after initiating TRT. I doubt that concomitant use of statins with TRT will have any affect on T levels since T production is about zero while on TRT.
HOWEVER, your pre-TRT observations are probably correct. Below is a link to a 2010 study of 3,484 men with ED, of these 244 were also being treated with statins.
Both total and calculated free T levels were significantly lower in subjects taking statins, when compared to the rest of the sample ( both P < 0.0001).
The use of statins was also associated with a reduced testis volume and a higher prevalence of hypogonadism-related symptoms.
Interestingly, there was a significant elevation in FSH and higher LH (though not significant) in the statin cohort.
This study supports that in otherwise healthy men, that lower testosterone production may be a side-effect of statin use. It also indicates that the mechanism of action is associated with testicular T production rather than gonadotropin release or production. In plain English, it affects the testicles rather than the brain (hypothalamus) or the pituitary.
So, it all comes to a risk-benefit exercise with regard to the use of statins to control cholesterol or lipid ratios. Additionally, men being prescribed statins should be evaluated regularly for testosterone levels and symptoms of low testosterone. TRT is a viable treatment for those who wish to continue use of statins.
@hardartery LDL was as high as 260 but averaged around 230. I’ve been 8-14% body fat my entire life, eat healthy, and have a relatively decent physique. I only say that to get across that I truly have FH and it is not dietary related.
I got my LDL down to 175ish with the use of Red Yeast Rice, however it doesn’t give the full benefit / protection of a statin, and 175 is still quite high. I fought statins for 15 years and finally gave in at 32 years old.
My LDL is down to 130 now in 10 weeks of just statin use, but I definitely feel the lowered test. I’ve had sex once in 8 weeks, and have not jerked off once. I’ve had zero desire, although I performed fine when the time came. I’ve also struggled with motivation for exercise, which is odd for me, in 10 years I have never struggled with motivation aside from when my kids were born when I took a little time off (few weeks / month). **[quote=“youthful55guy, post:3, topic:266860, full:true”]
I did not start statins (low dose 10mg Atorvastatin) until after I started TRT. There was a definite increase in cholesterol and negative balance of lipids after initiating TRT. I doubt that concomitant use of statins with TRT will have any affect on T levels since T production is about zero while on TRT.
HOWEVER, your pre-TRT observations are probably correct. Below is a link to a 2010 study of 3,484 men with ED, of these 244 were also being treated with statins.
Both total and calculated free T levels were significantly lower in subjects taking statins, when compared to the rest of the sample ( both P < 0.0001).
The use of statins was also associated with a reduced testis volume and a higher prevalence of hypogonadism-related symptoms.
Interestingly, there was a significant elevation in FSH and higher LH (though not significant) in the statin cohort.
This study supports that in otherwise healthy men, that lower testosterone production may be a side-effect of statin use. It also indicates that the mechanism of action is associated with testicular T production rather then gonadotropin release or production. In plain English, it affects the testicles rather than the brain (hypothalamus) or the pituitary.
So, it all comes to a risk-benefit exercise with regard to the use of statins to control cholesterol or lipid ratios. Additionally, men being prescribed statins should be evaluated regularly for testosterone levels and symptoms of low testosterone. TRT is a viable treatment for those who wish to continue use of statins.
Mine kicked around, total from 200 to 260 at different times. Co-Q 10 has me under 170 total cholesterol. Not as bad as yours, but plenty of high cholesterol in the family to go with diabetes and high blood prressure. I honestly don’t give a damn about cholesterol, I think it may be a symptom of something but not aproblem in and of itself, but I’m difficult. I take the Co-Q 10 to get the doctor to not harass me.
I have taken coq10 for years. I’ve tried to have that same mind set, but the more I dig, the harder it is to ignore. I have two young kids, and I finally bit the bullet because of them.
Thankfully I have good blood pressure and no other health issues. But I wasn’t willing to keep risking it after seeing a lipid specialist.
I’ve always wondered about this. As I understand, cholesterol is the precursor for the steroid hormones. So by inhibiting cholesterol via statins, we would then inhibit hormone production/ activity. Or am I simplifying it too much?
Could it then be that, on TRT, cholesterol is not being utilized as the body “has enough hormone” maybe that’s the reason for the raised levels of cholesterol? Again, probably seriously oversimplified or plain wrong. If I could go back 20 years I’d be studying endocrinology and hormone replacement, it’s incredibly interesting stuff.
I’ve read that as an idea, I don’t think so though. Your body makes the cholesterol it thinks that it needs, and some guys have a broken gauge. My cholesterol did not change due to TRT. Other guys have claimed a drop.
We’re getting into an area where my knowledge is a bit thin. I’ve done some reading on the use of statins and am convinced that the low dose I’m on is appropriate for my long-term health. Any negative side-effects are more than compensated with TRT. If were not on TRT, it would be a different risk-benefit exercise. Then again, my cholesterole and lipids were ALWAYS good prior to TRT, so I’m convinced that it was TRT that messed them up. However, I have absolutely zero regrets to starting TRT other than I waited about 2 years too long before coming out of my dark period.
With regard to the mechanism of action for statins in lowering T levels, given that this has been known for over 10 years (date of the one study I found), I’m sure there has got to be some research published into how it exerts its effect. I’ve just not taken the time to dig into the literature, not do I want to. Understanding the ‘how’ will not change my decision to treat my high cholesterol/lipids with a low dose statin. However, what you propose sounds like a good starting place. All steroids start with cholesterol as a building block to the main structure of the molecules, so it makes sense that anything that disrupts it’s synthesis will also have an impact on the synthesis of the downstream hormones that are derived from cholesterol.
I think another aspect of statin treatment that needs to be interpreted is the dose of the drug being used. In a conversation I had with my doc when I first started 10mg Atorvastatin, she was skeptical that such a low dose would have enough of an effect. She pointed out that cardiologists usually recommend at least double that and sometime up to 40 mg per day. I insisted on starting at the lowest possible dose and evaluating from there. As it turns out I was correct. 10 mg puts me squarely in the good zone. To me, this suggests that docs are probably over prescribing the dose of statins and not appropriately titrating dose of the drug to meet the individual patient need. In fact, I recently did some research on the drug and found that research has shown that the ED(50) (least effective dose to treat 50% of subjects) for Atorvastatin is only 2 mg/day. So, at 10mg (the lowest commercially available tablet), there is a 5X safety margin for effectiveness. That is, few people need to go above 10 mg and could probably get by with less. In the case of lowering T levels, I am guessing that dose makes the poison and that the effect on lowering T production could be minimized by properly titrating the stating dose to the patients need. See the article link below for a discussion of ED(50) for statins.