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How Genetics Influence Cholesterol, Heart Disease, and Testosterone Levels in Men

By Marina Shanafelt MS CNS

Testosterone production in men decreases with age, starting in the late 20s and early 30s and accelerating from there. Many men are concerned about symptoms associated with low testosterone such as changes in libido, reduced muscle tone, and accelerated aging; but they may not be aware of the impact that low testosterone may also have on cardiovascular health.

Hormonal balance and cardiovascular risk management for men


Studies suggest that men with lower circulating testosterone levels may be at a greater risk for cardiovascular disease (CVD).

However, it is unclear whether the low testosterone state itself promotes an increased risk of CVD, or is a product of other dysfunctions, and therefore serves as a biomarker of declining health.

Further, a relationship exists between circulating testosterone and cholesterol levels: there is a positive correlation between testosterone and HDL-C (often considered the “good” cholesterol) and an inverse relationship between testosterone levels and LDL-C, VLDL-C, and triglycerides, which are associated with increased risk of atherosclerosis and risk factors for CVD.

The good news is that there are many genetic and lifestyle factors that can influence testosterone production that can be leveraged with the right information and tools. It’s also important to know more about the influence of genetic factors when making choices with your doctor about how to support healthy testosterone levels.

Role of diet and exercise in supporting heart health and testosterone

Genes involved in testosterone biosynthesis such as CYP19A1, CYP17A1, and SRD5A1 can influence hormone metabolism and the ratio of androgens to estrogens.

This information is important to know because many common nutraceuticals, medications, and herbals that are intended to support hormonal health have a direct action on these enzymes and our genes can shed light on how we will respond and which supplements may be the best, most effective choice.

Other lifestyle and environmental factors that influence hormonal balance and testosterone levels are stress, diet, exercise, adiposity, inflammation, and exposure to toxins. Knowing your genes can identify which of these key areas you are more susceptible to and allows you to create an individualized plan targeting your genetic vulnerabilities.

Healthy lifestyle choices for testosterone and heart health"


Focusing on a heart-healthy, anti-inflammatory diet is a great place to start. Including lots of vegetables, especially leafy greens and brassica vegetables such as cabbage, broccoli, and broccoli sprouts can support detoxification and reduce inflammation.

Managing stress and getting proper sleep can reduce cortisol levels, improve DHEA production, and support proper testosterone metabolism. Managing weight with an anti-inflammatory diet and exercise and addressing insulin resistance can also have hormonal benefits and improve testosterone levels.

Knowing your genes can help you tailor a plan to your exact needs, improve hormone balance, and reduce cardiovascular risk!

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