Short answer: No GLP-1 drug is approved to treat cholesterol. In weight-loss trials, the biggest lipid change was in triglycerides, down about 20% to 29%. LDL barely moved, and HDL rose 5% to 9%. Testosterone tends to lower HDL: one dose study linked higher testosterone levels to lower HDL, and labels say to check lipids periodically.
| Compound | Best evidence | What it shows |
|---|---|---|
| Semaglutide (Wegovy) | Approved for a different use | Not approved for cholesterol. In the label's 68-week weight trial, triglycerides fell 21.9%, LDL 2.5% and HDL rose 5.2%, versus -7.3%, +1.3% and +1.4% on placebo. |
| Tirzepatide (Zepbound) | Approved for a different use | Not approved for cholesterol. In the label's 72-week trial, triglycerides fell 21% to 29% and HDL rose 7% to 9%, versus -5.6% and -0.7% on placebo. |
| Testosterone | Approved for a different use | Approved for deficiency. In healthy young men, higher testosterone levels went with lower HDL. The Kyzatrex label reports falls in total, LDL and HDL cholesterol. |
| Resmetirom (Rezdiffra) | Approved for a different use | Approved for a liver disease (MASH), not cholesterol. In its phase 3 trial, LDL fell 13.6% and 16.3% at 24 weeks versus 0.1% on placebo. |
"Animal or lab studies only" means no published human trial for this goal that we could find. Results in rats or cells often do not carry over to people. Compounds that are not FDA-approved have no tested label for dose, purity or safety.
MedlinePlus describes cholesterol as a waxy substance your body needs, but too much in the blood can build plaque in the arteries. A standard lipid panel reports:
Lipids were secondary results in the weight-loss trials, and the labels mark them as not part of the formal statistical testing. The Wegovy label study matches STEP 1 and the Zepbound label study matches SURMOUNT-1.
| Lipid | Wegovy 2.4 mg, 68 weeks | Zepbound 5 / 10 / 15 mg, 72 weeks |
|---|---|---|
| Triglycerides | -21.9% (-7.3%) | -21.2% / -23.8% / -29.1% (-5.6%) |
| LDL | -2.5% (+1.3%) | -4.6% / -5.6% / -7.1% (-1.7%) |
| HDL | +5.2% (+1.4%) | +6.9% / +9.2% / +8.0% (-0.7%) |
| Total cholesterol | -3.3% (+0.1%) | -3.8% / -4.4% / -6.3% (-1.8%) |
The pattern is consistent: triglycerides fall the most, HDL rises a little, and LDL changes very little. People starting a GLP-1 who need LDL lowered should not expect the GLP-1 to do that job. In the Zepbound withdrawal study, triglycerides rose 13.5% in people switched to placebo, versus a 4.8% drop in those who stayed on the drug.
In Bhasin 2001 (61 healthy men aged 18 to 35, 20 weeks), whose own testosterone was shut down and replaced at set doses, HDL went down as testosterone levels went up. The highest doses gave levels far above normal and are not a treatment.
Labels say this in general terms. The Depo-Testosterone label says serum cholesterol may increase during androgen therapy and lists dyslipidemia among problems reported with steroid abuse. The Kyzatrex label reports falls in total, LDL and HDL cholesterol and triglycerides in its trials. Xyosted, Kyzatrex and other labels say to check the lipid profile periodically, especially after starting, because statin doses may need adjusting.
Terms on this page: GLP-1 receptor agonist · Testosterone ester · Hematocrit