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Can Low T Be Genetic

Can Low T Be Genetic

By Mike Kocsis | 7 minutes read | Last updated: April 27, 2023
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    DNA is the hereditary material that controls all the activities in a cell. It has a unique sequence of bases (the building blocks of DNA), which must stay intact for a cell to perform its role. Any change to this sequence can alter the normal functioning of a cell.

    Humans have many genetic disorders – problems caused by changes in DNA. Research shows low testosterone could also be a genetic problem.

    Let’s discuss low testosterone in detail and talk about its connection with genetics to understand how your genes might affect your testosterone levels.

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    Low T and its symptoms

    Testosterone is an androgen produced in both men and women. However, it is secreted in large amounts in men and small quantities in women.

    Its serum levels are important to normal sexual development and maintenance of a healthy body in men. They keep fluctuating throughout a man’s life. They reach their peak during late teens and early twenties, and then start declining at 30.

    Some men have lower testosterone levels (below 300 ng/dL) than normal levels. It can be due to a medical condition, lifestyle, old age, or other factors. Whatever the cause may be, men with low T experience similar mental, physical, and emotional health issues.

    Men with low T often report the following symptoms.

    If you experience these symptoms, reach out to a doctor to diagnose the actual problem and find a suitable solution.


    Is low T genetic?

    Low T can develop due to several conditions, such as obesity and type 2 diabetes. Scientists now believe that your genes may also play a part in it. A study indicates that changes in the SHBG gene (that codes for SHBG protein) may be linked to low T in men.

    SHBG (sex hormone binding globulin) is a carrier protein that carries testosterone in your blood serum. 98% to 99% of the total testosterone is attached to SHBG, and it never gets available to body cells. Only 1% to 2% of the total testosterone is freely available that your body uses for different purposes. In this way SHBG controls the bioavailability of testosterone.

    In this study, researchers analysed the genetic material of thousands of men. They found out that men who had 3 or more genetic variations in their SHBG gene were 6 to 7 times more likely to have low testosterone levels sometime in their lives compared to men with a normal SHBG gene.

    Some recent studies also show an association between hypogonadism (low T due to a medical condition) and the SHBG gene.

    More research needs to be done on this subject so doctors can predict the low T before it actually occurs and help men prevent its symptoms beforehand.


    Genetic conditions that may cause low T

    Men may have low testosterone levels because of the following genetic conditions.

    Klinefelter’s syndrome

    There are two types of sex chromosomes (X and Y) that determine the gender of a baby. Females have XX, while males have XY.

    Babies born with Klinefelter’s syndrome have an extra X, meaning they are XXY. They are genetically male due to the presence of the Y chromosome, but they experience some symptoms, such as reduced body and facial hair, enlarged breasts, and broad hips due to the presence of an extra X. They also experience abnormal development of the testes, resulting in low testosterone levels and low sperm count.

    This genetic problem affects 1 in every 660 men.

    Noonan syndrome

    Noonan syndrome is caused by genetic mutations. A child can inherit it from his parents or develop it due to a spontaneous mutation. It causes developmental issues and reduced growth and sex hormone secretion in children. Men with Noonan syndrome usually have low testosterone levels and become infertile.

    Kallmann syndrome

    It is a rare genetic condition that occurs due to the underdevelopment of certain neurons, that make the hypothalamus (a part of the brain) release the gonadotropin-releasing hormone (GnRH). GnRH stimulates the pituitary gland to release luteinizing hormone (LH), which further stimulates the testes to secrete testosterone.

    Men with Kallmann syndrome have GnRH deficiency; hence, their testes do not release enough testosterone, and they experience late or no puberty. They may have undescended or partially descended testes and may stay infertile if they don’t receive hormone therapy.

    Prader-Willi syndrome

    It is another genetic problem that is caused by the deletion of certain genes on chromosome 15. It causes various mental, physical and behavioural problems in affected individuals. Its common symptoms include sleep issues, poor sexual development, and mood changes.

    Men suffering from this syndrome mostly have low testosterone levels. Testosterone replacement therapy (TRT) may help them increase their testosterone levels.

    Myotonic dystrophy

    This genetic disorder is caused by mutations in chromosome Y. It can happen at any age but usually shows its symptoms when you are in your 20s or 30s. It causes muscle weakness in different body parts and leads to delayed development.

    Men with this condition have small testes and suffer from low T.


    Other causes of low T

    Low T may also be caused by:

    Brain injury/tumour

    The brain sends signals to the testes to produce and secrete testosterone. Any injury to the brain part that sends these signals may result in low T in men. Brain tumours may also cause the same problem.

    Testes injury/cancer

    If your testes are damaged, they cannot properly respond to signals sent by the brain. Hence, they fail to produce enough testosterone.


    Fat tissues tend to convert testosterone into oestrogen. That is why the build-up of fat in men leads to low testosterone levels.

    Cancer treatment

    Male cancer survivors who have gone through chemotherapy or radiotherapy notice a reduction in their testosterone levels.

    Medicine side effect

    Certain medications, including antidepressants, anti-anxiety, statins, opioids, and hypertension medications, are known to lower serum testosterone levels in men.

    If your low T is due to these medications, you should ask your doctor to prescribe a different medicine that does not influence testosterone.

    Alcohol abuse

    Consuming alcohol in large quantities can badly affect Leydig’s cells, which secrete testosterone, leading to low T. That is why doctors suggest low T patients to restrict their alcohol intake.

    Lack of sleep

    Experts believe that healthy men who don’t get enough sleep can experience a drastic reduction in their testosterone levels.

    In a study published in the Journal of the American Medical Association (JAMA), researchers observed the correlation between sleep and testosterone levels in participants. They found out that healthy men who sleep 5 hours a day have 10% to 15% low testosterone levels compared to healthy men who sleep 8 hours a day.


    How to tell if your testosterone levels are low?

    Men experiencing low T symptoms are asked to have a serum testosterone test that calculates total testosterone, free testosterone, and bound testosterone levels in their blood. If 2 to 3 testosterone tests show your testosterone levels are below 300 ng/dL, your doctor will most likely declare you have low T.

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    Can a serum testosterone test tell if low T is in your genes?

    No, a blood test cannot give any information about your genes. You need a karyotype genetic test to check your genetic makeup and look for mutations in your SHBG genes. This test is normally done when a man does not show normal growth and development during puberty.


    Treatment for low T

    Low T caused by genetic problems is mostly treated with TRT, in which you take testosterone from external sources to elevate your blood testosterone levels.

    There are different ways to administer exogenous testosterone, including injections, gels, pellets, patches, and capsules. Your doctor will select the one that best suits your needs, budget, current testosterone levels, and lifestyle.

    TRT helps men with genetic problems improve their quality of life. It may reduce erectile dysfunction, improve libido, increase muscle mass, strengthen bones, and make you energetic.

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    Summing it up

    Low T is caused by various factors, including habits, diseases, medications, etc. Studies indicate changes in your genes may also lead to low T.

    Whether your low T is due to a genetic problem or some other reason, the best possible treatment option is TRT for all cases. Get in touch with one of our specialised doctors today where we can analyse your symptoms and discuss your treatment options.


    References/Further reading/Bibliography/Scientific studies 

    Coviello, A.D., Haring, R., Wellons, M., Vaidya, D., Lehtimäki, T., Keildson, S., Lunetta, K.L., He, C., Fornage, M., Lagou, V. and Mangino, M., 2012. A genome-wide association meta-analysis of circulating sex hormone–binding globulin reveals multiple Loci implicated in sex steroid hormone regulation. PLoS genetics8(7), p.e1002805.

    Ohlsson, C., Wallaschofski, H., Lunetta, K.L., Stolk, L., Perry, J.R., Koster, A., Petersen, A.K., Eriksson, J., Lehtimäki, T., Huhtaniemi, I.T. and Hammond, G.L., 2011. Genetic determinants of serum testosterone concentrations in men. PLoS genetics7(10), p.e1002313.

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    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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