If anything I would be far more concerned with diet/body composition let alone having low testosterone!
Having healthy testosterone levels and following a proper diet/training protocol will have a big impact on body composition (muscle gain/fat loss) which will improve overall blood markers.
We are on trt using therapeutic doses in order to achieve a healthy FT level.
Abuse of testosterone/AAS can have a negative impact on lipids and even then it is usually the 17-alpha alkylated orals such as methyltestosterone, oxymetholone, fluoxymesterone, methandienone, oxandrolone, and stanozolol which are notorious for driving down HDL and increasing LDL let alone stressing the liver.
*Effects of testosterone therapy (TTh) on lipid parameters are inconsistent and may depend on treatment duration, route of administration, and adherence. While in short-term studies, testosterone usually lowers HDL, long-term studies seem to increase HDL. Total cholesterol, LDL, and triglycerides are either reduced by TTh, or effects are neutral.
*Testosterone modulates the function of different tissues (muscle, adipose, and bone) and cell types (epithelial, endothelial, and hematopoietic) and regulates the metabolism of lipids, carbohydrates, and proteins.
Testosterone is closely related to blood lipid metabolism. Long-term testosterone therapy improves the lipid profile by reducing total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels, and increasing high-density lipoprotein (HDL) cholesterol levels compared with baseline levels.
My HDL-C lowered slightly. I don't think it is clinically meaningful - in the context of heavy anabolic steroid abuse, where HDL-C may be in the single digits - I do think it may be showing something pathological.
I am obsessed with CVD health and listen to lipidology podcasts, etc.
I have learned that HDL-C on its own is not that good of a predictor; it had predictive power when the Framingham studies came out, but that was just because ApoB / LDL-P was not measured.
I watch my non-HDL-C, ApoB, LDL-P and inflammatory markers. My non-HDL-C hovers around ~60, and I try to always keep it below 70; my LDL-C was 40 on my last blood test. I am not on a statin but I may experiment with a low dose of crestor in the future.
Overall my lipids are better on TRT than pre-TRT, but it is likely because I take my diet, health, etc more seriously now - and it's *easier* to do so than it was when I was low T.
I believe that if men see large, negative changes in LDL-C when beginning TRT it is due to eating a lot more (and eating perhaps poorly). Studies of men on TRT do not show a statistically significant change to LDL-C, but do show slight decreases in HDL-C.