What dose of niacin do u currently take?I am almost 80 and still on TRT. My HDL is great. But there is more to the story.
At age 52 I almost died from a heart blockage likely due to unusually low HDL. After an angioplasty, my doctor treated the low HDL very aggressively using mostly huge doses of niacin. HDL more than doubled, and LDL was cut in half.
At age 70 my doctor suggested TRT to treat my osteoporosis after fosimax did not work. She prescribed 105 mg/week, but I upped that to 175 mg/week for more muscle size and strength. TRT worked and bone density is now in normal range. Muscle size and definition improved significantly. HDL remains just as good as before.
So, it is possible to take high dose TRT and maintain good HDL. At least in my case.