Struggling with E2 (MWF 0.3mg/shot) Should I use AI?

[quattro]

Hi all — I’ve been on my TRT journey ~6 months (43yrs old) and I’m still trying to dial things in. I’m debating whether to tweak dose/frequency and/or add a very low-dose AI. Would love feedback from folks who’ve dealt with peak/slump issues. I started this journey with hCG, so I wanted to include that for more context.

Here is my journey so far:

• hCG monotherapy (7 months) — felt pretty good. Also took anastrozole 0.5 mg 2×/week (day after shot).
  • Total T: 680.7 ng/dL
  • Free T: 171.3 pg/mL
  • Prolactin: 7.0 ng/mL
  • E2/SHBG not measured on this draw - HCT was 44%
  
• I got off hCG and was “clean” for 7 months → started TRT (test cyp 100 mg/mL). 0.5 mL twice weekly (~50 mg each; ~100 mg/week). Also anastrozole 0.25 mg once or twice weekly. Labs ~8 weeks in (drawn day after an injection - peak levels):
  • Total T: 1110.0 ng/dL
  • Free T: 32.2 pg/mL (looks off vs TT - manual calculation suggests 306 pg/mL)
  • E2: 32.3 pg/mL
  • SHBG: 26.9 nmol/L
  • Prolactin: 8.4 ng/mL
  • How I felt: great drive/motivation (lifting 4×/week); occasional irritability but manageable - HCT was 47.4%

After this point things start getting complicated, and start going downhill. I decided to get off Anastrozole, and also switched to Sustanon250 for 3 weeks due to running out of my cypionate—due to travelling overseas longer than planned.

• Travel: Sustanon250 without AI (3 weeks @ 0.25mg 2x/week) → then back to cypionate without AI. Stayed 0.5 mL twice weekly (~100 mg/wk), no AI (9 weeks total; last 6 weeks on cypionate) before labs (drawn morning before injection - tough levels):
  • Total T: 773.0 ng/dL
  • Free T: 195.5 pg/mL
  • E2: 51.5 pg/mL
  • Prolactin: 17.0 ng/mL
  • How I felt: overall low drive/motivation, sometimes depressive, didn't feel like exercising due to low overall energy—felt worse than pre-hCG/TRT - HCT was 50%
  
  
• Current: cypionate without AI, M/W/F 0.3 mL (30 mg/shot, ~90 mg/week). Labs after ~6.5 weeks (drawn on Monday - trough levels):
  • Total T: 793.2 ng/dL
  • Free T: 209.1 pg/mL
  • E2: 51.2 pg/mL
  • SHBG: 25.0 nmol/L
  • Prolactin: 11.0 ng/mL
  • How I feel: a little bit better, but still get “high-E2-like” symptoms Fri–Sun, peaking Saturday; Monday feels decent, but nothing like the first 8 weeks with AI. Haven't gotten back to exercising like that cycle with AI (energy levels are like how they were), but started to walk daily for 45mins - HCT was 48%

I’m really trying to avoid an AI, but this week I caved and took anastrozole 0.25 mg on Tuesday (the day after my Monday 0.3 mL cypionate shot). It’s odd that my E2 didn’t budge despite increasing injection frequency from 2x weekly to MWF and lowering the weekly dose from 100mg to 90mg.

I’d really appreciate any guidance. The low drive/mood/motivation at E2 ~51 pg/mL has been rough. The 0.25 mg AI gave some relief, but I’m not sure if I should adjust dose/frequency more or keep a very low-dose AI in the mix.

 

[FunkOdyssey]

 

[quattro]

Thank you for your response. I appreciate the link to this video. I have watched it, and in summary, it suggests better weight management and consider metformin instead of anastrozole. I'm around 18%-20% body fat, so of course there is room for improvement.

I was hoping to get some suggestions on a new protocol after everything I've tried. I'm not worried about the E2 number, but more so the symptoms that I'm experiencing: fatigue, low drive, and lowered energy. I don't have nipple sensitivity. I've switched from 0.5mg 2x weekly to 0.3mg MWF, but E2 remained the same and symptoms are slightly better on Mondays and Tuesdays, and then goes down hill especially on Saturdays.

Just wondering if anyone else had similar numbers and a similar journey as me, and how they ended up resolving it. Any insight and suggestions is greatly appreciated.