I'd say the most glaring thing is your Estrogen @ 8, then as Coast and Ero stated, this Dr is not really doing you too many favors but in a vacuum, I'd pull back on the Anastrozole. Also rather bizarre that you're getting 300mg 1x per week but only pulling a trough of 664. If I were you and did just one thing I'd cut back on that Anastrozole. We typically NEVER see any of us taking but maybe .5mg, per week total. Getting 300mg at one-time I'm sure you need an AI as that's a 100mg over what any of us believe is a TRT dose, leaves for excess to aromatize.