Hey brother, I feel your pain!
I was more sensitive to TRT than anyone I've ever met and it took me nearly 10 years to learn how to get and stay dialed in. Below I've included a post I made to help someone else that I hope will help you to better understand the full picture, and help you be able to finally get totally symptom free.
Let me preface this: I do not give medical advice. This is not medical advice.
Here are some things that will keep you from years and years of suffering, while getting bad advice from forums and careless doctors, and not ever getting dialed in.
1st. Your e2 levels are probably not why you are having side effects unless they are insanely high. It takes 8 weeks for Testosterone to stabilize in your system, unless you started with a properly calculated loading dose. Once you are in steady state (8 weeks, no changing), then and only then will you actually feel the effects of your current dose. If you then decide to change doses and this time use a loading dose, you'll stabilize extremely quickly and you'll feel the actual effects of that dose without waiting the 8 weeks. After, you can change again if necessary. While things are moving, you will always feel weird and you will have side effects like those you described + many others (ED, anxiety, temporary gyno flare.etc), which everyone mistakenly claims are from e2 being too high. If your e2 is below 45-50pg/mL, aka you’re not on steroid levels of testosterone or a hyper converter, you probably don't need an estrogen blocker. Just WAIT.
2nd. Your Free Testosterone is what makes you feel good or bad, not your Total Testosterone. As long as your Total Testosterone is above a minimum threshold ON THE TROUGH (very important part!), you only need to focus on Free T to get dialed in. The minimum threshold is different for everyone but basically you need enough baseline Total T for the symptoms to go away. As far as Free T, many men report doing well with Free T peak levels between 30-60 ng/dL. The healthiest, natural, absolute beast 18 year olds alive have a max Peak Free T of around 21 ng/dL. I personally feel like death and get extreme anxiety if my peak Free T goes above 18.5 ng/dL. On the trough (low end), I think most will feel like death when Free T goes below 12 ng/dL. I personally start to feel off when my Free T trough dips below 15 ng/dL, and heavy side effects begin below 13 ng/dL. Clearly you can see from the tight Free T range I need to target, I'm likely far more sensitive than most, yet I am still able to keep it exactly where I need things to be to feel great!
3rd. If you get crazy anxiety when Free T peaks above say... 18.5 ng/dL, and the only way to make your Free T peak be at 18.5 or below is to lower Total T to the point that it makes your troughs levels provide an insufficient base, it likely means your SHBG is too low. You can reverse this quickly by raising your SHBG, then increasing the testosterone dose. Ways to raise SHBG so that you can have adequate Total T with the Free T level you want are: switch to everyday injections, eat a high fiber diet, do intermittent fasting, avoid sugar, balance your meals, be in a caloric deficit, avoid alcohol. If you do all of these things, your SHBG will rise very fast (probably just a couple of weeks), and it'll solve this issue of not enough Total T. On the other hand, if SHBG is too high and you have to take tons of testosterone to get enough Free T, you can crush SHBG by taking one big injection per week as opposed to smaller ones split up. Boron supplementation, I believe, has also been proven to lower SHBG.
4th. Your testosterone levels work on a cycle with the PEAK happening before 10am, 24-48 hours after your shot. You need to draw bloods only on the peak, and only during total and complete steady state, because from there you can calculate the trough, figure out your Free T peak and trough, and actually get dialed in and start feeling like the champ you really are.
5th. You need to go and get the app "TRT Pro" on the app store to help you with all of this. It is the most usefule TRT app I have ever seen and has everything you need to help get and keep you balanced. You can literally type in your lab results, choose how often you inject, and it calculates the peak and trough for what you are currently taking. Then you can choose any new dose and injection schedule you want, and it will calculate what your new numbers will be if you switch to that. I've tested it with my blood work and found it to be 4 ng/dl off after switching from a weekly dose, to a totally different daily dose. The key is that you use labs numbers for your testosterone level that were drawn on a peak and only at complete steady state, as with all Total T tests. It also a loading dose calculator, Free T calculator, a how to guide with linked research.etc -- all the tools required to accomplish what I outlined and hopefully put this nightmare to rest for you.
Godspeed brother. [Links removed by moderator] It's got images of the app screens so you can see what the heck I'm talking about in this post if you’re confused.
Core takeaways:
-You need to try and pin at the same time every injection and be as accurate as possible with the syringe. Period. If you do 2x/wk, it literally means every 3 days and 12 hours.
-Your symptoms are probably not from e2 if its below 50 pg/mL. Symptoms are normal for up to 8 weeks when making a change, as well as when not on the right dose.
-It takes up to 8 weeks of changing nothing with Testosterone Cypionate or Enanthate, to stabilize and see how your dose feels without using a loading dose. Loading dose is typically days instead of 8 weeks.
-Peak and trough for Free T is what primarily what makes you feel good or bad, as long as you have enough of a base of Total T on the fluctuation troughs and nothing else is grossly out of whack.
-SHBG influences you how often you must inject, how high your Free T is, how much testosterone you need to inject, and knowing how to naturally raise or lower it is very powerful in targeting a Free T range.
-If you are sensitive, I highly recommend this app to help you get balanced and to be able to keep things managed permanently. It'll take forever or might even be impossible to do this without software. I mean it.
[Links removed by moderator]
I'm also attaching an app store screenshot so you don't get confused. There is some junk out there. Best of luck bro!