I see zero evidence that your blood is too thick.
You need more anastrozole. At 320 mg T per week I would expect that you need 3.2 mg anastrozole per week.
You got E2=52 with a dose of 0.5mg twice a week. With a goal of E2=22pg/ml your new dose should be 0.5 X 52/22 = 1.18 or 2.36 per week. The difference of 2.32 vs 3.2 could be from lowish SHBG with more FT for FT–>E2 or from reduced E2 liver clearance and that can be from medications.
Why are you seeing a urologist every 6 months? Only for TRT? He can through T at a problem, but is an idiot for not checking FT. SHBG gives us a clue. Looking at FT your T dose may be too high. If you reduce, reduce AI dose by same factor.
High E2 can create major brain problems and panic attacks. We see same with low thyroid function too. Eval thyroid function via oral body temperatures - see below
Bromine fire retardant fabrics can put bromine in your system displacing iodine from where is needs to be. No problem if body temps are good.
BTW, E2=52 is really bad for the prostate and the brain. +more
Take fish oil and also aspirin until things settle down. Avoid dehydration.
How much hCG? 250iu SC EOD would be appropriate. Larger amounts can spike E2 via testicular T–>E2.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.