New to TRT, Prescribed High Dose to Start, Got Questions

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

I think that E2 will go too high with 200mg T and 1.0 anastrozole per week.

Your doc did nothing to find the cause. Low-T is the symptom, not the disease.
With young guys, the need to to see if the problem can be fixed.

Get these tested:
TSH
fT3
fT4 - please not T3, T4
CBC
hematocrit
prolactin
AM cortisol - at 8AM please
AST/ALT
fasting cholesterol - can be too low
fasting glucose

T levels are not static and will vary from time to time.

Energy:
Do you use iodized salt to support thyroid hormone production?
Do you get cold easily?
Outer eyebrows sparse?
If yes to any of the above, use oral body temperatures to evaluate overall thyroid function. If temps are good, you can skip TSH, fT3, fT4 labs.

In the stickies you will find what is needed to avoid infertility. Injecting 250iu hCG SC EOD is the best solution.

If prolactin is elevated, can promote gyno, this can be from a prolactin secreting pituitary adinoma than can typically be easily manages with 0.5 mg/week Dostinex/cabergoline. Need a MRI to eval/confirm. Do not want to ignore as a larger adinoma can press on optic nerves creating a loss of width of peripheral vision or other artifacts. Prolactin reduces LH/FSH and reduces dopamine which is depressing. With young guys, this should always be investigated when LH/FSH are low.