What country? Nice to see were we have guys come from and also affects what diagnostic and treatment options one has.
Your on-TRT T levels are low. While you are near ideal TRT level of E2=80pmol/L, your low T levels are making you estrogen dominant.
SERMs [Clomid, Nolvadex] do not decrease E2 levels, SERMs increase E2 levels but "hide" the E2 from estrogen receptors by interference in a dose dependent manner in only "Selected" tissue, not all.
You are better off managing E2 with anastrozole than masking higher E2 levels.
With your low T levels on sustanon, I worry that it might be fake or you are a T hypermetabolizer who needs much higher T doses.
Always do labs halfway between injections to avoid lab timing artifacts where changes in labs are from timing.
Try 100mg T twice a week.
Take 1/2mg anastrozole at time of T injections.
Judge effects after 6-7 days.
After 2nd dose, stop taking Nolvadex.
If you feel suddenly crashed/depressed, stop anastrozole for 5-6 days and resume at 1/16mg at time of injections and eval after one week.
With labs, target is 80 pmol/L
If you get E2=115 pmol/L, modify anastrozole dose 1/2mg X 115/80
Were labs done while on Nolvadex? How long?
What Nolvadex dose? Often doses are stupid high. [10-20 mg EOD is workable].
Please note that if you double your FT, FT-->E2 is expected to double and then E2 levels do get high and AI dose needs to increase.
You will be on T+AI. Your FSH/LH will go to zero as expected, testes probably will shrink and may ache. Scrotum then expected to be tight. And fertility at risk. You can use 250iu hCG SC EOD, but can be expensive or unobtainable. Alternatively, 10mg Nolvadex EOD may solve that problem inexpensively. But hCG, a human hormone is preferable.
Please read the stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=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.