New to TRT still trying to get dialed

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Okay my Dr is removing the anastrozole out of my testosterone and giving me separate .25mg pills. I take 1/2cc testerone etehnate 200mg/ml every 4 days. Since I take the 1/2cc shot every 4 days, I can’t take the pills the 4th day after a 1cc shot. So he’s telling me to take one .25mg pill the same day of my shot. I noticed when I was doing a 1shot / 1cc a week I Started felling my best on day 3 or 4 continually getting better to day 5 or 6. I mean feeling better as in better sleeping, not as anxious or moody, clearer headed and libido / performance without without taking meds. Question is, thing I should take the anastrozole with the shot or hold off to see how my body react without the anastrozole ? Or does anyone of you guys who been doing this think I could hold off and feel how my body reacts . Or do you think with the way my body sensitivity is to testosterone I take the pills because it’s a given my estrogen will spike. My test jumped from 540 to 1640 after only 6 weeks of being on testosterone. To be clear I had my blood drawn at 2:30pm 5 1/2 days after taking my 1cc shot.
 
Defy Medical TRT clinic doctor
You wrote of "1/2cc" of testosterone. That's a volume of oil, not a dose. It's best to express your dose in terms of milligrams. Your injecting testosterone dispensed in a vial that indicates there are 200mg per ml? So, that works out to 100mg of testosterone twice weekly?

In respect to blood draw for your lab tests, always test in the trough. That means just prior to your next injection so that you and your doctor can determine how well your protocol is sustained across the course of the week. That becomes particularly important when you have so many moving pieces, different drugs being taken at different points during the week.

You are on a significant dose of testosterone. You can always see how your body reacts without anastrozol in the six weeks that are about to start and then back up your subjective feelings with lab tests (always using the sensitive estradiol test only - the standard test is worthless for men). Or you could add anastrozole now and do the same sort of self-assessment.

Is your SHBG sitting just under 30? What was said about the large testosterone dose you've been prescribed given that your pre-TRT level was not unreasonable?
 
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My original labs had my SHBG at 29.4 before TRT treatment. What makes the sensitive estradiol test better than the standard estriadial for men test? My standard estriadial test I got back 6 weeks after starting treatment was 31 and a total T leve 1640. I mentioned standard estriadial and he acted like it didnt matter which one he uses. Also what is the answer to lowering my SHBG If it's to High?
 
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There are many other steroids in the blood that look like estrogen to the standard E2 test, the sensitive labs (Liquid Chromatography–Mass Spectrometry) doesn't have this limitation and should be used in men.

Excess androgens is what lowers SHBG.

Simultaneous measurement of total Estradiol and Testosterone in human serum by isotope dilution liquid chromatography tandem mass spectrometry
Different technologies for measuring circulating E2 and TT are available such as radioimmunoassays (RIA), enzyme-linked immunoassays (EIA), and mass spectrometry methods (12, 13). Most of the analytical methods used in patient care and public health activities only measure either testosterone or estradiol (1417), thus requiring separate assays for each analyte. Some of these assays were found to have a high level of inaccuracy, lack of sensitivity, and problems with reproducibility. These problems were reported especially at the low concentrations commonly observed for estradiol in men and postmenopausal women (approximately below 147 pM, 40 pg/ml), and testosterone in women, children and hypogonadal men (approximately less than 3.47 nM, 100 ng/dL) (1820). Thus, new analytical methods are needed to accurately and reliably measure E2 and TT in serum.
 
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