Are my high Total/Free T causing acne/anxiety?

Hey all,
I’ve been on TRT for nearly 6 years now. I’m on a protocol that has been great for me in the past. It seems i’m responding differently to the test cyp/HCG now and I’ve had a bit more anxiety and constant cystic acne for the past few months. I got labs done a month ago, and dropped my HCG down a bit more since them. Wondering if I need to drop my test cyp down too.

My protocol:
EOD .26 Test cyp IM of 200mg/ml (~182mg/week)
EOD 100 units of HCG subq (350 units week - i was taking around 420 units/week at the time of the labs in late august.)
EOD .125mg anastrazol
Latest labs: Total T is around 1300, free T is over 300, estradiol 42.
I’m 42, 6’, 178lbs with an 8 pack in otherwise great health. I’ve felt weaker at the gym lately, not hitting some as high of a bench/squat as I could last year. I’m a bit leaner, but same muscle mass.

I’ve attached my labs. Does anyone see a glaring reason for the Cystic acne? That’s the main problem I want to solve. I have a lot of anxiety/work stress, but there isn’t much I can do about that at the moment. I was thinking of dropping my test cyp down to .24 ish EOD. (~170mg/week). I love running on the higher end of normal for the libido boosting effects.

I had hematocrit over 50 and donated blood the next day.
My higher carbon dioxide result freaked me out and I stopped vaping - I was vaping off and on for a year but quit a month ago. That can mess with hormone levels too I know (DHT causing acne) but I don’t think its to blame.



Could it be your FT is 2x above the highest limit? Dropping your dose down less than 10% isn’t going to change that. You likely need to drop your dose about 30% or more. When you do this you may not even need all that AI you are taking. Your basically taking the AI because you are overloading on your T dose. So… a med to control the overdose of another med.

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I’ve been playing with my protocols for 6 years. This is the first dose that fixed all my sypmtoms of low T. I’ve kept logs of my protocols and how I felt on them going back years. I listened to that youtuber guy that shouts you don’t need AI, just dial in your dose, and tried to for 2 years. If i lower my T and or HCG to the point where I don’t need AI, i lose all benefits of TRT and once again, have no libido, energy, sleep suffers, feel less confident etc…

I agree my free T is off the charts, but it was around 250 or lower before on this same protocol before - so either my body is responding differently to the meds for some reason, maybe a bad batch of T, or lasting ripple effects from vaping (jacks up your DHT and fucks with test/estrogen levels too), or maybe the Chantix that i had to take to quit vaping.
Either way, I just lowered my dose of both meds today to see where that takes me.
switched to .25 test cyp EOD, and .08 HCG EOD (80 units), down from 100 units (.1)

I just realized a cortisol lowering supplement I take for stress has ashwaganda at 125mg. I’m wondering if taking 1 or 2 pills of that several times/week would boost my test levels to the problematic range. Its in the THC aphrodesiac taffies my wife bought us too.