Hi @winmil99, Many medications have a rebound effect if stopped abruptly. The same goes for HU (Hydroxyurea). According to Merckmanuals.com, “Too-rapid withdrawal of hydroxyurea can result in rapid rebound to very high platelet levels and platelet cycling.”

I know you’ve been waffling about starting this medication. I hated the thought of needing to take medications too. But I did, and now, 5 years later, I’m still here living a long and productive life. There comes a point when it is a matter of risk vs reward. You’ve been diagnosed with ET that also involves the JAK2 mutation. This basically means that there is now a DNA defect that will allow your body to generate platelets without a shutoff. Too many platelets can cause strokes, blood clot, excessive bleeding, etc.

Hydroxyurea has been around for decades. It’s the first line medication for ET and PV and it’s been effective in slowing the proliferation of red blood cells and platelets in patients who have the mutation. So, to do nothing you run the risk of catastrophic side effects or you can take a medication to help prevent clotting and strokes.

I can’t remember if I shared these articles with you or not but they may help you to understand a little more about what is happening right now.
https://www.verywellhealth.com/jak2-mutation-5217909
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https://www.verywellhealth.com/when-to-worry-about-high-platelet-count-5186732
What are you fearing the most about starting HU?