I had similar numbers as yours when diagnosed in Jan. 2023 at age 69 with ET/Jak 2, no bone marrow test. My oncologist wanted to start me at HU 500 mg. 3/days week. I accepted 1x week for HU 500 mg, daily iron, and daily baby aspirin. After 18 months, I have settled in at 4x week with HU, 500 mg with each dose, daily iron, and daily aspirin. I'm not anemic, but I do have low iron levels. My platelets are in the low 500s after jumping back to 800K in April 2024. and I see the oncologist for blood work every 6 to 8 weeks depending on my numbers. I feel okay with some fatigue and very dry skin and dry eyes. How is your spleen? If it's okay, you may be able to drop back a bit on HU with the doctor's agreement. You may want to get a second opinion. Make sure your eyes are well protected. In the last year, I've lost the vision in my left eye due to corneal scarring. I had no injury or infection. My only change has been taking HU and having this blood cancer diagnosis of ET. I'm using lubricating eye drops 4 x day, plus prescription steroid eye drops for the eye with the scarring, 2-4 times daily to prevent further scarring. My right eye is fine, so I can drive and do my hobbies. I also had retinal hemorrhages in both eyes 6 and 7 years ago. Retina issues can be related to ET. Some loss of hair, but I had a lot so not too noticeable. I also take B12, Vit D, calcium, multivitamins, and Tumeric. Of course, consult your doctor before adding vitamins or herbals. I drink lots of water, green tea, and OJ with my iron. I stay away from processed foods. Take care, keep active, and eat healthy!
Karla