I can relate to the low adrenal function. I am 48, diagnosed with PV last year, Jak 2 positive. I started on hydroxyurea last fall, then switched to Jakafi earlier this year. Jakafi took away the need for monthly phlebotomy and the constant hot flashes. Also, I do not have a thyroid so I'm constantly shifting thyroid doses depending on my thyroid lab results. I am tired all the time. I have 5 kids ranging from 21 yrs down to 11 year old twins. I do not like the idea of taking medication, but it does help keep the cancer under control. I will ask my oncologist at my next appointment about how to address adrenal fatigue in the midst of all of this. The best thing is that I know I am not alone as I walk through this. So thankful for this very informative message board!