Co-morbidities affect tolerance to HU, for sure. If you have side effects, you can try anagrelide or, if your insurance pays, besremi (interferon). However, many docs don't even bother prescribing besremi in the US because of the cost.

Some doctors are impossible to deal with, arrogant, abrupt, and unwilling to listen. Specialists can be especially stuck in their silos, unable/unwilling to see the effects of their treatment on co-morbidities.

But HU is not a "devil pill" for most people. Been taking one per day plus extra on M-W-F for 6 years (ET-CALR). No no anemia, no fatigue, no clots, only two mild aural migraines in all that time.

I hope those with problems with HU can find better docs and good alternatives. They are out there!