@appraiser1946. I've been on anagrilide for about 14 mos. After many small dose increases, I'm now on 2 mg a day. My platelets now range between 320 and 500, which is a vast improvement from 2.2 million when I was diagnosed. I'm very sensitive to the med with many side effects and have a hard time with dose changes. My hematocrit is on the high side at about 53. It's a balancing act for me between tolerating the med side effects and quality of life. As you mentioned, fatigue is a big one, as well as muscle pain, shortness of breath and heart palpitations. I can't take hydroxyurea as the side effects were severe and I was hospitalized for a month. I think it's a matter of adjusting and accepting that life has changed. Good luck with your side effects and hope they reduce with time.