@jodyjazz I've noticed most people on this site have started treatment earlier. I'm in Australia and was diagnosed with ET Jak2 in August 2025. Here is what my haematologist advised me. Starting treatment differs by country, Australia is more "conservative", starting around 1000, the US are more "aggressive" starting around 500. It's all about the risk factor and how it's determined, ie. stroke risk increasing from age 60 and then factoring in other contributors like high blood pressure and/or heart issues. I am 60, on medication for high blood pressure and am in the medium risk for heart disease. Both are being managed. I haven't had any previous blood clots. My platelets are at 920. Assuming it's standard everywhere but normal range in Australia is between 150-450. He also said the 100mg aspirin renders half of the platelets "helplesss" so my count is more like 460. I did not have a bone marrow test so not sure if that shows other information to factor in when to start treatment. I have blood tests every 8-12 weeks. I'm really on the cusp of starting treatment and was given the choice to start now or wait to see my blood results later this month.