@cetzler Welcome to the club no one wants to be in!

What "natural treatment"? I've had ET x 18 years, and there isn't a supplement or diet that addresses out-of-control platelets caused by a genetic mutation, though I've seen claims for everything from CBD oil to cinnamon to personalized IV infusions.

Some people right after diagnosis do feel they need to at least try an alternative treatment before they agree to HU. If that's what you decide to do, it's a good idea to let yr doctor know that's your plan so that you can be monitored appropriately.

Your oncologist will assess your need for hydroxyurea based on age, mutation type, and clot history. Docs may also look at your family history for types of strokes, heart attacks, and clots.

Doc will prob also recommend a daily baby aspirin, which reduces clot risk.

You *can* benefit by a heart healthy diet and appropriate exercise that will reduce over all stroke risks. Get a handle on weight, hypertension, and cholesterol if you need to.