Hi @arti4 I read over another discussion you started regarding Hydroxyurea for ET, and see that you’re getting a second opinion. In your case, I would too. Having platelet levels in the upper 400s that’s been stable for 4 years isn’t that far from the norm. The usual upper ‘norm’ for platelets is 450.

While it may mark the beginning of ET (essential thrombosis) there are other tests your doctor can do to determine if it is ET or another underlying blood disorder causing the increase in your platelets. I can undertand your hesitancy to begin treatment if not necessary. So seeking a second opinion is a really good choice.

A bone marrow biopsy and exam (BMBX) takes a core sample and a blood smear directly from the blood manufacturing system in the body and can give an overall picture of cell production and any anomalies in the marrow. So at some point your hematologist/oncologist may want to do that. A Jak2 gene mutation can be found in a blood draw, which you’ve already had done.
You may have already seen this site, but I’m posting the Mayo Clinic informational article on ET.
https://www.mayoclinic.org/diseases-conditions/essential-thrombocythemia/diagnosis-treatment/drc-20361131

There are a few more articles that you might find of value describing the acquired JAK2 mutation and how it affects the blood manufacturing.
https://blood-cancer.com/clinical/jak2-mutation

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https://www.dovemed.com/common-procedures/procedures-laboratory/jak2-mutation-analysis/
Were you having symptoms that your doctor was checking for or was this in a followup to a routine blood test?

@loribmt, thanks for the response. It was found just in routine blood work. But I’ve been having almost daily headaches for several years. Actually nighttime headaches that wake me up. Maybe related?

Oo headaches are miserable, especially if they’re daily. I’m not sure if it’s related to the possible diagnosis of ET or not.
But I have found some correlating discussions in the forum for nighttime headaches you might want to take a look at. There are a lot of conversations in the discussions dating from oldest to newest so take your time and read through some of them.
Here’s the like to: Headaches that wake you:
https://connect.mayoclinic.org/discussion/haches-that-wake-from-sleep/
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https://connect.mayoclinic.org/discussion/chronic-severe-nocturnal-hypnic-headaches/

And one more on Hypnic headaches. https://www.sleepfoundation.org/physical-health/hypnic-headaches

Any tightness in your neck and shoulders? That’s a cause for my neck/shoulder/upper back issues which used to cause headaches. I see a massage therapist who specializes in Myofacial release which helps tremendously. I also have acupuncture treatments and those two together have kept me headache free for years. Have you ever discussed those with your doctor to determine a cause?

Hi @arti4, as it happens, @tkp22 asked a very similar question a little while ago. Hence I moved your post to this existing discussion:
- Jak2 positive, biopsy next: Does it mean I have blood cancer? https://connect.mayoclinic.org/discussion/jak2-positive/

I think you may appreciate the comments in the discussion.