kto1452,

I have had Polycythemia Vera since 2018. My hematology doctor told me I will be on 500mg of Hydroxyurea 2x a day for the rest of my life or some kind of treatment. I plan on living until age 100 so that is a long time from now. I too get very tired in the late afternoons and evenings. I plan all my mentally demanding tasks in the early mornings. I believe going to my gymnasium 3x a week helps immensely. I have no other symptoms other than late afternoon, or early evening fatigue. I have no side effects from Hydro other than it takes a few minutes to stop my bleeding after a small cut.
I wish the best of luck to you,

James, 63ys young, living the good life in rural Kentucky