I had minor surgery in March 2019 and told there was something wrong with my blood count. It took until Feb. 2020 that I was told by my Hematologist that I have PV. I was told to take Hydroxyurea 500 mg once a day. After reading about it I decided not to consume what I call the 'Poison Pill' as you are not suppose to touch it with your bare hands. After 1.5 years I finally decided to try it only because my red blood count was 2057, (best range is 190-400) and I was experiencing fatigue. I am a devotee of healthy eating and holistic meds by taking 10 -18 supplements a day so I have never experienced the other side effects of PV. I did not have any bad side effects except catching a sinus virus for the first time since taking the PP has been devastating, I've never been so sick with a silly cold as now. I stopped taking the PP but will resume as soon as my ear infection and sinus clears up. BTW, I'm 75 years young. Also FYI, try fresh, organic ginger, about 1/2 ounce every day for joint pain/arthritis.