When is platelet count a concern for PV/ET patients?

[lfindley]

I have PV and ET, and take Hyrda to treat them. My hematocrit was 46% and my platelet count was 600K. (High normal for hematocrit is 45%, and platelet count is 400K.)

My question is does a platelet count >400K automatically require treatment, and if a person not diagnosed with ET saw their doctor with a platelet count of 600K would it be cause of concern to a doctor? The reason I'm asking is we increased the hydra. It lowered the platelet count, but unfortunately the drug also lowers the platelet count, so I went from feeling great to now feeling tired and drained.

[zfatherhen]

Perhaps an answer by example. I was first sent to a hematologist when my platelets were 750K at a normal physical. The hematologist just monitored my blood counts every 3 months until I reached 1M which took 3-1/2 years. From then on the goal was always to keep it below 600K. I'm sure the doctor would consider other risk factors based on your history and health which might put you at risk of blood clots and change the treatment based on that.