Headaches + fatigue

[Micky1956]

I too get headaches over my right eye. I have been taking hydroxycarbamide + aspirin for the last 6 weeks and they have reduced these bouts, but not totally. I have a bone marrow biopsy tomorrow to access the extent of my MPN and how they will go forward with treatment. I find that when I get to a certain time of day I feel the need for a sleep due to fatigue, irrelevant of whether I have done anything or not

[hunter5582]

This sounds like classic MPN symptoms. Assuming the headaches and fatigue predate the hydroxycarbamide, it is reasonable to look at the MPN as the cause.

The headaches are likely a microvascular issue caused by the abnormal behavior of blood cells. If you experience erythrocytosis, then hyperviscosity can also be a problem. There are things that can be done to help with the headaches. Sometimes it is as simple as aspirin 2x/day instead of once/day. Treating the headaches is something to discuss with a MPN Specialist for a case-specific treatment plan.

You noted that you also experience bruising on your profile. One of the peculiarities of thrombocytosis is that there is risk both of thrombosis and hemorrhage. While there is not a linear relationship between your platelet levels and risk of thrombosis, there is a linear relationship with hemorrhage risk. The higher the platelets, the greater the risk of bleeding/bruising. While protecting from risk of thrombosis, aspirin can exacerbate the risk of hemorrhage, particularly in people age > 65. Reducing platelet levels will likely help with this issue. Your MPN Specialist can do the best job evaluating this issue in your case.

Fatigue is the most common MPN constitutional symptom. The reasons are complex and multifaceted. One part of the issue is systemic inflammation due to overproduction of inflammatory cytokines and metabolic changes. Some people do find relief with cytoreductive medications; however, these medication can have fatigue as a side effect. We each respond differently to the treatment options. You MPN care team can help you review interventions that may help. Here is some information on managing fatigue.

mpnvoice.org.uk/living-with...

powerfulpatients.org/2023/1...

mympnteam.com/resources/man...

youtube.com/watch?v=lGVvbTc...(Not working as expected?)

Please do let us know what you learn and how you get on.

[Micky1956 in reply to hunter5582]

Thanks for your reply. This forum is so useful to fellow MPN sufferers. I will update.

[Anouchka]

Have they specified your MPN, Micky1956? I have PV and the fatigue and afternoons of feeling nauseous after taking my aspirin dosis is the worst of my side effects. Hope your BM test gives you more clarification. Good luck

[Micky1956 in reply to Anouchka]

Not yet. I get the results in 1-2 weeks. Hopefully its ET and contollable. Best wishes to you.

[Yarnhabit]

I have ET and the symptoms you mention, because I am under 60 I am only taking the aspirin. I hope you get the answers you need and please do update. I am awaiting my BMB results to inform future treatment too, all information is greatly received. Hunter is excellent in his advice.