Cytoreductive agents like HU will generally reduce all three types of blood cells to varying degrees. The other first-line treatment for ET is Pegasys. While you might respond better to PEG than HU, there is currently a PEG shortage so you may not be able to switch. PEG also lowers WBCs. The other option for treating ET is anagrelide, which more specifically targets platelets; however, anagrelide is harder to tolerate for many people.
You have a complex case with overlapping conditions that likely impact each other. The rising ESR might be related to HU somehow triggering inflammation but could just as easily be due to other changes in your body. This is going to be difficult to sort out. We discussed consulting an Integrative or Functional medicine doctor previously. Suggest a fresh perspective on your case could be very helpful.
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