While stress may not be a widely recognized or well documented cause of reactive thrombocytosis in MPNs, there is plenty of anecdotal evidence that it can be a factor. There is a theoretical basis for this hypothesis.

Stress activates the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to the release of catecholamines, causing a transient rise in platelet count. In addition, stress causes an elevation of inflammatory cytokines which can stimulate thrombopoiesis (platelet production) in people with MPNs, where the marrow is already abnormally active. There is also an additional increased thrombotic risk as stress can heighten platelet activation and aggregation, even if absolute platelet numbers don't spike dramatically.

It is also correct that infection, injury, inflammation, and bleeding events can cause reactive thrombocytosis. Platelets can rise by as much as 100K in a single day based on what is going on in the body, This is normal bodily function that has different implications for someone with preexisting thrombocytosis.

Stress, particularly unmanaged stress, can have very negative impact on the body, including cardiovascular risks. In the context of a MPN, this is even more significant. Managing tress is critical in managing a MPN,

Wishing you all the best.

I believe that, too, from my own experiences. Stress, and particularly extreme stress, has a devastating effect on our bodies.

Everyone is different and our body responds in different ways. For some it can be stress for others (like myself) it could be a slight cold or cough. I do know that our immune systems are very fragile and anything can cause our platelets to go up. The only thing we can do is not to ignore our body when it’s trying to tell us something.

Stress is ET
ET is stress

Thanks, Steve. I wasn't aware of the info in your post. Just had my own anecdotal evidence plus what my oncologist/MPN specialist said, which is that stress definitely influences platelet level. Good luck to all of us! Wish we all could live a life free of MPN's and of stress. Luckily there are many other things we can enjoy in our lives. I currently do informal piano shows, often for dementia patients. Simply having our minds intact is a big deal!