Anyone notice when we are most fatigued?

I have cyclic thrombocytopenia, so a bit different than everyone else, but, I'm wondering what people think of the fatigue of ITP or what people would guess would be most tiring with the cyclic form.

I know there have been times when I'm really feeling great when the platelets are dropping towards say 10. And I know I've been tired after the nadir and the platelets are rising quickly.

So I'm wondering if the biggest strain on the body is actually when my platelets go from 5 to 400 in 10 days. Maybe it is physically demanding for the body to produce platelets. Not sure, since I haven't paid enough attention thus far. This is probably not what people think would be the case... But it could be the case.

My count tends to fluctuate pretty dramatically, most recently from 15 to 1,064 to 2 in the course of 4 weeks- I was being treated with the TPO agents and sometimes my body overreacts. Anyway yes, when things are swinging dramatically it doesn’t seem to matter if they’re shooting up or plummeting down, I’m exhausted. Whether for good or evil, my marrow is working really hard and IMO that’s just draining. For me at least, maybe for you too.