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Shakes (SofDac) 8 years 2 weeks ago #12715

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Hi all.
I completed three months of Sofdac and I am undetected at six weeks post treatment. I am now due for my twelve weeks check up. I'm sure it will go well but I have a problem that doesn't seem to go away.

I started treatment at 54kg and during the course I lost weight and now weigh 48.5kg. I can not seem to put on the kilos that I lost, despite trying to eat eat and eat. I went to my doctor and tested for sugar issues and am approaching the diabetic stage but he said I'm not having sugar issues.

At the tenth week I began to develop the shakes. I also feel very weak. It seemed worse when hungry but I wasn't real sure about that..... I thought it was actually getting better by the seventh week post treatment. I am still very weak and shaky most of the time and I'm getting quite concerned. I do not seem to be handling stress either. When stressed the other day, by an untrue accusation someone made, I began to shake worse than ever. I have never had this issue before and in fact I have a reputation for being cold as ice under pressure. I play competition eight ball and when I get serious against top players I am shaking. I feel empty, even when full.

I'm wondering if there are any other cases similar to mine.
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015
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Shakes (SofDac) 8 years 2 weeks ago #12719

I am type 2 diabetic and it sounds a lot like what happens when your blood sugars get too low. This can be hard to find at a routine blood sugar test. Do you feel like that you need to eat to clear the shakes? Is that what your instincts tell you? You can buy inexpensively a testing kit and check your sugars while you have the shakes. If they are too low you have your answer. If that turns out to be the case, eat a tablespoon of honey or sugar and wait 15 minutes and see if it gets better. Sometime within an hour after taking the honey/sugar you should have a normal meal. Hypoglycemia is a nasty feeling. Shaky, anxious, inability to concentrate and a strong desire to eat something sweet. Very manageable however...
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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Shakes (SofDac) 8 years 2 weeks ago #12721

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Thanks for that answer. Yes, I do feel like I need food, often even after eating. I will try the honey and get a test kit. Much appreciated. It seems like a sugar issue to me as well. I am investigating it further with my doctor. If I tense myself up I can feel the vibration at all times. I love sweet food.
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

Shakes (SofDac) 8 years 2 weeks ago #12722

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While not discounting the possibility, most people's experience on these meds is that they gain weight and feel calmer. I agree with Ken about checking the hypoglycaemia angle, particularly as your doctor already says you are approaching diabetes.
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
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Shakes (SofDac) 8 years 2 weeks ago #12727

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A quick follow up question Ken.
What are the management strategies?
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

Shakes (SofDac) 8 years 2 weeks ago #12754

Eat more regularly and smaller meals. If you feel a sugar low only take about 15 grams of "fast acting" carbs. (sugar honey, glucose pills) . Meals themselves should have carbs with a slower glycemic punch (lower glycemic index). About 45 grams of carbs per meal. You can google which foods have a lower glycemic index. Stress ,as well as exercize, almost always guarantee a sugar crash for me.
Eating too many sweets or stuff with sugar in it will make your blood sugars spike. They will roller coaster. Go up too high and then come down too low. If you are prediabetic, not watching what kinds of carbs you are eating can turn it into diabetes in a hurry. Check it out! Buy a kit and prick your finger when you feel the shakes...
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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Shakes (SofDac) 8 years 2 weeks ago #12759

BTW, one thing i have never experienced is the shaking remaining after my sugars are back up to normal. That, to my understanding of hypoglicemia, is odd.
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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Shakes (SofDac) 8 years 2 weeks ago #12773

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Well Johnboy, I certainly hope you get this sorted by your Doc. I'm in week 9 of Sof/Dac and have been very unwell for several weeks, extreme fatigue, weakness, dizziness etc as well as exacerbation of pre-tx symptoms. I've just had bloods done Dr James wants to check levels everything including looking at diabetes. One thing I've noticed during Tx is a craving for sugar - I don't normally like sweets, 2 biscuits or 2 chocolates at a time is usually my limit.
I'm experiencing a type of weakness, unsteadiness - wonder if it's like your 'shakes' - i'm going to test what Ken has suggested with having some honey or sweet and see if there's a change.


Good luck and I hope you do find out what's happening :) #flower
QLD Australia ☀️
G3a HCV 35 yrs Tx naive
Started Sof/Dac 13/01/16

Dec '15
AST 70
ALT 89
GGT 124
Fibroscore 8.5
F1-F2
13 Feb'16 VL UND #woohoo!
AST 24
ALT 26
GGT 50H
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Shakes (SofDac) 8 years 2 weeks ago #12775

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Thanks for the responses peoples!

I figured it was my very light weight which was making me crook during treatment. The first few and last few weeks were very difficult. The middle section was fine. The shakes only came from week ten but I did notice a small nervy shake once or twice in a couple of big games around five weeks in. The last two weeks were very hard.... I dreaded taking the pills and have to admit to halving my dose a few times and/or spreading it out to 30+ hours. I don't like to make that public really but there you go.

I was a very easy case as far as VL and LFT numbers were concerned and I cleared at 21 days, so I took a punt on the dose being enough for my 48kg body after ten weeks, when I was getting bad. I really felt like I was overdosing.

I certainly feel a hell of a lot better despite the weakness and shakes. They are not there all the time and I'm pretty sure, after chatting here and talking to family that I am close to diabetic. The clarity I have now is fantastic.
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015
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Shakes (SofDac) 8 years 2 weeks ago #12793

Hey Chejai,
before you just start taking honey or sugar you should test your blood sugar with one of those little kits they sell. If your blood sugar reading comes out normal the honey or sugar won't help anything, if they are too low it will help a lot. If they are on the high side you shouldn't take any honey or sugar at all...
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL
8 weeks tx ALT 29/ AST 34. VL UND
4 weeks after tx UND. SVR4. ALT 24/AST 18
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Shakes (SofDac) 8 years 2 weeks ago #12796

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You guys are being very helpful, thank you.

My sister tells me that because I juice a litre every day....... Carrots apples and celery, that I am doing myself an injustice . I thought I was doing a very good thing. time for a re-think and a better load of fibre from different veggies too.
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

Shakes (SofDac) 8 years 2 weeks ago #12798

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Hi Johnboy,
"My sister tells me that because I juice a litre every day....... Carrots apples and celery, that I am doing myself an injustice . I thought I was doing a very good thing. time for a re-think and a better load of fibre from different veggies too.'

So, why does she think you're doing the wrong thing here? Juicing is very good for you and your liver - obviously depends on combo - but what you've listed are great! You're hydrating, you're getting fibre (less because you remove the pulp), concentrated vitamins and minerals in an easily digestible form. Fruit/veg contain 2 types of fibre -

"Insoluble fiber adds bulk to the stool, helps to keep the bowels regular, fills you up and speeds up the passage of food through the digestive tract. Insoluble fiber include cellulose, hemicellulose and lignins. This is mostly removed from the juice although it is still present in smaller amounts.

Soluble fiber absorbs water like a sponge and provides bulking matter that acts as a prebiotic to support good bacterial growth and digestive health. It also regulates blood sugar control, may lower blood cholesterol and slows the transit of food through the digestive tract and helps fill you up. Soluble fibers include pectins, gums and mucilage. This is still present in the juice."
Also Note -
"When you remove the insoluble fiber and are left with the fluid part of the fruits and vegetables, it allows easier assimilation and absorption of the vitamins, minerals and other important phytonutrients across the digestive tract. Insoluble fiber slows down the absorption of many micronutrients, so basically juicing is fast tracking our nutrients.

The body requires very little effort to absorb these nutrients in juice when insoluble fiber is removed. This can be very beneficial in cases where people are convalescing, suffering with an illness, fatigued, stressed, suffering with a digestive disorder or any other condition that may affect their ability to absorb nutrients and digest their food."

Here's a link for this article www.rebootwithjoe.com/the-facts-on-fiber-juice/

I say Good For You on Your Juicing - apparently 'blending' keeps both forms of fibre - either way it's all Good! As long as you are balancing your diet with proteins and fats etc.

Good Luck on your journey to Good Health and Healing :) #love #flower

BTW, Kenbadsman thanks for your clarification, I'm waiting on blood tests today; yesterday I nearly passed out several times and did grab 3 'fruit jellies', I improved a little until I could get something else into me, I'll wait to talk to Dr James.
All the best to you too :) #love #flower
QLD Australia ☀️
G3a HCV 35 yrs Tx naive
Started Sof/Dac 13/01/16

Dec '15
AST 70
ALT 89
GGT 124
Fibroscore 8.5
F1-F2
13 Feb'16 VL UND #woohoo!
AST 24
ALT 26
GGT 50H
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Shakes (SofDac) 8 years 2 weeks ago #12800

My VL went from 8 million to 37 million. I have never heard of it so high before. The only thing I can think of is I was on a 'juice only' diet. For 2 weeks. As soon as I stopped, VL went down again. I was doing a lot of kale, which is high in iron. Iron creates an environment rich for replication of Hep C virus. So I believe that is what happened. Be careful with excess ANYTHING.
This email address is being protected from spambots. You need JavaScript enabled to view it.

Genotype 3
VL 4,100,000
ALT 101 AST 71
Treatment Naive
Started Sof/Dac Jan 12, 2016
VL= <15 4 weeks in. AST/ALT normal.
VL=UNDETECTED 8 weeks in.
SVR4= Virus back. 3,300,000

Started generic Epclusa Sep. 23, 2017

4 weeks in <15 *Detected.
12 weeks in <15 *Not Detected.
16 weeks in <15 *Not Detected.
Finished 24 weeks treatment 3-17-18
SVR5 <15 Not Detected.
SVR 20 <15 Not Detected.
SVR 44 <15 Not Detected.

Thank you Jesus.
Thank you Dr. James
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Shakes (SofDac) 8 years 2 weeks ago #12804

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splitdog wrote: Be careful with excess ANYTHING.


Excellent advice splitdog!


I also wonder if large quantities of juiced or even blended fruits and veg gives our body a direct injection of concentrated sugars and vit C that it doesn't have to work too hard to extract? Apart from possibly causing spikes and dips in blood sugar, I believe high levels of both are thought to assist the HCV replication process too?
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:

Shakes (SofDac) 8 years 2 weeks ago #12807

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Apples and carrots are high in fructose. A litre of juice probably has as much sugar as a can of soft drink.
Moderation is the key.
M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia
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