TOPIC:

I am not finding a lot of my supplements on the chart for interactions. I stopped everything other than my prescription medications that I found on the chart.

I am not sure what to do because I would like to continue with my supplements but I don't want to take any chances of anything interfering with my treatment. thank you!

Hello Oregondaisy,

Yes, supplements don't appear on most interaction charts because it's impossible to know what's in most of them and what doses people are taking. There is no doubt that some will interact, and some won't but we don't know which ones.

On the general topic it's probably worth reading this:

sciencebasedmedicine.org/more-evidence-t...e-should-be-avoided/

While it's not true that 100% of supplements are 100% useless, it is basically true they represent 90% marketing on top of 10% fact - more hope than evidence if you like.

Most patients, taking most supplements, are either no better off, or actually worse off because of them.

There are exceptions, but most people need no more than clean air to breathe, clean water to drink, personal hygiene, and a good varied diet to eat to live a long and healthy life.

If you'd like to list your supplements and what benefits you expect from them, we can have a discussion about the pros and cons of each.

The main ones I want to continue taking are Collagen, Glucosamine /chondroitin and gelatin. I really feel that these have been helpful with my arthritis. My fingers used to lock up all the time and would be stuck and I couldn't bend them. Since I have taken these, this went away. My rheumatologist felt they would also be helpful with the pain in my knees.

My gastroenterologist put me on milk thistle years ago and I wondered if I should continue this since he felt it was helpful for my liver. I wondered if this is why my biopsies were all a number 1 when they rated them and they were done at 3 years after the diagnosis and then repeated 7 years after that. All 3 biopsies were the same.

Also, I feel I should continue my vitamins because of my sleeve gastrectomy, I don't absorb everything from food and my meals are very tiny. I take b12 and D

Hello Oregondaisy,

You're unusual in your supplements in that many of them (not all) have potential benefits or are clinically relevant to you.

Vitamin deficiency following sleeve gastrectomy is known so continuing your vitamins is both a good idea and won't impact treatment. A mutli B (not just B12) and vitamin D are best.

www.emjreviews.com/gastroenterology/arti...e-literature-review/

Milk thistle contains silymarin and there is some evidence it may help untreated patients

www.ncbi.nlm.nih.gov/pmc/articles/PMC4076489/

But, there is also some evidence it does not do anything much

nccih.nih.gov/research/results/spotlight/071812

While I suspect it should not interact, the best treatment for HCV related liver disease is to get rid of the HCV so stopping milk thistle during treatment avoids any worry of interaction. The major benefits are flowing from the DAAs. You can continue it after, but after treatment, you'll find your liver enzymes are normal and you can't get better than that - the cause is gone so...

In general, as far as your body is concerned, collagen and gelatin are just different forms of protein. They will be digested in your gut into their constituent amino acids and from there do no more, no less than eating a little chicken, red meat or fish. I'd rather have the real food myself, it's tastier and more natural.

That said, undenatured type II collagen (UC-II) is not intended to be used by your body as a collagen re-builder. In a process called oral tolerance, very small doses of UC-II are taken to train your body’s immune system to stop attacking its own collagen

Here is a vox pop on it:

blog.arthritis.org/living-with-arthritis...s-helpful-arthritis/

And here is a medical literature review suggesting a net benefit:

www.ncbi.nlm.nih.gov/pmc/articles/PMC4970562/

So UC-II in low dose would be a probable yes. It should not interact with DAAs.

With Chondroitin/Glucosamine there is some weak evidence they may help. I certainly have patients who say they benefit. Here is a review:

www.ncbi.nlm.nih.gov/pmc/articles/PMC5241539/

So I'd suggest that while on the treatment:

1. You should take the B complex + Vitamin D and it won't interact.
2. I'd skip the Milk Thistle for now and don't think there is going to be a reason for it after.
3. General collagen and gelatin are no better than fish/meat based food which is natural and tastier.
4. UC-II collagen at low dose may be useful and won't interact.
5. The chondoitin/glucosamine are fine to continue, probably beneficial and won't interact.

Thank you very, very much! I was hoping this would be the case and I thought there would be no reason to continue the milk thistle anyway.

i am very excited that there is a good chance I will be cured! You are so wonderful!

Very good information Dr James, thanks for that. Best of luck Oregondaisy, looking forward to hearing excellent news from you in a few months.

One more thing I forgot to ask about was calcium. I was instructed when I had my sleeve gastrectomy to have 1500 mg of calcium citrate per day.

Is this okay during treatment?

thank you again! I hope it is because I've been taking it and totally forgot about it as a supplement.

What medication are you taking?

I am taking generic Harvoni and Daclatasvir

Ah yes, I remember. You have to take a proton pump inhibitor. You can take the calcium but not at the same time as the medication.

thank you so much! I really appreciate all of your help throughout this process!

This response helped me as well! Thank you!

Welcome to the forum Hopeful425!

The executive summary is that for Hep C the best "supplements" are direct acting antivirals. The perform magic.