TOPIC: Supplements -The Ketogenic Diet and HCV Viral Load

I was sent a link to this which is about GS-5816 (Velpatasvir) treatment but also has an interesting observation about the impact of the ketogenic diet on viral load levels.

hopefulgeranium.blogspot.com.au/2014/03/...se-iii-trial-of.html

There is more about it here:

hopefulgeranium.blogspot.com.au/

And this is also interesting:

www.ncbi.nlm.nih.gov/pmc/articles/PMC3504385/

Various nutrients have lately been identified to be associated with suppression or promotion of HCV proliferation and attract considerable notice [45]. It is known that  β-carotene, vitamin D, linoleic acid, arachidonic acid, eicosapentaenoic acid, docosahexaenoic acid, iron, and zinc have suppressive effects, while retinol, vitamin E, vitamin K, vitamin C, cholesterol, and selenium have promoting effects on HCV proliferation. For example, when the serum concentration of vitamin D was maintained at 32 ng/mL or more by daily administration of 2,000 IU vitamin D3, the antiviral effect of IFN-based treatment in CHC patients was markedly improved [46]. There is a fair possibility that a shortage of PUFA intake worsens the antiviral effect of IFN-based treatment in CHC patients [47]. Also, in an in vitro study, HCV proliferation was markedly suppressed by treatment with PUFAs, such as arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid [48, 49]. Additionally, it has been reported that  β-carotene-containing food and herbal food show an adjuvant effect for IFN-based antiviral therapy [50, 51]. Accordingly, these nutrients are expected to be used as adjuvants in antiviral therapy for patients with HCV infection.

Thx Dr F, much interesting reading.

Re 1st link I notice the patient appears to have continued to take Magnesium during tx. After looking at the whole picture when diagnosed with a holistic view to all my personal symptoms, I started on : Alpha Lipoic Acid (as mentioned before in another post), Magnesium, Vit D & Vit B12 (the latter 2 also discussed in another post).

I applied my thinking with a chart of symptoms and which suppliments were recommended after much reading. Then deleted the ones which were not recommended for liver desease. Magnesium came up in all my symptoms so I started on a course of quality Mag . Symptoms eased considerably. (I am aware that it needs to be a certain type of Magnesium which the name of which I forget at this moment in time) .

I told my (then ) liver consultant, (who is one if the top leading Professors of liver desease in the world) about the Mag & he said 'I doubt very much the Magnesium is making any difference' . I am convinced it did, especially for joint pain but does it help with the HepC ? and would it be ok to take while on treatment if I feel necessary?

The article is quite technical for my brain-fog & recollecting names. A simple synopsis would be great!
Have stopped taking Mag currently,
Also, is this person saying a low carb diet definitely helps and would that apply to all or just some?
I also notice much reference to fatty liver etc - which I personally don't have. I had to up my carb intake, as proteins / 'good' fat just weren't cutting it, weight wise.

I guess the 'one size does not fit all' thing appears again? but there are staples that there is evidence of benefits, The question is, 'Is it your opinion that Magnesium can help' ? I would think re metabolism, the majority of HepC patients are in the 'trying to avoid fatty liver' side of things, most literature is aimed at this, but we have a few 'skinnies' on here with the opposite and ss you know my Triglycerides are way too low.
Sorry for long post, but I find this most interesting

(edit) I'll come back in 6 months after I've read the rest

Thanks Dr Freeman, I also find it interesting read but much is a little above my head. Curious about the Mg and Zinc and if these are ok to take during tx? I am a light weight also LG at about 52kg. I have eaten a low carb, high protein, lots of veggies and greens type of diet for a long time but still had a fatty liver and some inflammation. All other labs were normal and VL low. I have taken lots of supplements over the years and have now stopped all but B12 and D and should be starting tx soon as I am awaiting arrival of meds. So Mg,Zinc yes or no?

CC2B -Thx for that. I eat a similar diet to you, but since re-introducing more carbs I've gained much needed weight.
However, it is in the way of wholemeal bread & pasta, organic potatoes & with lots of veggies.
It's cold outside !

Going to tackle the next bit of reading now, wish me luck

I Have used many foods and supplements including whey and colostrum containing lactoferrin but they have small impact on HCV viral load.

I believe only in sofosbuvir .

Just got my Vit B12 result and it is 398 ng/l. The normal range starts from >182. I will possibly stick to my plans and take B complex twice a week.
Still waiting for the Vit D result.

Dan,
I have that B12 350 too, it is normal. I prefer to eat some meat rather than supplements

Hi all,

While I agree that a good diet should supply sufficient vitamins for most people, we need to keep in mind that most of us have had chronic HCV for long periods and our diets and digestive processes may have been impacted by that. Having had bloods taken recently to test my B12 & D levels I went looking for information on what was optimum for B12 (Dr James had already provided the link that suggests Vit D levels greater than 30 ng/mL (75 nmol/L) during treatment). Anyway, I found this link, which seems a fairly reputable source for what are good levels of B12. So it seems 200-900 pg/mL is considered normal range. But interesting to read: "Older adults with vitamin B12 levels between 200 and 500 pg/mL may also have symptoms" of deficiency. I'll leave it up to each of you to decide whether you qualify as old.

www.nlm.nih.gov/medlineplus/ency/article/003705.htm

Once I get test results back I will be supplementing if my results are below 30 ng/mL for vit D and 500 pg/mL for B12. At least until end of treatment. YMMV.

That is interesting Gaj. I didn't know the top normal range. Looks like I need to take it more often then .

I should get Vit D result tomorrow.

Just came back from getting my test results with B12 at 582 pmol/L so that looks reasonable given I only started supplementing at low levels about three weeks ago so will boost that a little till end of Tx at least.

OTOH vitamin D was only 32 nmol/L (13 ng/mL) so far too low despite what should be an adequate diet and sunlight.
My GP has recommended a high initial daily supplement to get me back in range then tapering off over time.

Also got LFT some of which can be seen in my sig. At the very top of the normal range so not as good as some on here but the overall summary for all results has changed from "consistent with active" to "consistent with mild" hepatocellular damage. Can't complain too much considering the lump of old boot leather I started the Tx with.

So what is a good diet to have?

Lately, I've been having carrot juices, beta carotene seems to suppress anti viral treatment along with pumpkin, spinach and sweet potato.
Also iron...no more beef for a while?
No nuts, seeds?
Should I take Vit B12 and Vit d on treatment?
Thankyou for any advice

Hello hope it goes well for you Magpie. I am confused what to eat - I have some chicken thighs (nice lean chicken) and was going to add turmeric, cumin, paprika, ...I am adhering to a 'prevent gastric reflux' diet which has quite a list of foods to avoid, eg tea coffee tomatoes, broccoli [cabbage family] onion family, chocolate, [of course alcohol] citrus fruits, and more. I though sweet potato / orange yam was fine and spinach, that probably means the ones you cook that has oxalic acid in it.
I am pretty keen to settle my issue naturally and avoid taking Somac a PPI, and sleep semi upright with a comfy pillow arm chair style arrangment. So far since implementing these strategies plus try to stay calm it has worked.
It would be good to know what other choose to eat to maximise the meds kicking the HCV out of the body. Cheers Anne

Hi Magpie & Anna,

This thread started about ketogenic diet which is a form of Atken or high fat/low carb diet as possibly being beneficial for those with HCV. It then got sidetracked to vitamins which I was responding to, so my bad.

I take the view that a good, balanced diet consists of basically the recommended five food groups pyramid but with emphasis toward veggies and fruit and maybe a bit less carbs than often suggested. So meat, white and red, fish, seafood, nuts, dairy, eggs, whole grain carbs, fruit, veggies, etc. not necessarily in that order and a bit of each in moderation. I like fresh and I'm not a big fan of concentrated smoothie or protein drinks etc. please note I'm no nutritionist, it's just what seems to work for me. .......ohhh! and since starting treatment pizza!

Edit: my diet was more restricted pretreatment when I found I had problems digesting fats and large serves of protein or anything spicy, much of that has now resolved. I also eat very little processed sugars or added salt.

For supplements there is evidence that vitamin D and B12 were important for success under the old interferon treatments although little research has been done on these new DAAs they are probably beneficial which is why I got mine checked. See below link for all things supplements.

fixhepc.com/forum/supplements.html

It is also important to be aware of potential drug and food/spice interactions with these DAAs. Don't over worry it as most things are fine but it pays to check any prescription or over the counter drugs, strong herbs and spices and things like grapefruit and pawpaw. The latter two are no go with Daclatasvir but okay if you are on Ledipasvir. See below for interaction info:

fixhepc.com/forum/drug-interactions.html

Any questions that you can't find answers for, ask away and someone should be able to help.

Gaj wrote: Thanks Gaj!
My tests came 10 days ago. It shows for vit B12 204 pg/mL (190-980) and vit D 34.2 ng/ml (30-100). Low but in normal range.
I started to take B12 and D vitamins in the second half of the tx.
Hoping to be finally on the row with the others UND before ending the tx.

Your ALT/AST dropped every time you tested. Good sign! You are half tx, right?
I wish you all the best and only UND!