emo Supplements with evidence

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6 years 7 months ago #6874

Great, with evidence too - Thank-you Dr F .


GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

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6 years 7 months ago #6896

I had always a problem with the cholesterol, since my 20s . High cholesterol. :ohmy:
This means that it is harder to treat hep C because I 'offer' more transportation for viruses? :woohoo: :)
Thanks! :lol:


HCV since I don't know. Diagnosed in 2010.
GT1b, F0/F1, VL 9M, ALT 44, AST 42, Tx naive,
started 12 wks Twinvir on 06.12.2015. Feeling great and grateful :)
virus not detected 06.02.2016 & SVR24
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Last Edit: 6 years 7 months ago by isaing4.
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6 years 7 months ago #6928

This is fascinating. I've just started Sof/Dac treatment and I've been considering taking ALA as I'm concerned that as well as the virus I may have Post-Interferon Syndrome, and there is apparently evidence that ALA can help with this. However I'm worried about taking any supplements due to possible interaction with Daclatasvir. Is ALA safe to take with Dac?

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6 years 7 months ago #6933

Hi Phoenix,

I have not been a big believer in supplements figuring that if you are fit and well and eat a balanced, varied diet you should get all you need from that without requiring extras. However, recent reading such as the doc's musings above along with further research has me pondering the facts that I am fast approaching the big six-ohh and have probably had chronic hep c for 2/3 of that period! Apparently neither are ideal for helping to extract all the nutrients you need from even the best diet. So I'm taking myself off to my GP for some diagnostics to see where I am lacking and will be giving serious consideration to supplements such as B-complex (+ extra B12?), Betaine, SAMe and now ALA.
For your question, the post above and the references quoted in it don't seem to give any concern of a likely interaction between these items and Dac or Sof. Hope this helps.

<edit> and now vitamin D as well. :)


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:
Last Edit: 6 years 7 months ago by Gaj.

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6 years 7 months ago #6935

How about N-Acetyl Cysteine (NAC)?
It is also a glutathione precursor.
I stopped taking it a while back when I didn't notice any improvement but now that I'm on Twinvir it might help.
I've still got several large unexpired bottles


GT1 F4 compensated, I/F non-responder 1997
@2015-11-06 VL 3.5 x 10^6, started Twinvir
@2015-12-31 VL:UND
@2016-01-29 started 2nd 12 weeks of Twinvir
@2016-03-01 ALT=42 AST=42, other LFT in normal range

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6 years 7 months ago #6942

How about N-Acetyl Cysteine (NAC)?

Hi Tim,

Yes and No.

Theoretically it should do a similar job to ALA, SAMe, and Betaine (and it's worth considering you almost certainly don't need all of these given the final common pathway).

www.hepatitiscentral.com/news/hcv_and_the_bod/

But practically:

  1. NAC tends to make people feel sick
  2. NAC does not seem to help much


www.ncbi.nlm.nih.gov/pmc/articles/PMC3953807/

However this article did dig up Vitamin D which seems to be usefully active.

www.ncbi.nlm.nih.gov/pubmed/21145801

hepatitiscnewdrugresearch.com/vitamin-d-and-treatment.html

I will edit the original post to include Vit D but not NAC because of the lack of evidence it helps SVR.


YMMV
Last Edit: 6 years 7 months ago by DrJames. Reason: Typo
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6 years 7 months ago #6985

Hi Dr F, This post is most helpful indeed.

A question, if you have time?

A good friend is on harvoni, one failed Interferon/Riba prev. tx which has left her with long term health problems .

Does this info apply to those on Riba too?
She has appointment with her UK consultant tomorrow & is suffering low red blood cells.
She will be asking her medical teams advise tomorrow.

Many thanks in advance & best wishes.


GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
Last Edit: 6 years 7 months ago by LondonGirl.

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6 years 7 months ago #6993

Pretty much all the supplements data relates to Interferon+Riba treatment and is being extrapolated into the age of DAAs.

The jury is still out as to their utility with DAAs, but unless we get a 100% pan genotypic combo I would be thinking about normalising LDL cholesterol with a statin and making sure my B12 and vitamin D were high normal. I would probably take an antioxidant too.

But that's just me and YMMV.


YMMV
Last Edit: 6 years 7 months ago by DrJames.
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6 years 7 months ago #6997

Thank you Dr. James,
I'll check for B12. I already know that I have vit D deficit.
My LDL is 149 mg/dL - borderline 130-160 mg/dL
I'll check with my doctor for statin.

But if I understand correctly, statin & B12 supplement & vit D supplement & antioxidant only end of treatment, after 12 weeks of Twinvir.
Am I right?
Thanks! :lol:


HCV since I don't know. Diagnosed in 2010.
GT1b, F0/F1, VL 9M, ALT 44, AST 42, Tx naive,
started 12 wks Twinvir on 06.12.2015. Feeling great and grateful :)
virus not detected 06.02.2016 & SVR24
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6 years 7 months ago #6998

Hi isaing, I 'think' the B12 article says it could 'aid' SVR - but trial was for Int/Riba ?
so not much literal evidence for DDAs as yet, but Dr F would personally recommend
(hopefully I have got this right!)


GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
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6 years 7 months ago #6999

Hi LondonGirl,
I know that B12 and vit D supplements were studied for IFN / RIBA.
But where is a deficiency probable is worth taking supplements/vitamins.

My question comes from mentioning aid for SVR and RVR.
So, taking B12 & vit D& statin & antioxidant AFTER and/ or DURING treatment with DAAs. :unsure:
Thanks again!
:cheer:


HCV since I don't know. Diagnosed in 2010.
GT1b, F0/F1, VL 9M, ALT 44, AST 42, Tx naive,
started 12 wks Twinvir on 06.12.2015. Feeling great and grateful :)
virus not detected 06.02.2016 & SVR24
This email address is being protected from spambots. You need JavaScript enabled to view it.
Last Edit: 6 years 7 months ago by isaing4.

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6 years 7 months ago #7000

And we know that B12 helps with RVR and SVR
www.ncbi.nlm.nih.gov/pubmed/22810757

but the above was a trial on Int/Riba tx - hence :
The jury is still out as to their utility with DAAs, but unless we get a 100% pan genotypic combo I would be thinking about normalising LDL cholesterol with a statin and making sure my B12 and vitamin D were high normal. I would probably take an antioxidant too.


GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
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6 years 7 months ago #7007

I started to take B12 twice a week, but 4 hours after the Twinvir tablet.


Gen 1b, F1-F2. Naive.
Started Twinvir tx on 2 nd of December 2015 for 12 weeks.
Starting VL 400000, Alt 49/AST 44
1 week VL 29, ALT 44/AST 30.
4 weeks VL 12, ALT 33, Platelets 145, all other tests normal.
7 weeks VL Detected, ALT 28, all other normal
8 weeks UND, 12 week UND, 24 week SVR UND
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6 years 7 months ago #7010

Thank you LondonGirl and Dan,
I avoid all supplements, vitamins and other medication because I am afraid of unknown interactions with Twinvir. :woohoo:
I don't know, maybe is wise after finishing the treatment to consider the all four:
B12 and vit D if there is a deficiency.
Antioxidant] like ALA and statin for ''bad'' LDL cholesterol.

:lol:


HCV since I don't know. Diagnosed in 2010.
GT1b, F0/F1, VL 9M, ALT 44, AST 42, Tx naive,
started 12 wks Twinvir on 06.12.2015. Feeling great and grateful :)
virus not detected 06.02.2016 & SVR24
This email address is being protected from spambots. You need JavaScript enabled to view it.
Last Edit: 6 years 7 months ago by isaing4.

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6 years 7 months ago #7011

Hi All,

I think there are a couple of points here:

1.) Most of the data currently available is for old Interferon treatments which is understandable due to short period that DAAs have been in use. But what we do know from that old data is that people with hep c tend to be deficient in B12 and D vitamins, even more so in those in the over 50s age group when our bodies become less efficient at extracting/manufacturing them from our normal diet. But we also need to remember that interferon is not some drug from outer space that our bodies have never seen before. We naturally produce our own similar interferon chemicals to boost our immune systems, see link.

en.m.wikipedia.org/wiki/Interferon

What we refer to as interferon treatment is the addition of extra artificial interferon to try and compensate for/trigger extra immune response to fight the virus. So boosting B12 and D should still assist our natural interferon to fight the virus. The ALA, Betaine, SAMe, etc and the rest of B group complex are part of the process of converting/using B12. So ensuring that we have sufficient of each of these should assist our bodies in absorbing enough B12 to support both the fight and healing process. In other words, while the DAAs kill the virus, our bodies need to efficiently dispose of those dead virus and then heal the damage they caused.

2.) RVR is at the start of treatment and SVR is the hoped for result after treatment. You could also include another Viral Response group in there and maybe call it MVR (Maintained Viral Response or continuing UNDetected readings after RVR and before SVR) So the whole process of treatment and then waiting for confirmation at SVR12/24 needs to be supported by maintaining good B12 and vit D levels throughout the whole period.

In other words maintaining B12 and D levels, and the other things that support that process, at upper normal range throughout treatment should be beneficial when using DAAs just by not starving our bodies of the required nutrients even though it hasn't been proved in trial yet.

The above is my understanding in simplified terms as best I can describe so if any scientists/medicos out there spot any basic errors please feel free to correct my admittedly laymans understanding.


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:
Last Edit: 6 years 7 months ago by Gaj.
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