I am 5 weeks into Sovaldi/Ribavirin treatment and all is going very well. I have been undetected since week two and I feel fine. I am cross country skiing in the Vermont mountains 3-4 times a week and feel good, maybe a little off but then I have been skiing quite a bit lately. I was out yesterday with a bunch of guys 10-20 years younger than me and I was the one waiting at the top of the climbs. The nurse practitioner at the hepatology department said I should exercise all I want. The nurse who calls me every two weeks from the specialty pharmacy called today and said I should be vigilant because if I become anemic I wouldn’t want to stress my heart muscle. I had an echocardiogram two weeks prior to starting treatment and was given a clean bill of health. I have always been active so skiing this much is not new to me. My hemoglobin went from 15.5 at baseline to 14.1 at 2 weeks to 13.8 at 4 weeks. 13.7 is the upper limit of anemia so I am close. I have read that hemoglobin tends to level off by 4 weeks. So I am wondering if I should be cutting back on the exercise or if I should continue. It seems to me I would feel winded and weak if there was a problem. If that did happen I would of course stop immediately. Anybody have an opinion?  I am not due for another blood draw for three weeks.

Reply by a medico
As long as you feel well enough and have no other medical restrictions you should stay as active as you can.
Anemia is hemoglobin <10 g/dL. You are not close to being anemic.
Anemia is a condition in which the body does not have enough healthy red blood cells to supply oxygen to body tissues. The symptoms of low hemoglobin and anemia are fatigue and loss of energy which can be combined with shortness of breath. So some people can feel a lack of energy as their hemoglobin get lower. They don't have to be technically anemic.
Since you are not taking peg-interferon you only have a small chance of becoming anemic taking treatment.
In the trials 650 subjects received SOVALDI + ribavirin (RBV) combination therapy for 12 weeks. 250 subjects who received SOVALDI + ribavirin combination therapy for 24 weeks.
Data from the Sovaldi/Ribavirin clinical trials showed only 8% became  <10 g/dL while treating for 12 weeks. 6% became  <10 g/dL while treating for 24 weeks and
The most common adverse events (≥ 20%) for SOVALDI + ribavirin combination therapy were Fatigue and Headache. NOT anemia. Anemia was the 6th most common side effect after Insomnia and then Pruritus (itching).