With Epclusa, the problem to hand is that it is not very well absorbed and a high fat meal improves that so while the official line is that it can be taken with or without food, I suggest with a meal with some fat in it.
2) While many patients with Hep C do take liver supplements (nd were likely included in the trials) formal testing of drug interactions with almost all the supplements you list has NOT been done.
3) While most people think of a tablet of (say) vitamin C as being a vitamin C supplement it also typically contains half a dozen other ingredients that turn the API (vitamin C) into the tablet.
My suggestion would be to leave the supplements alone for the duration of your treatment. In order of “known not to be a problem”
DHEA is part of the steroid axis, and although it is not specifically listed at the Liverpool interactions checker https://www.hep-druginteractions.org/checker we can see things like female HRT (oestrogens and progestogens) and cortisols do not interact. In addition, you would probably start to miss this after 3 months
Milk thistle contains silymarin and is helpful in liver disease. If the liver disease is cause by Hep C then any of the new DAA Rx are MORE helpful but plenty of my patients took it during their Rx with no problem. Note that after patients liver function numbers come back to normal on treatment the logic for it evaporates
Whey protein
Vitamin C
VMultivitamin
Now let’s look at some of the things that you might like to consider, both short and long term.
With Vitamin D there is a simple blood test. If you are not deficient you don’t need it. If you are deficient you may like to consider sunshine for its side effects…
Colostrum
I encourage new mothers to breastfeed. That gives their newborn children what nature intended, but that said…
Nature did not really intend for humans to consume cow’s milk – it was designed for baby cows. Are cow antibodies likely to be useful for you? Cow growth factors? …
Colostrum is a liquid and contains live cells as well as other proteins that will not survive spray drying so (and this is probably a good thing) people consuming colostrum are not getting the fresh product, they are getting the “processed food variety”.
I’m none of paleo, vegan or vegetarian so quite happy to eat my yoghurt and cheese. That’s a taste/protein thing rather than a health thing.
In general
In general, a diet that has variety will almost invariably everything needed for good health – supplements are marketed but are not required.
The story of Fish Oil
Fish oil is not a health food. It’s probably toxic, but here is how it enters the zeitgiest.
In the decades after WWII it is noticed that Japanese living in Japan have less heart attacks and strokes then genetically related Japanese living in the USA.
Why? Theory – it is the diet. Ah ha, what is different. Ah ha, fish vs McDonald’s. Ah ha, what is in fish? Ah ha oil!
If you’ve ever been to Japan, and stayed in a hotel, and visited the breakfast buffet, you might have noticed that ~ 90% of all the food on the Japanese side is more or less unrecognisable to Western eyes ie the Japanese diet differs in almost ALL respects to a Western diet.
Anyway, it turns out that after you have filleted a fish what is left are the bones. What do you do with them? Well, we used to make blood and bone fertilizer but that is a low value add…
Ah-ha! Eureeka!Tada!
If you crush waste fish and bone you can remove the oil and put it in a gelatin capsule so thick the consumer will not be able to taste or smell the rancid fish oil flavour and market it…
So starts a 20+ year human experiment. You can look up the results yourself but it turns out stale fish oil does not deliver the same health benefits as a Japanese, living in Japan, eating a Japanese diet.
I’m equally sad to say we’ve tested pretty much every HIV/Hep C medication we could get hold of, both in the lab and in the clinic, and the results have been disappointing (once we’ve got to real patients with real disease in the clinic).
It’s not that we can’t/won’t have antivirals active against SARS-CoV-2, it’s just that our current HIV/HCV meds are not quite get up to snuff. Close but no banana and all that…
We have been testing lots of stuff in countries as diverse as Brazil and Iran.
There have been a few things that work in the test tube.
I’d love to have good news but sadly everything we have tested to date has failed in the clinic where “the clinic” = 1000 person double-blind randomized controlled trial.
The handful of ~100 person “hmm, maybe this works” trials have failed when we’ve pushed them to scale…
It totally sucks, but so far there is no small molecule salvation.
Seventeen years on, the U.S. is suffering its worst addiction epidemic in American history. In 2016 alone, an estimated 64,000 Americans died from opioid overdoses—more than the combined death tolls for Americans in the Vietnam, Afghanistan, and Iraq Wars. In Portugal, meanwhile, the drug-induced death rate has plummeted to five times lower than the E.U. average and stands at one-fiftieth of the United States’. Its rate of HIV infection has dropped from 104.2 new cases per million in 2000 to 4.2 cases per million in 2015. Drug use has declined overall among the 15- to 24-year-old population, those most at risk of initiating drug use.
All people infected with Hepatitis C will develop antibodies.
Testing for antibodies as quick and cheap so we use antibody testing for screening.
In about 25% of patients the antibodies eliminate the virus (so they are cured) – these people have a positive antibody test and a negative PCR RNA test <<< THIS IS YOU
In about 75% of patients the antibodies fail to eliminate the virus and the PCR RNA test is positive.
So
1) You were infected with Hepatitis C and have developed antibodies that will be with you for many years or even for life
2) Your antibodies have cured the disease as shown by your negative PCR RNA
3) No treatment is required
If the reason for testing was elevated liver enzymes then that needs to be investigated but the cause is not hepatitis C.
