There are quite a number of options, and to a degree they are all “suck it and see” in that some work great for some patients and not so great for others.

The full list is here: https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/diagnosis-treatment/drc-20354081

We would usually start with methotrexate but that might not be the best idea in you. As you can see there are stacks of options and it’s really something best managed by a rheumatologist. Not only do they have expert skills in this area they are also allowed to use stuff GPs are not.

Hi Kris,

The Mavyret pills are quite small. It could have been 1 big tablet but they made it as 3 little ones to make swallowing them easier.

While no medication is 100% side effect free Mavyret gets pretty close to that ideal. Most people cruise through treatment without any problem whatsoever.

Hello p711,

Hep C is not the sort of disease you go to bed with and wake up dead. It’s a slow progression over time so there is plenty of time to get things sorted.

Do you know what the fibroscan result was? It is usual expressed as a number like 7.4kPa

Really, the key question for the specialist is what can you get me for retreatment and when. What country are you in?

I’d expect your pains are anxiety-related, or totally unrelated to the Hep C. It may be the virus growing back and annoying your liver but that usually happens quite promptly on stopping the tablets.

A good healthy diet, exercise, enough water, enough sleep, don’t smoke or drink too much alcohol remain the basis of good health. Relationships are also important and that includes your relationship with yourself (don’t beat yourself up about the past) and your friends and family.

Hello tellietubbie,

Itching probably relates to an increased level of bilirubin and suggests your Fibroscan might be F4 (>12.5kPa). That potentially has some impact on the choice of treatment, best duration of treatment and if we should consider Ribavirin.

In a perfect world we have full blood count, liver and kidney function results.

In patients with cirrhosis, we like to have an AFP as cirrhosis carries a 3% per year risk of liver cancer and this generally shows up with an elevated AFP. Treated early we can fix it. Leave it too late and it sadly becomes get your affairs in order time.

The best way to proceed would be for you to book an online appointment with me so we can go over it all together. https://gp2u.com.au/

Now, for the really important question: Is your favourite Tinky Winky, Laa-Laa, Dipsy or Po?

Hello sudjoy,

No. Himalayan Rock salt is basically ordinary table salt – NaCl

“Chinen Salt” is a salt derived from Berberis sp. plants (commonly known as the Barberry plant).

https://www.quora.com/What-is-chinen-salt-used-for

Here is a scientific overview of Barberry extracts

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678494/

Hi Jimmy6429,

Great to hear from you! Thanks for checking in.

I know it’s true but it’s hard to believe we’ve been doing this for going on 5 years and patients are getting to SVR208 and beyond.

I reckon at 4 years we can definitely ditch the “Sustained Virological Response” and call it cured.