Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance.
Mahamid M, Nseir W, Abu Elhija O, Shteingart S, Mahamid A, Smamra M, Koslowsky B.
Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
Got new test results.
After decreasing the Vit D3 dose to 5000IU per day in September the 25(OH) level went down to 32ng/ml (was 74 ng/ml)
I also tested 1,25(OH) and it is interesting that it is 82 pg/ml that is 40% above upper reference range. That is unusual for 25(OH) insufficiency. In fact many researches show that 1,25(OH) is not elevated even when 25(OH) reaches 150 ng/ml.
Allviruses make vitd deregulation by the same way, they increase 1,25oh which makes immune suppression and lower vitd25oh which makes immune suppression too
When you increase vitd25oh the 1,25oh decreases, i ve seen this in cfs patients who are full of reactivated viral infections like herpes viruses,cmv e ebv viruses and others
Another extremely interesting study i read lately has found that vitd25oh is active too on immune system and directly.both vit d types can activate same genes and receptors, only few are activated only by 1,25 and 25oh
Of course they found proof of this not just theories, i did not link it because very complicated to understand,they studied gene expression.it is very new study published during this year
although about hcv this is interesting, they check gcmaf receptors, vit d levels and response to pegintf on difficult to treat hcv genotypes and as expected best response gcmaf receptors and normal vit d levels give much higher svr
i will be testing early december, i want to give it some time
extremely strange vitd25oh is declining despite 50.000iu of d3 daily, last test was only 92ng/ml, i guess immune system is making good use of it......if next test is lower than 90ng/ml i will be forced on 100.000iu daily
It would be intereting to know your 1,25 OH too. If it is elevated your body may not want to produce 25-oh, trying to decrease 1,25-oh. So all d3 is just wasted. I would also check PTH for the same reason.
i cannot go on normal calcium diet my calcium was 10.1 already at around 80ng/mlon 10.000-15.000iu dose
1.25oh is probably normal, on cfs it gets normal on gcmaf
this test is too expensive and available only in few labs here, i m just interested in keeping fast hbsag decline so i will not check it as long as i keep these results
pth was checked few times in the past, always normal, i think lower range of normal
we have a new law, dont know if european or italian but difficult to be european, that every food must be labelled so that it can be tracked from field/producer to prevent frauds and take away from market contaminated foods
of course it will always be a matter of poor or rich, because the organic foods are very expensive, but at least it will be easy to control also all the other foods for the sake of people.
in the end it will be saving money and protecting people's health since treatments are paid by public healthcare
update on my sister, she reached vitd25oh 150ng/ml but she had no response from gcmaf mafx5 and vit d at all on hbvdna and alt, hbsag results not ready yet.
she ll be now on tenofovir and keep vit d around 100-120ng/ml.she will try again stablized vitamin d instead of gcmaf mafx5 but only when fully hbvdna undetectable for sometime, just like i did
"I also tested 1,25(OH) and it is interesting that it is 82 pg/ml that is 40% above upper reference range. That is unusual for 25(OH) insufficiency. In fact many researches show that 1,25(OH) is not elevated even when 25(OH) reaches 150 ng/ml."
In chronic disease, the body tries to activate to VDR in order to kill the pathogens, that is why 1,25 is elevated. And pathogens block the VDR in order to survive in our bodies. This is a known chronic disease paradox: low 25 with high 1,25. check mpkb.org to understand.
Very high D3 does not make much sense to me, maybe 10 times less gcmaf with a low dose VDR agonist (according to gcmaf paper, this way gcmaf will be affordable to anybody) will work together and let the body heal itself (over a long period of time)...this way one avoids the high dose VDR agonist ( recommended on the MP) and also the high gcmaf price. But will it really work?
In my case, high D3 leads to even more 1.25 which lowers renin -> low na/k ratio(low vitality, exactly the opposite of healing).
Did people taking high D3 measure their Na and K?...this are very inexpensive tests, to see if it correlates with my results.
To my understanding/experience (does not mean I am right) is like this:
I have a low Na/k ratio (1.2) (yours is 30/33 = +-1)...normally should be 2.5, but for chronically disease people is lower.
When I take high D3, I assume renin lowers because 1.25 gets higher, based on this: http://www.ncbi.nlm.nih.gov/pubmed/12122115 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system.). I did not really do the renin test. low renin ->low NA/K ratio: http://circ.ahajournals.org/content/39/5/685
Is your 1.25 level always high and it gets higher when you take D3? ...this is expected for chronically disease people (immune system detects pathogens and converts all D3 in 1.25 in order to activate VDR and defend the body) and correlates with the fact that high 1.25 lowers Na/K ratio (vitality ratio). I will try to lower 1.25 (by taking a VDR agonist, the body does not need to increase 1.25 in order to activate the VDR so 1.25 should get lower (like normal healthy people have)) to see what happens to NA/K, according to my ideas it should rise up (like healthy people have).
Experimental Drug For Chronic Hepatitis B Cure ARC 520 to Begin Phase 2a Clinical Trial
Hepatitis B has been one of the leading causes of endemics throughout the world, with as many as 350 million cases reported. Among them, around 700,000 to 1.4 million cases have been reported in the USA alone, with an additional 5,000 to 8,000 cases of chronic infection being reported each year. Around one-third of the world’s population gets affected every year, with one million deaths reported annually. Once infected, the most common serological tests include those for the surface antigen of HBV (HBsAg), which is detectable within 1-6 months of infection, and the e antigen (HBeAg), which can be detected within 1-3 months from infection. Entecavir is one of the standard drugs used for treatment in HBV infections.
ARC 520 aims to deliver a functional cure for the HBV infection and restore the adaptive immune system with the help of its RNAi mechanism. It has been tested successfully in mice and chimpanzee models, where it has been shown to reduce the amount of viral DNA, HbsAg and HbeAg by as much as 90 – 95% , lasting up to one month or more.
On completing animal trials, a phase 1 human double blind, placebo controlled, dose escalating trial with a combination of ARC 520 and Entecavir was proposed and successfully executed. Arrowhead’s CEO and President, Dr. Christopher Anzalone, commented that, “We successfully completed enrollment in a Phase 1 clinical study in healthy volunteers with initial data indicating that ARC-520 is generally safe and well tolerated in humans. We will be filing with Hong Kong regulatory authorities this quarter to enable a Phase 2a study in patients with chronic HBV infection.”
The clinical trial will focus on an escalated intravenous dose of ARC 520 with a combination of Entecavir. The escalated dosage would have strengths of 1 mg/ Kg and 2 mg/Kg, and each will be used in cohort studies with 8 people, with 6 receiving ARC 520 and 2 receiving a placebo. The target demographic will be people aged between 15 – 65 years with immune active chronic HBV infection, HBV e antigen negativity, and ongoing Entecavir therapy.
The primary objective of the study will be to check the depth and duration of the decline of viral antigens and products in response to a stronger dose of ARC 520 along with Entecavir. Other factors to be tested through this include pharmacokinetic properties (safety, tolerance of patients) and pharmacodynamic properties (effects of the drug on HBV DNA serum titers and antibodies against HBV surface antigens).
SEVERE 25-HYDROXYVITAMIN D DEFICIENCY IDENTIFIES
HCC PATIENTS WITH A POOR PROGNOSIS
F. Finkelmeier, V. Ko ̈berle, B. Kronenberger, J. Bojunga, S. Zeuzem, J. Trojan, A. Piiper, O. Waidmann. Internal Medicine, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
Background and Aims: We performed a prospective cohort study to investigate the relation of vitamin D levels to stage and the prognosis of HCC patients.
Methods: 200 patients with the diagnosis of HCC presenting at the Department of Internal Medicine 1 of the Frankfurt University Hospital outpatient clinic were consecutively enrolled into the present study. 25-hydroxyvitamin (25(OH)D3) levels were quantified. Patients were followed until death or last contact. The primary end point was overall survival (OS).
Results: The mean follow-up was 322 days + 342 days with a range of 1–1508 days. 19 patients underwent liver transplantation and 60 (30%) patients died within the observation time. 34.5% patients had 25(OH)D3 levels below 10ng/ml (insufficient), 38% had levels between 10 and 20 ng/ml (deficient) and 27.5% patients had levels above 20ng/ml. 25(OH)D3 levels differed significantly between Child Pugh stages and showed a negative correlation
with the MELD score. Patients with decompensated liver disease had significantly lowered 25(OH)D3 levels. There were significant differences between stages of HCC according to BCLC and CLIP score. Patients with severe 25(OH)D3 deficiency had a significantly shorter OS (hazard ratio (HR) 2.631, (CI) 1.354–5.113, P = 0.004). In a multivariate Cox regression model 25(OH)D3 levels 2 were independently associated with shorter OS. Conclusions: We show that 25(OH)D3 serum levels differ between HCC stages and correlate with the severity of liver insufficiency. 25(OH)D3 levels below 10ng/ml were associated with a higher mortality risk in univariate and multivariate analyses.
. I would never know for importance of vit d if it wasn't this forum and you Guys,especially Stef, I began to take vit d only 2 months ago because i saw my levels was 33, and only because of you. Doctor didn't say nothing. We have to be aware of every detail. Thank you
dr coimbra and experience on more than 2500 patients treated by high dose vit d3
during this long interview (portuguese plus italian subtitles) i have learnt a lot especially on our resistance to vit d due to our chronic infection, our vdr types, our nagalase and other factors.they use a very simple test available everywhere to see biological activity of vit d and see the level of resistance by PTH
vitamin d suppresses PTH, so as biological activity of vit d increases the pth goes down to low end of normal
when we supplement and increase vitd25oh we can check serum PTH and we have to make it low end of normal, at the point we know we have got around the vit d resistance problem
for example i found out:
my sister with vitd25oh 150ng/ml (max safe level while on no diaries diet) has PTH to 39.3pg/ml (range 11-67).if there was no resistance PTH should have been to very low
it is not the dose but keeping vitd25oh between 100-150ng/ml, for her 10.000-15.000iu daily are enough to reach this.
i need 20.000iu daily for example just to keep the levels and loading dose of 50.000iu daily to reach 150ng/ml
lately i lowered to 10.000iu daily thinking it would keep the levels, in few months vitd25oh got back to 90ng/ml...
so you have to find your dose to get to high levels and monitor pth too, to see if vit d is biologically active.both me and my sister have vit d interference and resistance since pth does not get to low levels despite such high values of vitd25oh
when vit d is very high pth must go to very low normal range if the vit in your blood is biologically active, some must care to keep low norm levels but not undetectable.low norm range pth is healthy but undetectable is not good
no it is not enough at all for us, it is low.you also have to check intact pth because most of us have receptor resistance and vitd25oh doesn t tell us the level of vit d
pth lowest value of normal range means there is enough vitamin d
after taking antibiotics this winter i got a increase of creatinine (antibiotics are toxic for kidneys and some brand may even lower creatinine clearance while on it, it happened to me), this is not resolving with creatinine 1.2 high range of normal.since also tdf is toxic on kidneys with damage i will stay off vit d for one month and restart full heptech protocol to make it as before antibiotic use 0.8
i hope hbsag will at least stay stable around 800iu/ml but anyway with cuban vaccine close to available this year and rep9ac advancement and my low hbsag i think i need not to worry about hbsag anymore
it was posted on another thread, should be on the market in cuba by this year and south america next year.
combo with nucs or peg should help immune system clear hbv, they have not published hbsag quant data so difficult to say how much it can help
because of the issues with creatinine, i also checked my pth and it had gone to 5pg/ml (norm 10-80) too low, so i lowered my dose to 100.000iu daily, then to 50.000iu, then 40.000iu and then stopped for 3weeks
then i restarted with 15.000-20.000iu daily which looks enough to keep pth 17pg/ml, i added also vit A (not in betacarotene type), creatinine is now 0.68 (norm 0.6-1.3)
the fact that now i need normal vit d levels to lower pth means that now my vdr receptor is working different and much better.i dont know if this reflects a new balance with hbsag since i dont have yet results
How much vitamin k2 mk7 would you take with 10000-15000 iu vitamin d? It seems like vitamin k2 mk7 makes my eye twitch and gives me a sickest feeling. I take 100 daily. I was trying to take 200-300 a day but couldn't handle it.
no not interested to change anything, she s having zero issues from tdf, kidney function perfect, she feels immensely better than before using antiviral
Any plans to add INF?
no intf, she tried intf when experimental when she was a teen and sides were so bad she didn t even make any tests for decades or doctor's visits.she doesn t care about hbv, she only cares to feel well
i m sure if we did fibroscan after gcmaf it was already low because all her response was superfast thanks to gcmaf/vit d according to me:
hbvdna baseline 1.600.000iu/ml hbsag 13.000iu/ml
started tdf 3 dec 2013
hbvdna 490iu/ml 13 jan 2014
hbvdna und 8 apr 2014 hbsag 9000iu/ml
19 may 2014 hbsag 7000iu/ml
then lost response on hbsag, i think she lost the effect of gcmaf.she has felt incredibly good on gcmaf but she stopped it because she didn t like injections and the fact it s a blood derived product
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