Aa
tenofovir plus entecavir
Dear members,
I've been using tenofovir for almost four years. When I started using it, my HBV viral load is higher than 9 log. I waited until my ALT to rise (as the doctor said, immune responsive phase) to go for medication. After first three months, I had about 5 log, since then the decrease in the viral load is quite slow but consistant. Recently I got the test results that show I still have about 134 Ul/ml comparing to the result of last year 285Ul/ml. My fibroscan and ultrasound have always been normal. ALAT 67 U/l (only indicator which is out of the normal range). I'm HBeAg positive. Now my doctor suggested me to use enticavir. Do you think it is a good idea? can you give me your thoughts why I'm such a slow responder? many thanks.
I've been using tenofovir for almost four years. When I started using it, my HBV viral load is higher than 9 log. I waited until my ALT to rise (as the doctor said, immune responsive phase) to go for medication. After first three months, I had about 5 log, since then the decrease in the viral load is quite slow but consistant. Recently I got the test results that show I still have about 134 Ul/ml comparing to the result of last year 285Ul/ml. My fibroscan and ultrasound have always been normal. ALAT 67 U/l (only indicator which is out of the normal range). I'm HBeAg positive. Now my doctor suggested me to use enticavir. Do you think it is a good idea? can you give me your thoughts why I'm such a slow responder? many thanks.
Also, the study showed that vitamin D supplementation was safe up to 20,000 IU/d, even with normal weight.
so you can use also 20.000iu daily for a limited period if you are no t testing
so you can use also 20.000iu daily for a limited period if you are no t testing
http://www.prnewswire.com/news-releases/current-vitamin-d-guidelines-pose-serious-public-health-issue-with-significant-cost-and-health-impacts-284078211.html
Increasing vitamin D intake could prevent 37,000 deaths annually and help taxpayers save billions
CALGARY, Nov. 27, 2014 /CNW Telbec/ - New research finds that current national vitamin D intake recommendations are too low and that body weight must be taken into account to determine the appropriate vitamin D dose in any given individual. This is currently not the case, posing a serious Canadian public health issue with significant cost and health impacts.
The impact of vitamin D deficiency is costing taxpayers billions
"Vitamin D, the "sunshine vitamin", is very important to our health. It is used by nearly every cell in the body and has an effect on every system – it acts as a protector and regulator, and enhances the functioning of our body's systems to protect against disease. Simply put, optimizing vitamin D levels results in better health," stated Dr. David Hanley, Endocrinologist and Professor in the Departments of Medicine, Oncology, and Community Health Sciences at the University of Calgary.
Studies have found that if Canadians increased their intake of Vitamin D, the estimated death rate could fall by 37,000 deaths annually, representing 16.1% of annual deaths. In addition, the economic burden would decrease by 6.9% or $14.4 billion per year based on 2005 figures.[1]
Recommendations for vitamin D need to be re-evaluated
In the newly published study "The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers[2]" the recommended daily allowance (RDA) for vitamin D, 600 IU/d, was found to be much lower than the dose needed to achieve optimal vitamin D status when more than 20,000 measurements of 25-hydroxyvitamin D [25(OH)D] were analyzed. The dose required for overweight or obese individuals to reach optimal 25(OH)D levels is actually 12,000-20,000 IU/d; 2-3 times higher than the amount needed by a normal weight individual, and 4-5 times higher than the tolerable upper level of intake currently recommended by Health Canada. Given the fact that two thirds of our population is overweight or obese, this has significant public health impact. Also, the study showed that vitamin D supplementation was safe up to 20,000 IU/d, even with normal weight.
"The public health and clinical implications of an error in the calculation of the recommended dietary allowance for Vitamin D are serious, particularly for residents of Canada," stated Dr. Paul Veugelers, Research Chair in Nutrition and Disease Prevention at the School of Public Health, University of Alberta and one of the authors of the new study.3 "Current public health targets are not being met. Many Canadians will still be vitamin D deficient or insufficient, even if they follow Health Canada's recommendation of 600 IU per day," he added.
"Canada's current approach to health must change from treating disease to optimizing health. This is the only way to prevent chronic illness. A proactive preventative approach increases health benefits for individuals and has cost-benefits for taxpayers and government. Based on these new findings we believe that it is imperative the Canadian guidelines need to be reviewed," stated Dr. Samantha Kimball, Director of Research for the Pure North S'Energy Foundation.
About Pure North S'Energy Foundation
The Pure North S'Energy Foundation is a chronic disease prevention program that uses nutritional supplements and is backed by research. We are Canada's largest primary prevention focused not-for-profit organization. Pure North evolved from an employee health and wellness program that was offered to employees of Canadian Natural Resources Limited, their families and contractors. It now operates as a separate foundation that has been expanded to include participants from the public and is offered at no charge to populations who are considered at-risk or vulnerable. Our mission is to give people the opportunity to "Feel Better and Live Longer."
Increasing vitamin D intake could prevent 37,000 deaths annually and help taxpayers save billions
CALGARY, Nov. 27, 2014 /CNW Telbec/ - New research finds that current national vitamin D intake recommendations are too low and that body weight must be taken into account to determine the appropriate vitamin D dose in any given individual. This is currently not the case, posing a serious Canadian public health issue with significant cost and health impacts.
The impact of vitamin D deficiency is costing taxpayers billions
"Vitamin D, the "sunshine vitamin", is very important to our health. It is used by nearly every cell in the body and has an effect on every system – it acts as a protector and regulator, and enhances the functioning of our body's systems to protect against disease. Simply put, optimizing vitamin D levels results in better health," stated Dr. David Hanley, Endocrinologist and Professor in the Departments of Medicine, Oncology, and Community Health Sciences at the University of Calgary.
Studies have found that if Canadians increased their intake of Vitamin D, the estimated death rate could fall by 37,000 deaths annually, representing 16.1% of annual deaths. In addition, the economic burden would decrease by 6.9% or $14.4 billion per year based on 2005 figures.[1]
Recommendations for vitamin D need to be re-evaluated
In the newly published study "The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers[2]" the recommended daily allowance (RDA) for vitamin D, 600 IU/d, was found to be much lower than the dose needed to achieve optimal vitamin D status when more than 20,000 measurements of 25-hydroxyvitamin D [25(OH)D] were analyzed. The dose required for overweight or obese individuals to reach optimal 25(OH)D levels is actually 12,000-20,000 IU/d; 2-3 times higher than the amount needed by a normal weight individual, and 4-5 times higher than the tolerable upper level of intake currently recommended by Health Canada. Given the fact that two thirds of our population is overweight or obese, this has significant public health impact. Also, the study showed that vitamin D supplementation was safe up to 20,000 IU/d, even with normal weight.
"The public health and clinical implications of an error in the calculation of the recommended dietary allowance for Vitamin D are serious, particularly for residents of Canada," stated Dr. Paul Veugelers, Research Chair in Nutrition and Disease Prevention at the School of Public Health, University of Alberta and one of the authors of the new study.3 "Current public health targets are not being met. Many Canadians will still be vitamin D deficient or insufficient, even if they follow Health Canada's recommendation of 600 IU per day," he added.
"Canada's current approach to health must change from treating disease to optimizing health. This is the only way to prevent chronic illness. A proactive preventative approach increases health benefits for individuals and has cost-benefits for taxpayers and government. Based on these new findings we believe that it is imperative the Canadian guidelines need to be reviewed," stated Dr. Samantha Kimball, Director of Research for the Pure North S'Energy Foundation.
About Pure North S'Energy Foundation
The Pure North S'Energy Foundation is a chronic disease prevention program that uses nutritional supplements and is backed by research. We are Canada's largest primary prevention focused not-for-profit organization. Pure North evolved from an employee health and wellness program that was offered to employees of Canadian Natural Resources Limited, their families and contractors. It now operates as a separate foundation that has been expanded to include participants from the public and is offered at no charge to populations who are considered at-risk or vulnerable. Our mission is to give people the opportunity to "Feel Better and Live Longer."
Thanks stef, I'm a bit relieved.
I learnt that HBeAg positive and high ALT has much higher rate of clearance, I hope that is what is happening in my body.
I used old prescription for this latest test, where my stupid doctor even didn't bother to include VitD25oh. Of course, I have changed her, but my next appointment with the new one is in April.
I'll ask him to test qHBsAg, VitD, intact PTH. I wish I'm in the right range in PTH.
Meanwhile, I'm taking VitD 10,000ui daily(after first 100,000ui shot), Selenium, VitB,VitK etc. At least 2l of water. A lot of olive and two spoons of black cumin.
I learnt that HBeAg positive and high ALT has much higher rate of clearance, I hope that is what is happening in my body.
I used old prescription for this latest test, where my stupid doctor even didn't bother to include VitD25oh. Of course, I have changed her, but my next appointment with the new one is in April.
I'll ask him to test qHBsAg, VitD, intact PTH. I wish I'm in the right range in PTH.
Meanwhile, I'm taking VitD 10,000ui daily(after first 100,000ui shot), Selenium, VitB,VitK etc. At least 2l of water. A lot of olive and two spoons of black cumin.
Keep using the combo by 6-12 months of combo hbvdna must be und or extfemely low.if you are hbeag pos it may happen you require years to get und
i dont think there is a resistance mutation, just slow response to monotherapy
your liver is perfect
monitor also vitd25oh which must be 100ng/ml by vit d3 supplements and hbsag quantitative in iu/ml
i dont think there is a resistance mutation, just slow response to monotherapy
your liver is perfect
monitor also vitd25oh which must be 100ng/ml by vit d3 supplements and hbsag quantitative in iu/ml
Here are my new results after taking Entecavir+Tenofovir for one month:
ALAT DNA Fibro
01/02/2010 46 >1.7e10^8
16/03/2010 42 >1.7e10^8
20/09/2010 65 >1.7e10^8
started using Tenofovir (10/2011)
14/01/2011 55 100,000
05/12/2011 78 3.9kPa
23/03/2012 83 4075
06/06/2012 93 1620
23/11/2012 96 930
23/04/2013 132 831 4.4kPa
20/09/2013 85 281
21/03/2014 113 61(another lab) 3.5kPa
19/11/2014 67 134
Started using Enticavir +Tenofovir (15/12/2014)
22/01/2015 54 98
Probably I have viral mutation, what do you think?
ALAT DNA Fibro
01/02/2010 46 >1.7e10^8
16/03/2010 42 >1.7e10^8
20/09/2010 65 >1.7e10^8
started using Tenofovir (10/2011)
14/01/2011 55 100,000
05/12/2011 78 3.9kPa
23/03/2012 83 4075
06/06/2012 93 1620
23/11/2012 96 930
23/04/2013 132 831 4.4kPa
20/09/2013 85 281
21/03/2014 113 61(another lab) 3.5kPa
19/11/2014 67 134
Started using Enticavir +Tenofovir (15/12/2014)
22/01/2015 54 98
Probably I have viral mutation, what do you think?
during cirrhosis low plt and WBC happens, increasing vitd25oh should help
i sue inulin, lactobacillus reuteri and bravo probiotic suppositories to help probiotic and prebiotics
also liposomal glutathione, lipo vit c are a must if she has cirrhosis.good brands livonlabs or maxhealthlabs
i sue inulin, lactobacillus reuteri and bravo probiotic suppositories to help probiotic and prebiotics
also liposomal glutathione, lipo vit c are a must if she has cirrhosis.good brands livonlabs or maxhealthlabs
She still has very low Lymphocyte: 0.4 (normal 1 to 3.6) and low platelete count: 41 (normal 150 to 390). Other than that, she has normal ALT, DNA undetected, HBeAg negative. What is your comments on these unusually low levels?
I asked her to do fibroscan.
As for suppliments, besides VitD, what are the probiotic and prebiotics that you are taking? other suppliments?
I asked her to do fibroscan.
As for suppliments, besides VitD, what are the probiotic and prebiotics that you are taking? other suppliments?
your sister has probably regressed her cirrhosis, it takes about 5 years of antivirals and a healthy life/diet with all fresh food and no processed foods as much as possible.also low weight and normal vitd25oh levels
by the time her fibrosis will get to zero, only nodules are very slow to regress but the liver works perfectly indipendent to nodules
fibroscan will show her improvement
by the time her fibrosis will get to zero, only nodules are very slow to regress but the liver works perfectly indipendent to nodules
fibroscan will show her improvement
Stef, do you have some suggestion? is it good idea to use tenefovir plus lamivudine? is liver transplant only option in the end? at the moment, her condition is quite stable, no worsening nor improvement.
I see.
I posed the second question as my sister developed cirrhosis even she had HBeAg negative (while mine was positive). She used lamivudine years ago. The treatment was not systematic. She went through pregnancy, etc. Now she is on systematic treatment with tenefovir plus lamivudine for about five years. We are the only two who have HBV in a large family. It's been more than twenty years we learnt we have this desease.
It is clear for me what to do now. What can my sister do?
I posed the second question as my sister developed cirrhosis even she had HBeAg negative (while mine was positive). She used lamivudine years ago. The treatment was not systematic. She went through pregnancy, etc. Now she is on systematic treatment with tenefovir plus lamivudine for about five years. We are the only two who have HBV in a large family. It's been more than twenty years we learnt we have this desease.
It is clear for me what to do now. What can my sister do?
only hbsag quantity in iu/ml will tell you what happens in the liver, the rest is of little or no meaning to clearance of infected cells
Is it good thing that I have high ALT (it is always around 60 to 120) all these four years? does it mean I'm killing the infected cells?
Another confusion I have is why HBeAg negative patients respond less for medication than HBeAg positive patients? For me positive means the virus is replicating, so it should be more difficult to clear the virus, isn't it?
Another confusion I have is why HBeAg negative patients respond less for medication than HBeAg positive patients? For me positive means the virus is replicating, so it should be more difficult to clear the virus, isn't it?
it doesn t work taking big doses once because both vitd25oh and pth will be unstable and this may do more damage than good and this is what trial showed.this is very unnatural
the natural way is taking the dose everyday and usually 10.000iu of d3 is ok to keep vitd25oh 100ng/ml and pth less than 20pg/ml.again it is all different person to person, you just have to take the test every month
but if vitd25oh is less than 10ng/ml a very high dose to start is mandatory, guidelines require 300.000 to 1.000.000iu in this case
the natural way is taking the dose everyday and usually 10.000iu of d3 is ok to keep vitd25oh 100ng/ml and pth less than 20pg/ml.again it is all different person to person, you just have to take the test every month
but if vitd25oh is less than 10ng/ml a very high dose to start is mandatory, guidelines require 300.000 to 1.000.000iu in this case
Merci flyinsky.
It would be nice if I can maintain normal to high level of VitD25oh with your recepie. I'm not sure if the doctor will agree to prescribe me such a high dose for the first three months. After you start using 100,000 ui every three months, I'm wondering, if your test was done at the end of the three months or shortly after you take the shot? What I mean is can the level be stable during the three months, before you take another shot?
hello
it must be requested by your doctor or your hepatologist . for me I'd joint pain and when I 'm doing a blood test for vitamin d the result was 17ui therefore under the standard, my doctor prescribed a dose as 1million ui , ampoule every month for three months, after I have redone the check and the rate of vit d was normal and now I take 100.000ui / ml every three months and I have checked every 3 months the dose of vit d which is normal . avoid the purchase by internet there have always fraudsters
it must be requested by your doctor or your hepatologist . for me I'd joint pain and when I 'm doing a blood test for vitamin d the result was 17ui therefore under the standard, my doctor prescribed a dose as 1million ui , ampoule every month for three months, after I have redone the check and the rate of vit d was normal and now I take 100.000ui / ml every three months and I have checked every 3 months the dose of vit d which is normal . avoid the purchase by internet there have always fraudsters
bonjour
il faut bien demandé l avis de votre médecin traitant ou ton hépatologue . pour moi j avais des douleurs articulaires et quand j ai fais une prise de sang pour la vitamine d le resultat etais de 17ui donc sous la norme, mon médecin traitant m as prescrit une dose de 1million ui ,une ampoule chaque mois pour trois mois,apres j ai refait la ps et le taux du vit d est normal et maintenant je prend une ampoule de 100.000ui/ml chaque trois mois et je vérifié a chaque 3 mois la dose du la vit d qui est tjr normal .ev évitez l achat par internet il y as tjr des fraudeurs
il faut bien demandé l avis de votre médecin traitant ou ton hépatologue . pour moi j avais des douleurs articulaires et quand j ai fais une prise de sang pour la vitamine d le resultat etais de 17ui donc sous la norme, mon médecin traitant m as prescrit une dose de 1million ui ,une ampoule chaque mois pour trois mois,apres j ai refait la ps et le taux du vit d est normal et maintenant je prend une ampoule de 100.000ui/ml chaque trois mois et je vérifié a chaque 3 mois la dose du la vit d qui est tjr normal .ev évitez l achat par internet il y as tjr des fraudeurs
Got it. The target is clear for me now.
Where can I get reliable VitD3? I see on the internet, there are many types, but most of them are low doses. I don't wanna take several pills. Who knows what else they have inside. Can you suggest me an internet site, where they have 10,000 iu dose in one pill or two? I'm in France.
Where can I get reliable VitD3? I see on the internet, there are many types, but most of them are low doses. I don't wanna take several pills. Who knows what else they have inside. Can you suggest me an internet site, where they have 10,000 iu dose in one pill or two? I'm in France.
it is full of posts about sequential, just go backwards or search on google sequential 100% response and 91% clearance:medhelp
stef, I read many posts, and most commonly I encounter the comment "lucky 5%". That's why I'm surprised by this 91%. Do you have a link for this study? do you think slow responders for nucs still have as high chance for clearance? I may sounded stupid with these questions, I do admit I didn't do much research on HBV (due to family, work etc). I probably relied too much on my doctors.
hbsag quant in iu/ml
check all the studies of sequential we posted and all the members that are clearing on it or cleared already
check all the studies of sequential we posted and all the members that are clearing on it or cleared already
Thanks again stef.
91% chance of clearance when HBsAg lower than 1000iu/ml with peg? I thought the chance is about 5%. If it is the case, it is really encouraging...
I read somewhere the chance of clearance is much higher for the patients responded in short time period for nucs. If I clear viral load in four years, I thought I had almost no chance of clearing the virus.
What are the most important quantative tests I should do to monitor the progress with both ent+tnf and all the suppliments? I'll update members with my results from now on.
91% chance of clearance when HBsAg lower than 1000iu/ml with peg? I thought the chance is about 5%. If it is the case, it is really encouraging...
I read somewhere the chance of clearance is much higher for the patients responded in short time period for nucs. If I clear viral load in four years, I thought I had almost no chance of clearing the virus.
What are the most important quantative tests I should do to monitor the progress with both ent+tnf and all the suppliments? I'll update members with my results from now on.
Yes selenium is good from 200 to 400mcg daily, i dont remember which is the best type google " best type of selenium"
vitamin b2 helps vit d3 absorption, vit k (mk7 type) helps take calcium away from blood and fix into bones.natto is a japanese food extremely reach in mk7
vitamin b2 helps vit d3 absorption, vit k (mk7 type) helps take calcium away from blood and fix into bones.natto is a japanese food extremely reach in mk7
Entecavir must betaken empty stomach 2hrs before and 2 hrs after so best take it before bed while tdf at breakfast.it is possible totake all together but i dont think this is the best absorption way
etv befoe bed
tdf breakfast
d3 lunch or dinner
etv befoe bed
tdf breakfast
d3 lunch or dinner
Many many thanks steff. Maybe you have writen about these several times here in this forum. Sorry, if I made you to repeat it. It's not easy to go through all the posts to find the answer one is looking for.
I'll follow that. Can I take Tenefovir+Enticavir+VitD at the same time?
Everymorning, I drink 250cl of cow milk . If I stop that, what should be the right diet? I eat a lot of meat, vegetable and fruit anyway.
What are the other suppliments that I should take? Vitamine C etc? Some one mentioned selenium?
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you dont risk resistance and you may give vit d a try for few months, you must use very high doses at start to get vitd25oh at 100ng/ml, what are your levels now?
no dairies and drinking 2.5l of water daily will help get the targets and void any calcium increase, probably will lower calcium