People with liver disease usually have deficiencies in all of the fat-soluble vitamins, including vitamin A. Its advised by my liver doc to take it and all fat-soluble vitamins with vit e (tocopherol) (TPGS, even better) for a higher absorption rate.
Iron is a different matter but that too generally does not need to be worried about unless you have an iron disorder. Vitamin C should not be taken in large amounts as it can lead to an increased rate of fibrosis. Besides, its a water-soluble vitamin which is no problem for the liver to metabolize in adequate amounts, and the stuff is everywhere in our food. The RDA for vit C is 65 MG but many HCV sufferers OD on the stuff for some reason. We know more about vitamin C now than Linus Pauling ever did in his lifetime. The general rule of thumb is a one-a-day vitamin for F1-F3 and two vitamins for those with cirrhosis due to the impaired metabolism. Additional D doesn't hurt, but like everything else just don't get carried away.
I would continue with the Crestor (rosuvastatin) if you have been tolerating it well as shown on repeated labs. Rosuvastatin (all statins, actually) have shown anti-HCV properties to varying degrees. If anything it will help you in the fight against the virus.
All of the other items you listed are very benign and there are no ill effects known from taking them as it relates to your HCV infection. For a variety of reasons some treating doctors prefer that patients not take any herbs while on treatment including alternative meds like milk thistle. However, there is anecdotal evidence that patients taking MT without informing trial researchers in the HALT-C trial (a subset of the 1065 participants) found it did not negatively affect tx nor clinical outcomes. I would ask your treating dr. how she/he feels about this subject.
As for the tramadol I can't make any specific comments as you are the only one that knows what is needed to alleviate your pain. I'm sure you know all the cautionary warnings for these classes of meds but if not Rocker has covered that info above.
Always keep your doctor informed of what you are taking especially supplements, herbs, and all RX meds.
Best of luck to you for an uneventful yet successful tx. -- ML
I would advise you to stay on the vit D and also the vit C. I would stop the fish oil, due to the vitamin A. A hep c liver has difficult assimilating it, the same with iron.
As to the tramadol, be sure your doctor knows that you are on it, in case you need to go on antidepressants. Some antidepressants don't mix with tramadol and mixing them could be fatal.
Physical dependence and withdrawal
Tramadol is associated with the development of physical dependence and a severe withdrawal syndrome.[57] Tramadol causes typical opiate-like withdrawal symptoms as well as atypical withdrawal symptoms including seizures. The atypical withdrawal symptoms are probably related to tramadol's effect on serotonin and norepinephrine reuptake. Symptoms may include anxiety, depression, anguish, severe mood swings, aggressiveness, brain "zaps", electric-shock-like sensations throughout the body, paresthesias, sweating, palpitations, restless legs syndrome, sneezing, insomnia, tremors, and headache among others. In most cases, tramadol withdrawal will set in 12—20 hours after the last dose, but this can vary. Tramadol withdrawal lasts longer than that of other opioids; seven days or more of acute withdrawal symptoms can occur as opposed to typically three or four days for other codeine analogues. It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and this is particularly relevant to tramadol because of its SSRI and SNRI properties, and, when the time comes to discontinue their tramadol, to do so gradually over a period of time that will vary according to the individual patient and dose and length of time on the drug.[58][59