Food and Treatment

I have been told once treatment stops your appetite comes back...so when does that happen?
Treatment ended last Friday....
rg

[nygirl7]

That is the understatement of a lifetime.  Once I got the meds out of my body (honestly if you stopped a week ago the inf should be out in about another week which is why we take a weekly shot) I couldn't stand it food tasted so incredible! Not having those horrid tongue ulcers or being nauseaus the first time I ate an Oreo cookie I almost wept with joy.

It's coming, you just have to wait a little longer (the riba won't leave you for a much longer time period but once the inf is gone.......look out).  And be warned.......it seems something changes after treatment and every single thing we eat  sticks to our body.......no fun there.

[Trinity4]

You know what puzzles me.  I have been literally forcing myself to eat -  same portions as always and of course I don't enjoy eating like I used to but I still eat adequately.  I developed a particular fondness for sweets, mashed potatoes and gravy, country fried steak and chicken, pasta (I think my parents put pureed pasta in my bottles so that's nothing new) -  Fattening things.  I no longer exercise, pretty much sit at a desk all day and sit around at night -  no walking, no swimming and I've lost weight.  About 8 pounds since starting tx.  I keep dropping down so the tx must cause the metabolism to change -  food must not be processed the same.  So wierd because I never ate this much in my life and could always plan on gaining a couple of pounds if I ate 3/4 of what I am right now.  Go figure.

[nygirl7]

I lost almost 20 when the first six months of treatment and all I ate was ice cream and Macaroni (for some reason spaghetti sauce although I'd think it would be horrible while on treatment was one of my FAVORITE things too!) - all I did was crave sweets and sugar why I realy wanted to eat it st raight out of the bowl at times I think!  It was so bad. Yet I lost and lost and lost.

AFTER treatment - totally different story altogether. (Although I did lose my thyroid to the interferon........first was hyper then went hypo but my numbers are perfectly fine with the synthroid so I don't think it could be it any longer).

I LOOK at food now and I gain a pound. I was always so so thin all my life. I gave up so many cheeseburgers and fries and pizzas! All for nothing cause now just looking at them makes me gain.

I can't figure it out but it's rather common.  Enjoy it while it lasts and I hope for you it lasts afterwards!

[CoWriter]

" I developed a particular fondness for sweets,"

"and I've lost weight. "

That shouldn't be happening if you're eating the same as before.  Usually you loose one pound per week if you cut your daily calorie intake by 500 calories.

Have you had your blood sugar checked lately?    

[jmjm530]

RJ,

Be careful what you wish for because many gain weight very quickly once treatment stops and it seem to come on mostly as fat. If I remember correctly, took 3-5 weeks before appetitite starting coming back.

Trinity/Co,

My caloric intake on treatment is probably close to what it is now but I also lost signficant weight. Over 30 lbs at one point and a lot of it muscle. As my doc explained, interferon does eat muscle and I have no doubt that it altered my metabolism as well burning up whatever calories I took in. Problem is that once the interferon is stopped the reverse seems to happen and the metabolism becomes sluggish. So...enjoy all those treats while you can because you may have to watch the diet post tx.

[CoWriter]

"As my doc explained, interferon does eat muscle"

Yes, it does, especially during long periods of fast (like at night time).  If your protein intake is not enough, your body will use your muscle as a source.  That's why on treatment, you should increase the protein (using protein powder for shakes is a great option).


"enjoy all those treats while you can"

No....that will make her insulin resistant.

[122 Tactical Fighter Group]

It took me literally years to have any appetite again. And immediate post treatment the joke with my wife was about what a cheap date I was....I could fill up by smeeling good food!!!

[jmjm530]

enjoy all those treats while you can"

No....that will make her insulin resistant.
--------------------------------------------------------------
Sort of a good point except that if weight loss becomes a serious issue during tx then what I would call "commando eating" trumps healthy eating. I'll define commando eating as doing what is necessary to keep weight loss from avalanching so that treatment will not be stopped. In my case, for example, I had very little control over what I could eat on treatment because of the tx-induced anorexic like eating disorder where foods I used to like and enjoy made me nauceous. So, like many here, I ate what I could tolerate and prayed that I could stop the weight loss. But yes, in an ideal situation where one could eat "healthy", then I agree to limit the simple sugars for reasons you mention.

[Trinity4]

Fasting - always under 110 usually in the low 90's.  After a meal depending on what I eat it's around low to mid 100's.  Never has been higher than that.  As I mentioned, I haven't exercised much at all since starting tx.  Muscle weighs more than fat and I certainly don't have the tone I used to.   It's got to be the interferon and muscle loss.  Thanksgiving and Christmas are coming up - no holding back this year!!

[RJGCEDARS]

To my group of supporters:
Thank each of you for your replies...unreal.
I even got an answer to a question I didnt ask...
I now know why my arms look like the model Twiggy's.
rg

[CoWriter]

I totally believe that you can teach people how to prevent the nausea and weight loss...... IF you can get to them BEFORE they start tx (obviously, it has to be people who are willing to listen).  

Nutrition is very important because it actually affects the response to treatment.....


Impact of Diet on Fibrosis Progression and Response to Treatment in People with Chronic Hepatitis C

By Liz Highleyman

It is increasingly clear that hepatitis C virus (HCV) infection is associated with various metabolic complications including insulin resistance, but the effects of diet on liver fibrosis progression and response to interferon-based therapy have not been extensively studied.

As reported in the September 11, 2008 advance online edition of the American Journal of Gastroenterology, researchers from the University of Naples in Italy conducted a study to evaluate whether diet affects the severity of liver damage and response to therapy in patients with chronic hepatitis C.

The prospective study enrolled 1084 patients with biopsy-proven HCV-related chronic hepatitis -- of whom 432 were treated with interferon plus ribavirin -- and 2326 healthy HCV negative control subjects.

The investigators collected data on dietary habits and alcohol consumption. All participants underwent routine liver function tests and HCV genotyping, as well as assessment of body mass index and plasma levels of glucose, nitrogen, creatinine, cholesterol, and triglycerides.

Results

• At baseline, there were no differences in metabolic status or alcohol consumption between the HCV positive patients and HCV negative control subjects.

• About 50% of each group was overweight and about 60% consumed alcohol.

• HCV positive patients and HCV negative control subjects also had similar dietary habits.

• In a logistic regression analysis, intake of carbohydrates, lipids, and polyunsaturated fatty acids, as well as alcohol consumption, were independent risk factors for liver damage.

• In a univariate analysis, consumption of some dietary components -- including unsaturated fatty acids, iron, zinc, vitamin A, and niacin -- differed significantly between responders and non-responders to interferon-based therapy (P < 0.05).

• Alcohol consumption also differed significantly between responders and nonresponders (P = 0.01).

• In a multivariate analysis, HCV genotype, age, body mass index, liver steatosis (fat accumulation), and fibrosis were independent predictors of treatment response (P < 0.02).

"Our results show that dietary composition is related to the extent of liver damage," the study authors concluded. "Although traditional risk factors independently affected treatment response, SOME DIETARY COMPONENTS WERE ASSOCIATED WITH NON-RESPONSE TO THERAPY IN OUR PATIENTS."

"This suggests that HCV patients may benefit from instructions regarding their diet," they added.

9/16/08


Reference
C Loguercio, A Federico, M Masarone, and others. The impact of diet on liver fibrosis and on response to interferon therapy in patients with HCV-related chronic hepatitis. American Journal of Gastroenterology. September 11, 2008

[epiphiny]

I seem to be one of the few people that are putting on weight on tx and it's driving me crazy.  Initially I lost  4kgs in the first 6 weeks. Now I force myself to eat fat with my riba meals and each week my weight is slowly increasing, it's freaking me out.  I also feel that I have developed a body dismorphic disorder as even tho I have sized up my clothes I still feel really big and bloated particularly around my torso.  The same thing happened to me on my last treatment when I went from 62kgs to 72kgs in 6 months and I never ever lost the weight I gained. I don't know whether what I am feeling is real or not as the scales say I am still a bit less than when I started treatment but my body feels really weird.  Anyone else have these issues?

[jmjm530]

C0: I totally believe that you can teach people how to prevent the nausea and weight loss...... IF you can get to them BEFORE they start tx (obviously, it has to be people who are willing to listen).  
----------------------------
We will have to disagree here, based on my experience and others, and in the absence of any studies showing otherwise. As already stated -- and I'm not alone -- I had a type of tx induced anorexia where tase and food perception was altered to a significant degree. Keep in mind that this wasn't just a physical thing as you imply -- that if you just ate the right types of food you would be OK. The mere THOUGHT of certain types of foods would make me nauceous and turn away. Maybe you can outline specifically what you would advise people before and after treatment to prevent weight loss, but based on what I know I am highly skeptical. Theory is one thing. Treatment is another. BTW inital nausea was no doubt in part caused by the ribavirin and resulting anemia. I could not tolerate the anti-nausea medication nor medical marijuana which was suggested.

-- Jim

[Isobella]

I am so glad to see your post.  I was feeling like I was the only one.  I have gained about 5 pounds so far (9 weeks today)  Food has been an issue for me from the start.  GI troubles have been my biggest sx.

I am concentrating on trying to eat heatlhy, but have developed a sweet tooth and it has me worried.  

Lack of muscle tone is setting in.  I am hoping now that it is cooling off, getting back into my walking routine will help.  Right now I am kind of at a loss.......

Isobella

[nygirl7]

"I still feel really big and bloated particularly around my torso. "
-----------

Unfortunately that is really a very common complaint around here while on treatment.  At least you know it's the diseasae and it's treatment causing it...and although it takes a while after treatment is over it does seem to slow down and stop.

Have you had your thyroid checked lately? I'm asking because weight gain can be associated with hypothyroid.....which is not all that rare on treatment (having thyroid related issues)?

[portann]

Thank you so much for posting. I gained  almost six pounds in the first three months of tx. I worried it might be my thyroid or something but the lab numbers were okay.

It was just like my pregnancies in the first trimesters. All I could stomach, morning, noon or night, was plain pasta and butter - no sauce. Sometimes toasted white bread - no jam. And peanut butter and mustard. I couldn't stand the sight or smell of healthy food and, bad me, never forced myself to eat what I didn't want.

One day, almost four months in, that changed. I now enjoy vegetables again (kind of) and some of my old favorites, except fish. And my weight is almost back down to where it was. My loss of muscle tone is shocking, though, after four months.

The biggest difference is I don't have a zest for food and eat mechanically and dutifully. What a loss. Still, my dreams are intact and I look forward to eating my way through Italy someday, without flab.

Hugs.

[epiphiny]

Thank you so much for replying, it's good to know I'm not the only one out there with these weird body/food issues.  

I am also trying to focus on eating healthily but it does seem that I am mechanical in my approach and no matter how little I have to eat I feel incredibly bloated.  And the sweet tooth has been driving me crazy.  I find myself eating peanut butter, almond butter, and tahini by the spoonful and I started adding honey to my tea which I never used to do and found myself drinking lots of tea (decaffeinated, because I read a study that suggested the tannin in tea inhibits riba absorption) just to get the honey hit.  I'm trying not to do that these days but sometimes it seems the honey hit is something to look forward to in an otherwise bland culinary day.

NYGirl, thank you for the suggestion about getting my thyroid function checked; I am seeing my NP next week so will check with her, I know they do it as a standard part of my safety bloods.  I know I am low on hb and platelets and I am doing everything in slow motion compared to my pre tx self, so perhaps it's also a combo of the increased fat and sugar and decreased activity.

I just wish my body would make up it's mind about the way it feels!!  It seems to change throughout the day and I struggle with choosing clothing that I feel confident will be comfortable all day at work and still looked reasonably well presented, and not draw attention to the fact I now wobble when I walk!

[Isobella]

LOL!  Definately a little jiggle in my walk!

[NJDrummer]

I am Italian and love food..but I have to force myself to try and eat anything. I ook in the refigerator and just can't eat.  Been drinking water and craberry juice..and toast and tea.  Gonna try and eat some chicken in a bit, whatever my brother is cooking smells good.  Maybe will get some more energy if I eat some real food.

[Effiedanna]

Hi, i understand totally i have lost 32 lbs in 6 mos. Its a constant battle.
Goodluck everyone Effie

[helpnikki]

Fruity or flavorful sweet cravings are driving me crazy too...but I can't stand anything with salt.  I tried lime coconut cupcakes - vegetarian style... yum. Can't stand chocolate anymore. Can't eat Italian food - stomach bloats... Japanese food agrees with me - Tuna, rice, edamame, cucumber salad, italian and creamy garlic salads... lots of raw veggies and fruits taste good. I was a Starbucks **** (everyone knows my drink) - now I don't even go in there. I still crave the whip cream though - but stomach ache again if I had one!  EAT to Live - for now... and you will get to enjoy food later.