Stiff joints

I have had Hep C for probably over 25 yrs. I was recently DX w/RA factor when I complained of jt. pain. Rheumy says its the Hep C. I have not started TX for Hep C yet, waiting for my Thyroid to get stable. In the last 2 yrs I have noticed that if I sit for more than 15-20 min and get up I am very stiff. I do OK if I keep moving but if i stop get out the WD40. It is hard to sit for a long car drive, movie or stay in bed for more than 7 hours. I'm tired from not sleeping well but can't sleep in because I'm in to much pain and can't find a comfortable position. I've heard this can get worse on TX. Has anyone had this and what if any meds seem to help?

[alagirl]

frequently people find out that they have hepc for the first time when they go in for treatment for their aching joints.  Because hepc eventually causes RA for so many people, good physicians know to screen people for it.  Unfortunately, ridding oneself of the virus does not get rid of the RA if it's already there, which is one of the many reasons I am an advocate of early treatment for hepc.

You will have to talk with your physician about which medications he or she feels are safe for your liver, but will also help with your RA.  Others on the forum may have some ideas along those lines for you.  Your RA can get worse on treatment, and sometimes this lessens after treatment and sometimes it doesn't.  Without treatment, however, you definitely risk progression of the disease, and you risk damage to your renal system as well as other issues.  HCV appears to be doing a great deal of extra-hepatic damage to you already with the RA and thyroid issues, I would probably want to bite the bullet and treat so that you can rid yourself of this disease for once and for all.  While the interferon is not a walk in the park, the pegylated interferon used today is at least better than the harsh types of interferon they used to give, and its used once a week now, as opposed to several shots per week.

That said, I'm one of the lucky ones for whom RA runs in the family and tx has definitely brought it on for me.  And yes, it hurts badly at times, so much so that I can't move my legs by myself to get up in the morning sometimes.  But my doctor has given me strong meds to deal with it, and during the latter part of the week a couple days before my next shot the pain eases to a minimum.  This tells me that when I go off of interferon I may not experience this as a permanent thing.  Or maybe I will.  Either way, I don't at all regret my decision to treat.  I feel relieved, actually, that I won't have to deal with this virus in the future.

[CMcH]

Thank you for your thoughtful response. I wanted to start TX on Dec. 27th but as I had mentioned my GI Doc/NP want the Thyroid levels normal. This concerns me because they have not been normal for the past 10 yrs that I know of, always up and down. My GP thought the levels were within normal ranges last month but the GI folks are being sticklers. Doesn't TX mess with your Thyroid levels anyway? I would just like to get on with it and adjust meds as I go along. Now my twin girls birthday is coming up at the end of March, a work conference early May and my birthday at the end. Always a good reason to put off TX. So there is a mix of relief and frustration when they keep telling me I have to wait to start. I have been hesitant to make plans that require travel etc. in case I don't feel well on TX and I hate to use any sick days at work hoping to store them up for TX.
I am 1a with a low VL 240,000 stage 1/1 so no rush but I feel as you do that this chronic condition is causing autoimmune problems, fatigue, dry eyes etc. I want to do anything I can to get better even if it makes me feel worse.
Thank you again for your response. I hope you feel better I have been reading for a few months now and you have been through so much. I wish you strength and good health.

[Mikkimoe]

I too have severe RA (many surgeries) and am pretty sure I can stay on my enbrel injections when I start Hep C tx. My pain will get worse but thats OK as long as I get this virus out of me. Some of you may have arthralgia (arthritis without severe bone deformaties) - not RA. The cryoglobulin and RA factor test as well as ACC peptides will tell - also see the link below.

This study below is a bit dated but does show the rate of extraheptic manifestations (arthralgia is 10%). If you take the labs listed at the botom and come back neg like I did then you have a less chance of having them. So mine seems to be all RA - darn

http://www3.interscience.wiley.com/cgi-bin/abstract/79502956/ABSTRACT?CRETRY=1&SRETRY=0

[Bobby1952]

What Labs ? I went to the link then logged in and saw an article but no labs.

Bobby

[Susie2007]

Hep C does not cause rheumatoid arthritis although in people who are prone to it (or other auto-immune illnesses) hep C might exacerbate it or even cause it to come on sooner than it naturally would have. Hep C does cause a false positive RH factor in lots of people as well as false positive lyme disease and parvo virus titers. What helped me the most is a drug called plaquenil. A rheumatologist can help with these issues.

[TeeVee36]

I was told by my doctor that any conditions that you have pre-treatment could possibly be exacerbated by the treatment.  If you read enough on this forum you will see that it is true for the majority.

TX does effect the thyroid and that is why it is monitored throughout tx.  Are you currently on meds for your thyroid condition?  You mentioned that it has been up and down for 10 yrs.  I have never had a diagnosed thyroid problem until tx.  After one week on tx and my first lab results I was started on a low dose of Synthroid (25 mg) for hypothyroidism.  Now I am taking 50 mg.  

I have been on this tx for 8 months and have never missed a day of work.  There were times that I shouldn't have gone in but did anyway.  The interferon really messes with your emotions and brings about depression etc.  

Tx dries you out all over: Hair, skin, mouth, sinuses, eyes.  Take good care of yourself buy any products to help you out for the above and have faith.  Treatment is tolerable, I can honestly say that.  Would I do it again...don't think so.

Good luck to you.  You have found a great support group right here and you are lucky to have found if before you even start your tx.  I didn't find this forum until I was 6 mos into it.  I always wanted to talk to someone that was going through what I was going through and it was very hard at times.  

Peace and Love to you,
TV

[Lady Lauri]

Hi, one of my symptons leading to dx was stiff joints, pain in muscles (especially legs). On tx , yes, worse BUT.....before tx my knee joints were starting to hurt, stiffen, etc. That has stopped now!! Still on tx and no more knee troubles! confusing.
I am not dx'd with RA, but still have awful muscle pain during tx. Doc say's should clear up after???
  When bad I take a Vicoprofen or Vicoden, limit use tho. Dr. tried to get me to do celebrex (he's not much into pain pill's if possible) and I just don't want to 'introduce' any more drugs into me right now, so didn't do. Also haven't heard good things about it.

Good luck to you, now and on tx.

LL

[dlr2007]

I've had Hep C for about 17 years and my PCP said I have arthritis. I slept for 11 hours last nite - rare for me!- and could barely walk upon awakening. After sitting for more than a half hour, my hips are so stiff, I limp. I've noticed pain in my fingers lately too :(. And I'm only 38! My joint pain (and emotional pain over other things, I'll admit) was one of the reasons I became dependent on narcotic pain pills. It got so bad that I couldn't possibly get enough meds to function, so I got on methadone. I would love to get off, the sx are killer- weight gain, fatigue, mental fog- and it's confusing cuz some of those syptoms (symptoms) could be from the Hep C. But I have 2 kids to raise, a husband to look after, a house to run and work, so I'm terrified that without medication I would be a nonfuctioning mess. Scary.
  Oh yeah- I have thyroid problems too. I'm only a Stage 1, but it does make me think- could the Hep C be causing all this? Should I be tx'ing now rather than later w/ the new meds? I was a slow responder 12 years ago. It's such a gamble. But it's encouraging to hear of people who get better on tx, and who clear the virus and go on to find enhanced quality of life. Hopefully that will happen with you! Hang in there and be sure to get educated on any meds- for pain and otherwise, of course- the doctors give you- only then can you decide if it's worth it.
-Dee

[Mikkimoe]

Hi,

Here is the article (last paragraph mentions the tests - mixed cryoglobulins, antinuclear antibodies, and anti-smooth muscle antibodies.) mine came back Neg

Clinical Science
Extrahepatic manifestations of chronic hepatitis C

Objective
To assess the prevalence of clinical and biologic extrahepatic manifestations of hepatitis C virus (HCV) infection and to identify associations between clinical and biologic manifestations.

Methods
To analyze the natural history of extrahepatic manifestations of HCV infection, we reviewed only the data recorded prospectively during the first visit of 1,614 patients with chronic HCV infection, coming from a single monocenter cohort. Exclusion criteria were positivity for hepatitis B surface antigen or human immunodeficiency virus. The prevalence of dermatologic, rheumatologic, neurologic, and nephrologic manifestations; diabetes; arterial hypertension; autoantibodies; and cryoglobulins were assessed. Then, using multivariate analysis, we identified demographic, biochemical, immunologic, virologic, and liver histologic factors associated with the presence of extrahepatic manifestations.

Results
At least 1 clinical extrahepatic manifestation was observed in each of 1,202 patients (74%). Five manifestations had a prevalence >10%: arthralgia (23%), paresthesia (17%), myalgia (15%), pruritus (15%), and sicca syndrome (11%). Four biologic abnormalities had a prevalence >5%: cryoglobulins (40%), antinuclear antibodies (10%), low thyroxine level (10%), and anti-smooth muscle antibodies (7%). Only vasculitis, arterial hypertension, purpura, lichen planus, arthralgia, and low thyroxine level were associated with cryoglobulin positivity. By univariate and multivariate analyses, the most frequent risk factors for the presence of clinical and biologic extrahepatic manifestations were age, female sex, and extensive liver fibrosis.

Conclusion
Extrahepatic clinical manifestations are frequently observed in HCV patients and involve primarily the joints, muscles, and skin. The most frequent immunologic abnormalities include mixed cryoglobulins, antinuclear antibodies, and anti-smooth muscle antibodies. The most frequent risk factors for the presence of clinical and biologic extrahepatic manifestations are advanced age, female sex, and extensive liver fibrosis.

[CMcH]

Mikkimoe, Sorry to hear about your RA. They have just detected the RA factor in my blood, all Xray's were OK just my neck had mod/severe degeneration w/spurs. I will have to get tested for Cryo since the cold does affect me. It may be my Thyroid that has my sensitivity to hot & cold.
TV, I was on 125 mg Synthroid for many years but recently I went from Hypo to Hyper in the last year. My meds were reduced to 110 and not 80mg. I test again next week to see if my numbers are OK so I can start TX. It's nice to hear that someone was able to work on TX because that is a big concern for me. My job is labor intensive so I'll have to see.
Most of the sides I read about on TX I feel like I already have! Maybe it is menopause but I have severely dry hair, skin, eyes and mouth. I feel like I have run out of moisture and my muscles are tight as beef jerky. I use tons of lotion and I have always been athletic so this is really bothering me. Makes me feel like asking for HGH or something.

LL That's interesting about your knee's getting better on TX. I have a friend that went through TX and could not make a fist w/hands before but could after TX, so that kind of gives me hope that some of this might get better. Sometimes I have to take a 1/2 Vicoden before getting up and going but usually my hot tub can loosen me up. After work though on the way home more often than not I take another 1/2 to help manage the kids homework, band practice, gynastics, make dinner and not be able to sit until 9:00. I take some anti inflammatory Voltaren for jt. pain in AM for stiffness.

Thank you all for responding, sorry it took so long to reply. I don't seem to have a minute just to do e-mails. As is family is upset that I am on the computer instead of being with them. What on earth are they going to do when I start TX?

[Mikkimoe]

Just do like I do - I tuck my hubby in next to in bed at 10:30 then prodeed to correspond with my 3 support groups till about 1 am  on my laptop in bed (I too had many symptoms - insomnia being the worst). I take a xanax and a 1/2 of a soma and finally doze - but wake up no later then 6:30 am - UGH. I was so excited when I stopped working so I could sleep in - there is no justice :-)