Vitamins During Tx for Sx and Liver Detox etc?

[NYgirl]

I want to go out tonight and get the RIGHT vitamins that could help me with the sx and also one's that could help with detoxing my liver and my immune system etc.  Anything that can help me with this disease! I start tx next week.

I thought it might be a good idea to start a thread where we could find all the relevant information in one place.  I know I've asked before...but some people in here are too weak to go reading every single thread to find the right info.

I was thinking tonight of getting at least C, E, Selenium, Garlic and Zinc.  I worry about the multi cause of the iron (which seems messed up cause of the worry of anemia but...)

Can anybody help list what would be beneficial and why?

Thanks so much to everyone.  The more knowledge I have the more I feel like I can beat this thing!

Debby

PS I am not talking about vitamins INSTEAD of treatment..just in conjunction WITH treatment.

[Lynne5477]

The only thing my dr suggested taking to me was 800 IU's of Vitamin E.  She said some people also take milk thistle and that would be okay.

I think you should really discuss with your dr before adding any type vitamins.  You may end up taking so many that your liver is working extra on these when it could concentrate more on the HCV meds.  Just my opinion.

Good luck starting tx.  I did 48 wks and finished 1 year ago.  It's worth it.

[NYgirl]

Thanks Lynne.  I WOULD ask my doctor but he's impossible to get a hole of. I even called and asked for his nurse and she never called me back. I am almost thinking of finding a new doctor but I really want to get started next week. I dont want to give these bugs any chance to create MORE of themselves in me before I get going!

I figure there must be just common knowledge things that make sense?

[jmjm530]

They make multi-vitamin tablets without iron. That's all I would recommend. I know it's not the American way, but sometimes less is more. :)

As Lynne suggested, you don't want to introduce anything that might intefere with the action/absorption or the interferon and ribavirin. Before and after treatment is a different story.

Sounds like your're revving to go. A positive attitude is a good thing.

-- Jim

[NYgirl]

REvving to go is an understatement!  ;-)

Jim question for you - you mentionned something about the Riba needing fat for absorption and you eat bacon and eggs every morning or something.  Can you explain that? (Sorry if I misinterpreted but I think that's a basic of what you said elsewhere).

[jmjm530]

You know I support your treatment 100% but I'm a little concerned about some of your reservations about your current medical team.

From experience, let me tell you it's very important you get your ducks in order with your med team BEFORE treatment begins.

This discussion group if full of too many people who started with the wrong team. In some cases it simply meant running around and switching to a new doctor, but in others the mistakes by the medical team resulted in serious treatment mistakes.

You want to have a discussion with the team before treatment begins. You want to feel comfortable with how they will schedule your routine blood tests and your PCR tests. If you decide you want that week 4 PCR, make sure they are on the same page. You want to feel comfortable how agressively they will deal with possible anemia. You want to make sure they will intervene with Procrit before reducing your ribavirin. These are important discussions that many of us wish we had prior to treatment.

I know you're raring to go which is terfific, but you really want to start the right way. Hopefully, they will get back to you soon. But if you can't get the answers from them before treatment, this is not a very good sign.

-- Jim

[Tallblonde]

If I were you, I'd consider taking zinc.  Below is a study that supports my recommendation.  Good luck toy you! -- Susan


    
Zinc supplementation enhances the response to interferon therapy in patients with chronic hepatitis C.
______________________________________________________________

J Viral Hepat. 2001 Sep;8(5):367-71.Takagi H, Nagamine T, Abe T, Takayama H, Sato K, Otsuka T, Kakizaki S, Hashimoto Y, Matsumoto T, Kojima A, Takezawa J, Suzuki K, Sato S, Mori M.

    The First Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Gunma, Japan. ***@****-u.ac.jp

    We evaluated the synergistic effect of zinc supplementation on the response to interferon (IFN) therapy in patients with intractable chronic hepatitis C in a pilot study using natural IFN-alpha with or without zinc. No clinical differences were observed between patients treated with IFN alone (n=40) and IFN with polaprezinc (IFN + Zn, n=35). All patients were positive for HCV genotype Ib and had more than 105 copies of the virus/mL serum. Ten million units of natural IFN-alpha was administered daily for 4 weeks followed by the same dose every other day for 20 weeks. In the IFN + Zn group, patients received an additional dose of 150 mg/day polaprezinc orally throughout the 24-week IFN course. No additional side-effects of polaprezinc were noted but four out of 40 IFN alone treatment and three out of 35 IFN + Zn group withdrew because of side-effects. Complete response (CR) was defined as negative HCV RNA in the serum on PCR and normal aminotransferase level 6 months after therapy. Incomplete response (IR) was normal liver enzyme and positive serum HCV RNA. Both of them were evaluated at the 6 months after the completion of the treatment. Patients with higher levels of serum HCV (more than 5 x 105 copies/mL) had little response in both treatment groups. Patients with moderate amount of HCV (105 to 4.99 x 105/mL) showed high response rates in combination group (CR: 11/27, 40.7%; CR + IR 15/27, 64.3%), better than IFN alone (CR: 2/15, 18.2%; CR + IR: 2/15, 18.2%). Serum zinc levels were higher in patients with IFN + Zn group than in the IFN group. Our results indicate that zinc supplementation enhances the response to interferon therapy in patients with intractable chronic hepatitis C.

[jmjm530]

The bioavailability of ribavirn is increased up to 70% when taken with a high-fat meal. The fat also helps with the side-effects of the riba. I understand many people don't like a high-fat diet, actually I'm one of them. But in this case, the trade-off appears worth it. For the next 48 months your priority is to get those big drugs (riba and interferon) into your systems as effectively as possible to kill the virus.

Ribavirin has a half-live of around 100 hours. That means a single dose stays in your system a long time. For this reason it's also not very important what time of day you take it or how you space out the dosages. In other words, don't go crazy trying to space out your doses 12 hours apart.

I usually eat breakfast between 10-12 and my second meal between 3-6. I take my riba right at the end of the meal.

-- Jim

[Fisheress]

I LOVE MY TEAM!  They are wonderful!  Even my boyfriend was VERY impressed!  The clinic is awsome and I can reach my team 24/7!!!!!  Yes jmjm the right team is very importent, I will not be looking for other docs!

BEst ot all!

Oh and I take a Protegra Antioxident and a multi vitamin w/o iron alonf witha lil extra vitamin c.  That was my regimen prior to treatfment and they said to continue it.

Good luck

[jmjm530]

Just to clarify, none of my doctors ever told me to take riba with a "high-fat" meal. Their advice, and what you usually hear, is to "take it with a meal". Sometimes you will hear "take it with a meal that has some fat."

However, I did come the study and put two and two together. The original study is on the net somewhere. Here's a link explaining and I believe it's even mentioned on the riba package insert now.
http://www.rxlist.com/cgi/generic2/ribav_cp.htm

Note that they use the disclaimer "no clinical significance" has been found. In other words, there are no studies proving that better riba absorption translates into more of a chance of SVR. But again, I'm just putting two and two together for myself here.

The other thing with riba (can you tell I'm obsessed with the drug. LOL) is that taking it with antacids can do the opposite of of a high-fat meal. In other words interfere with it's absorption. For this reason I space any antacids at least three hours apart from my riba. Again, no clinical signifiance has been proven, but I want all the riba my insurance pays for. LOL.

This is also partly why I'm reluctant to take too many supplements, etc. Many drugs, vitamins, etc, interreact with each other in ways not always understood.

-- Jim

[v eggie dip]

I gave you my vitamin list the other day and it was approved by my Doctor, however, only before treatment...I have not discussed the vitamins with him while on treament...I can tell honestly say that vitamins made me feel better, for those of you waiting to start treatment, or not treating at all, vitasmins work great for aches and pains and fatigue (at least on me they do)...

You have a great attitude, don't think I ever heard anyone say they were looking forward to starting treatment :)...I am scared to death of it....Send some of that attitude my way :)

Your Doctor and his/her team sounds like mine...I have had 5 phone calls into mine for over 4 weeks now and still haven't got a call back...I would love to switch but can't...Here in Canada you get who the primary care physician sends you to and that's it!

Best of luck with your first shot, we'll all be waiting to hear how you did...

Beth

[NYgirl]

I love this thread it has so much good stuff in it.

I am going to try to make sure that I take the riba with a meal with some fat...even if I have to eat bacon or whatever.  I totally think it makes sense to me...plus i am very thin to start and don't want to lose too much weight if possible. that is one of the doc's biggest concerns with my treatment.

I have a list of questions for my doc WHEN he finally calls me:
1. will i have a 4 week pcr?
2. procrit?
3. treatment if slow responding?
4. vitamins / food restrictions?

I go to a medical group in a very upscale area (although we are actually the poor guys in town).  Supposed to be a very good place.  I think half of the problem is that I didn't have the right questions in place when he was talking to me...but if he won't call me back now that I have more knowledge how can I ask him?

[jmjm530]

Some docs don't return phone calls and you have to work though the PA or nurse. If they're too busy to return your calls, try working through the office manager -- nicely but persistently explaining your situation -- that you're about to start treatment and there are certain things you want to go over BEFORE treatment.

In my case, I correspond with both my doctor and PA via email. They invariably get back to me the same day, sometimes within an hour or two. I only ask them to call me if I think it important.

Not all doctors like this but it's worth asking for their email address and if it's OK if you email them (instead of calling) from time to time.

If nothing seems to work -- and you just can't get through -- I'd hold off injecting anything until the situation was resolved

-- Jim

[NYgirl]

When you mention that antacids have the opposite effect with the Riba.........does that go for stuff like dairy? Milk?

I dont know why I am asking that especially except when Ihave heartburn & dont have antacids a glass of milk will usually help.

Thanks as always over and over and over for your wealth of knowledge Jim.

[cougareyes]

I think the issue of taking riba with high fat has been taken out of context. The recommendation is to be taken with a meal (mainly due to nauseua) with a normal amount of fat content(due to absorbtion). I don't know about you but with my red counts declining and the way I feel, I'm pretty sure the ribas getting into my system.
I'm male 5'10", 170 lbs, little amount of body fat; and when I found out about my compromised liver function, I also found out my cholestrol was slightly elevated. Because of my physical shape and diet I was surprised. Then I found out there is a connection between liver function and cholesterol.
Also the issue of weight; the more overweight a person is there is a possibility that tx will not be effective. Combo treatment can also have issues with your coronary health, and a high fat diet certainly can't help that.
I think we all need to use common sense to maintain a balanced healthy diet, and certainly not to all of a sudden dramatically increase your fat intake for 6 mo or a year. The health consequences of that could have its own set of risk.
thanks for listening

[avidreader]

I really can't stand fatty meats, but I take my Riba with a very high fat content yogurt drink. It's by Stoneyfield Farms which may be regional but they make a banana yogurt drink specifically for babies and it's loaded. The rest of the time I drink low-fat yogurt smoothies because I have osteoporosis and need to calcium load in order for my osteo meds to work. I don't think it is the calcium in antacids that cause the problem.

[NYgirl]

I've spent so many years staying away from fat that it's going to be a change.  I like the yogurt drink idea.  

I'm thin to begin with and can't really let too much weight get away either.  I dont start until next week but I want to make sure I get every single benefit that I can.

I am glad calcium doesn't appear to play a part because I figure I'll be needing that as well.  Women of course have to worry about that.

[1fairygirl]

Here is some info I had come upon somewhere, sorry that I can't give credit to the source.  I do agree with the others that you should always run anything you want to add to your diet by your medical team.  I also saw that you were thinking about adding garlic and according to this article, garlic in the pill form isn't a good thing.  Good luck and Smiles, Sue

Some supplements and/or herbs to stay away from:

AVOID Gingko, Kava, Ginger, Garlic capsules (garlic in food is okay), Valerian Root, Comfrey, Germander, Chaparral, Gordolobo. They can all be toxic to the liver, even in small amounts. St John's Wart (an over-th-counter anti-depressant) can interfere with the Peg and make your treatment ineffective.
  

[couldn't think of a nickname]

I just started take an apple cider vinegar cocktail the other day because I wanted to cleanse the toxins from my system-I feel that the toxins are settling in my muslces and joints and creating problems. ACV is a known healthful substance, used for thousands of years. I had to drink it when I was sick as a kid and it did help as it is anti-viral and anti-bacterial. There are some web sites where people claim that their HIV viral declined or went to 0 while taking it regularly, and then when they stopped, it came back. I don't know about any of that.
I can tell you this though: on my second day of it, I must have started to get some sort of healing crisis that is sometimes seen when the body detoxes. I had several muscle groups burn, old trigger points were twitching, some current trigger points actually responded to treatment when they usually don't, and I felt fatigue, etc.
I experienced this once before taking an herbal remedy that also cleansed the tissues. The first 3 days I felt terrible, then, I felt better than I had in 10 years. I also made sure I drank more water last night to flush stuff out.
I use the pure, unfiltered, kind from www.bragg.com , and it is also found on amazon.com.

John

[NYgirl]

Oh thank you thank you Fairy.  This is exactly the sort of stuff I need to know.  I dont know where I read otherwise but I was going to do garlic!

I am going to run it by him today. In fact I am going to keep calling until they get sick of me and call me back hahahaha!

I looked at St. John's Wort last night and thought that would be a good thing to get.  See that? How valuable your information is!

[1fairygirl]

You go girl and make him pay attention to your needs!!!!
Let us know what you find out.  Good luck and Smiles!

[NYgirl]

I am going to check that out and ask my doctor.  Anything that helps wash the toxins out is sort of what i am looking for.  It sounds absolutely gross...but I am willing to do it!  :)

[NYgirl]

Well I finally got the Doctor's nurse anyways.  ON my two most important questions she told me the doctor would have to tell me (a. 4 week he usually only does at 12 weeks because the results are too early to tell? (b/s) and if I was slow responder would they up the meds or let me continue (she said probably not up the meds as it's weight based and I am already so thin)

But she did say

a. take a good multi and NOT worry about the iron it's not that much?  huh?

b. If i fit the parameters they will give me Procrit for the red blood cells and if the white freak out Nupagin(sorry dont know how to spell).  Some people take both.

c. I am going to be taking PegIntro and Rebetol 200mgs x. 4

I wish I got the doctor...but at least I know something now.  Sounds like he does this very often as she had all the answers straight on hand for me pretty much.

PS they did try to call me yesterday it turns out but they called my home - where I am not when I'm at work. So I feel a bit better now.

[jmjm530]

Yes, substituting "healthy" fats like olive oil, avocado, full-fat yogurt, nuts, almond butter, etc,is a good idea.

The reason my diet is so "bad" right now is because I suffered significant weight loss (30 lbs) at the beginning of treatment and am trying to maintain my weight by any and all means.

Milk is fine. The antacids I was talking about is stuff like tums, maalox, mylanta, gaviscon and things with magnesium, aluminum. I stil take them on occasion but again space them away from the riba. I believe they can affect riba absorption by about 15% which again may have no clinical significance but more and more keeps pointing to ribavirin as being the key to SVR.


-- Jim

[jmjm530]

Well, you got a call back and some partial answers and that's better than nothing, and sometimes that's the best you can get -- so it's up to you how far you want to pursue. My original NP didn't usually do the 4-week PCR either, but when I brought it up, said I really want it, she said OK. Just tell them that you'll pay for it if your insurance won't cover it. Really don't know how they can refuse you.

I'd also want something more specific regarding what "parameters" they use for Procrit and Neupogen intervention.

Only other comment is your riba dose. Forgive my memory but you're geno 1 right and if I remember correctly you're around 125 lbs?

In any event, usual dosing for geno 1's is 1200 mg/day (6 pills) if you're over 165 pounds and 1000 mg/day (5 pills) if you're under 165 pounds.

If I were you I'd nicely insist on the 1000 mg/day (5 pills). More and more evidence is mounting that riba, especially in the first 12 weeks, is critical to SVR. Right now my weight is 150 pounds, down from 176 pre-tx, but I'm still taking 1200 riba day.
If you were like 100 pounds maybe I could understand the 800 mg.

-- Jim