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Avatar universal

Zinc levels

We have often discussed here the suspected benefits of Vit D as it pertains to HCV and treatment. I came across this awhile ago
. A small study from last year. Given the findings ,possibly having  "serum zinc" level checked "may " be beneficial  if found low to bring it up to normal reference range.
I personally had mine tested a few months back and it was low and now supplement  "25 mg pr day with my hepatologists approval.
Best..
Will

http://www1.easl.eu/easl2011/program/Posters/Abstract1037.htm

SERUM ZINC BUT NOT SERUM VITAMIN D LEVELS ARE ASSOCIATED WITH DISEASE SEVERITY AND TREATMENT RESPONSE IN CHRONIC HEPATITIS C VIRUS INFECTION

Sorry for the capital letters,they copied like that.

Best Answer
446474 tn?1446347682
Interesting post...I had missed that.

Along with my other daily cirrhosis drugs for HE, ascites, portal hypertension, vitamin D (as I tested very low) about 6 months ago my hepatologist recommended I also take 50 mg of Zinc per day.
Note: I have noticed the Zinc upsets my stomach so I have to take it with a little food. Just my personal experience.

As I think you all know, I plan on treating with triple therapy (INC, peg-INF, RBV) leading into my transplant. Meaning I will attempt to become UND during those weeks (4-12) before transplant. If UND I will then choose a liver without hepatitis C so I will not reinfect my new donor liver and be free of hepatitis C after my transplant. Otherwise of course it is 48 weeks of (peg-IFN, RBV as of now) treatment with a 30% chance of SVR post transplant.

Since I will hopefully be getting rid of my cancerous liver in 7-9 months I would assume Zinc, vitamin D is only in hopes of HCV treatment success.

Thanks Will!

Hector
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Avatar universal
I am looking at my bottle and it is saying: Zinc 50 mg, as amino acid chelate.
    I am going to get my vitamin levels tested, after my Tx. (My Doctor pulled me off of all my vitamins and supplements, before Tx, due to my AST/ALT being 400/500...she thought one of them may have been causing problems with my liver.  All my enzymes went back to normal at 4 weeks into tx)
   I always try to do alot of research on the company that I get the vitamins from, etc
Helpful - 0
1815939 tn?1377991799
I went on-line last night and looked up Zinc supplements. Here is part of what I found:

"Note that many zinc products also contain another metal called cadmium. This is because zinc and cadmium are chemically similar and often occur together in nature. Exposure to high levels of cadmium over a long time can lead to kidney failure. The concentration of cadmium in zinc-containing supplements can vary as much as 37-fold. Look for zinc-gluconate products. Zinc gluconate consistently contains the lowest cadmium levels."

"Different salt forms provide different amounts of elemental zinc. Zinc sulfate contains 23% elemental zinc; 220 mg zinc sulfate contains 50 mg zinc. Zinc gluconate contains 14.3% elemental zinc; 10 mg zinc gluconate contains 1.43 mg zinc."

http://www.nlm.nih.gov/medlineplus/druginfo/natural/982.html

I am going out to buy some today zinc gluconate today, lol.
Helpful - 0
223152 tn?1346978371
I remember back a few years ago Califia was big on using zinc to enhance  tx.  I seem to recall that there were a couple of different kinds of zinc and I cannot remember now what the correct kind was to buy.  I never have had mine tested and I will ask my doc next time.

The vitamin D issue seems to be the rage. For the past few years they have been testing women.  Mine was at a low of 17 and still hovers at about 29 even with 50,000 units of Vit D3 once a month.  Now the current protocol is to test men.  My big strapping husband who is a carpenter and out of doors all of the time got tested and his Vit D is low.  Now he is on 50,000 units D a week.  I was really stunned that he was low.

Note to Hector - no, I didn't know your plan was to start triple prior to the transplant.  Wow - that is an aggressive plan.  As hard as these PIs are on the system I wonder if that is the best stragegy  but you are under top notch care.  Will you have enough lead time on knowing when the transplant is to reach UND on triple?

bean
Helpful - 0
446474 tn?1446347682
Basically if my hepatologist recommends it I do it. She is one of the internationally known hepatologists with emphasis in hepatitis as well as transplant.

M.D., M.P.H.
Director, Advanced Transplant Hepatology Fellowship Program
Director of Viral Hepatitis Research in Liver Transplantation
AASLD Councilor-at-Large

Active Projects:

Natural history and therapies to prevention complications of cirrhosis in patients with HCV and HBV.
Outcomes of HCV infection in dialysis patients and those undergoing kidney transplantation.
Natural history of post liver transplantation disease in patients with HCV infection, determinants of disease severity and management strategies for recurrent disease.
Therapeutic trials with new drugs to treat chronic HBV and HCV.

Techniques in Use:

Population-based studies with sentinel surveillance for incident and prevalent cases.
Cohort and case control studies for in patients with chronic HBV and HCV.
Phase I, II, and III clinical trials.

She is also a lovely and compassionate person. I am so very lucky to have had her caring for me for the last 4-5 years.

:-)
Hector
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Avatar universal
  I believe I posted that too a few months ago  lol  and yes I take it  also.again with the advice of the Hepa.
   Lots of conflicting info. ...Like Mike says  just when we think we know something they throw wrenches in to the mix..
Best.
.Will
Helpful - 0
446474 tn?1446347682
For what its worth....

Benefits of vitamin D and during HCV treatment.
-----------------------------------------------------------------------------------
Transpl Int. 2011 Jan;24(1):43-50. doi: 10.1111/j.1432-2277.2010.01141.x.

Vitamin D supplementation improves response to antiviral treatment for recurrent hepatitis C.

Bitetto D, Fabris C, Fornasiere E, Pipan C, Fumolo E, Cussigh A, Bignulin S, Cmet S, Fontanini E, Falleti E, Martinella R, Pirisi M, Toniutto P.
Source
Medical Liver Transplantation Unit, Internal Medicine, University of Udine, Udine, Italy.
Abstract

In immune-competent patients, higher vitamin D levels predicted sustained viral response (SVR) following interferon (INF) and ribavirin therapy for chronic hepatitis C. This study aimed to verify the influence of vitamin D serum levels and/or vitamin D supplementation in predicting SVR rates for recurrent hepatitis C (RHC). Forty-two consecutive patients were treated for RHC with combination therapy with INF-α and ribavirin for 48 weeks. Vitamin D serum levels were measured in all patients before antiviral therapy. In 15 patients oral vitamin D3 supplementation was administered to avoid further bone loss. SVR was observed in 13 patients; it was achieved in 1/10 severely vitamin D deficient (≤ 10 ng/ml) patients, in 6/20 deficient (>10 and ≤ 20 ng/ml) and in 6/12 with near normal (> 20 ng/ml) 25-OH vitamin D serum levels (P < 0.05). Cholecalciferol supplementation, in the presence of a normal or near normal baseline vitamin D concentration, (improvement of chi-square P < 0.05, odds ratio 2.22) and possessing a genotype other than 1 (improvement of chi-square P < 0.05, odds ratio 3.383) were the only variables independently associated to SVR.

In conclusion, vitamin D deficiency predicts an unfavourable response to antiviral treatment of RHC. Vitamin D supplementation improves the probability of achieving a SVR following antiviral treatment.

© 2010 The Authors. Journal compilation © 2010 European Society for Organ Transplantation.
----------------------------------------------------------------------------------------
Hepatology. 2011 Nov;54(5):1570-9. doi: 10.1002/hep.24575.

Vitamin D: an innate antiviral agent suppressing hepatitis C virus in human hepatocytes.

Gal-Tanamy M, Bachmetov L, Ravid A, Koren R, Erman A, Tur-Kaspa R, Zemel R.
Source
Molecular Hepatology Research Laboratory, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Abstract

Vitamin D supplementation was reported to improve the probability of achieving a sustained virological response when combined with antiviral treatment against hepatitis C virus (HCV). Our aim was to determine the in vitro potential of vitamin D to inhibit HCV infectious virus production and explore the mechanism(s) of inhibition. Here we show that vitamin D(3) remarkably inhibits HCV production in Huh7.5 hepatoma cells. These cells express CYP27B1, the gene encoding for the enzyme responsible for the synthesis of the vitamin D hormonally active metabolite, calcitriol. Treatment with vitamin D(3) resulted in calcitriol production and induction of calcitriol target gene CYP24A1, indicating that these cells contain the full machinery for vitamin D metabolism and activity. Notably, treatment with calcitriol resulted in HCV inhibition. Collectively, these findings suggest that vitamin D(3) has an antiviral activity which is mediated by its active metabolite. This antiviral activity involves the induction of the interferon signaling pathway, resulting in expression of interferon-β and the interferon-stimulated gene, MxA. Intriguingly, HCV infection increased calcitriol production by inhibiting CYP24A1 induction, the enzyme responsible for the first step in calcitriol catabolism. Importantly, the combination of vitamin D(3) or calcitriol and interferon-α synergistically inhibited viral production.

CONCLUSION: This study demonstrates for the first time a direct antiviral effect of vitamin D in an in vitro infectious virus production system. It proposes an interplay between the hepatic vitamin D endocrine system and HCV, suggesting that vitamin D has a role as a natural antiviral mediator. Importantly, our study implies that vitamin D might have an interferon-sparing effect, thus improving antiviral treatment of HCV-infected patients.

Copyright © 2011 American Association for the Study of Liver Diseases.
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Avatar universal
Yes..I am very fortunate to be under the care of a team of experienced Hepa's from my past trial that are following through with my care.
.Their expertise is invaluable to be sure...
Best..
Will
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Avatar universal
I also agree with Hector, that it works better, if taken with food. I always got a weird taste in my mouth, and a bit of a stomach ache, when I took it with-out food.
    I'm glad you found this information out, and that you are setting up a good foundation, for your next Tx. The fact that Hectors' Hepatologist has also recommended it, is also a good sign.
   I also tried to cut down on foods that were high in purines, and then relaxed a bit, with my diet, once I was Und.  There is a list of foods that are high in purines, on here somewhere. I remember anchovies as having the highest amount.
    
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Avatar universal

Hi Dee...I was thrilled to hear about your 12 week UND.. you are certainly on your way to success.

I guess I can hijack this thread..it's mine...he hee

Will
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317787 tn?1473358451
Will, thanks so much that is very interesting, I appreciate you sharing
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Avatar universal
Obviously there was no "best answer" per se on this as it was just some info I passed on ,however I picked Hector's as the best one just for this part of his response which to me  seemed like "best attitude"

Will


"Since I will hopefully be getting rid of my cancerous liver in 7-9 months"
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766573 tn?1365166466
This is interesting. I take Nature Made Cal-Mag-Zinc with D3 every day. Actually several times a day since for some reason it makes my legs fee so much better. A three pack is dirt cheap via Amazon Prime.
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Avatar universal
That is interesting. I never did have my zinc levels checked, but was on 25 mgs a day, myself, for the couple of years, before I did treatment, and I did respond quickly to treatment.  Every few months, I would take a few weeks off though, because I didn't want to have a build up of zinc. Did you find any research, pertaining to wether zinc (a metal) has this kind of problem?
   I also took folic acid, along with it~
Helpful - 0
1815939 tn?1377991799
Thanks for posting that article, Will. It is very interesting. (Maybe I better add some zinc, lol.)

It is interesting that they found no correlation between Vit D levels and treatment response. From that study in Israel,i t seemed that there was a correlation between Vit. D levels and treatment response.

It also seems to me that if these factors play a role, then testing people to see what their levels are should be part of the standard protocol.  I never had either Vit D or Zinc level checked and I did not know I should have had them checked until I was quite a ways into treatment.
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Avatar universal
Just when you think you know something you find out that maybe you don't.

Good luck with the supplementation.

Mike
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