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fatique not r/t to hep C: per doc
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fatique not r/t to hep C: per doc

same GI doc states as well as the itching not caused by liver neither is my fatigue. States the hep C and liver is not bad enough.  WHAT?! The Hep C just only recently caused cirrhosis. How friggin bad does it have to be. This virus had been in my body 25-30 yrs now.  States it is my depression since my son died almost a yr ago.  Shoot I was depressed before that and received counseling and antidepressant. I get depressed when I get fatigue.  They really don't know what their saying do they.  As a said ,I'm an R.N (not working now) and I do not trust many doctors. There are good ones that don't have a GOD complex but the one's that do...I wish they would just say...I don't know!
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163305_tn?1333672171
One of the best things I like about my hepatologist  is how willing he is to say," we don't know."

You know you need to find a good hepatologist who can help you.

Fatigue is the main symptom of hep C.
Your GI is not only misinformed but dangerous.
Shame on them.
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Avatar_f_tn
yeah, I always say that...shame on them...god again i have to look for someone to help me without insurance but i do have a spenddown.  calling MUO in toledo
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1654058_tn?1407162666
Heck yes! This virus can wear you out. I've slept off n on for a week since I'm on Christmas break. Your body is fighting, irregardless of how much damage. I've napped almost daily for 30 years. I know there are stats somewhere. My dr says sleep anytime you can get it so your body can recoup.  
Take care of you.. Karen :)
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oh I wish my doc could see all this.my printer is not working may print at a friends. I'm going to sign off for now but if you have anymore info that could help just let me know? I'll check back.
Hey...does anyone go to a Hep C support group?  Bet the group has so good info tike everyone here.
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Avatar_f_tn
oh I wish my doc could see all this.my printer is not working may print at a friends. I'm going to sign off for now but if you have anymore info that could help just let me know? I'll check back.
Hey...does anyone go to a Hep C support group?  Bet the group has so good info tike everyone here.
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Avatar_f_tn
It is sometimes difficult to tell the difference between depression and fatigue related to other causes.  Depression, like hepc related fatigue, can be long lasting despite a course of therapy and AD.  Although I feel that my long standing HepC caused some fatigue, I can see now that there is a contribution from depression, diabetes, aging, loneliness, grieving as well.   He/she may be responding to other signs of depression that you are demonstrating and trying to convey that a consultation with mental health providers may be helpful but isn't very effective in communicating that to you.  
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87972_tn?1322664839
From an anecdotal perspective fatigue was a real deal for me. I was dragging butt at work; falling asleep some days after only several hours on shift. After pursuing this with my doctor I was diagnosed with HCV, stage 3-4 fibrosis (w/possible transition to cirrhosis). Technically I don’t believe chronic HCV is considered symptomatic but patient-reported symptoms don’t seem to bear that out.  I was previously diagnosed with type II diabetes, but blood glucose was tightly controlled at the time of HCV dx.

Yes, fatigue and depression often present hand and hand, but still....

Good luck and take care-

--Bill
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Avatar_m_tn
Fatigue can arise from depression, dehydration, eating too many refined carbohydrates, lack of exercise, obesity, lack of healthy foods, etc.

It is reckless to blame fatigue just on Hep C.  If one's liver is functioning well (as many a cirrhotic liver does), why should it cause fatigue?
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Avatar_m_tn
Fatigue is the most reported and studied symptom of HCV. Clinical estimates of a median 50% of HCV infected people have this symptom(Weissenborn et al., 2009) to as high as 97%( Goh et al.,1999) This after 85 Journal articles and 11 years of on-going studies.

http://www.hepcaustralia.com.au/images/documents/Fatigue_In_HCV_Infection_A_Review_1989-2011.pdf


On a personal note it was unexplained (and often debilitating intermittent fatigue that led to my diagnosis as it is for many according to the 2 experienced hepatologists I have seen.

Will


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Avatar_m_tn
My ex-wife (internal medicine phsyician) treats people all day long, one after another, who come into her office complaining of being tired.  They are typically overweight, don't exercise and eat poorly. (ie - oil-soaked Lays or fries, sugar-filled Coke and chemical-laden processed meat sandwich wrapped in nutritionless refined bleached wheat bread.

Which probably describes close to 90%+ of our populace.

Now if 97% of Hep C people who feel fatigued eat properly, exercise, have good weight and low blood sugar, I'd say you were on to something.  

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Avatar_f_tn
Well,  let's ask the people who have treated successfully and whose liver is no longer inflamed.  Hey!  You out there!  Yes.  That's right!  You!  Do you feel any less tired now that you no longer have HepC?  No?  Well, do you mind putting down that glass of champagne (beer, whiskey, wine) for a minute to answer this question?  :)
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rambleon

I see you didn't read ..or possibly didn"t understand my post...it is not myself that " is " or " is not " on to anything. It was was the research and studies by the people in the field articled,and what my own particular Hepatologist mentioned. Unlike your self and your ex. I have no knowledge of the facts in the matter.

Curiouslady.. Not sure what you are saying  ,however I personally often don"t..
Will
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Avatar_m_tn
PS -

I appreciate the document and looked it over.  It was interesting.

Besides the fact that it is impossible to tell if the studies completely accounted for lifestyle, I respectfully submit that all research is subject to bias, also, and one needs to know who is funding it.

See, e.g.,

http://blog.hcfama.org/2010/09/16/studies-industry-funded-research-produces-bias-and-is-not-always-disclosed/

www.policymed.com/2011/03/jama-disclosure-of-interests-in-meta-analyses.html

http://www.editage.com/resources/art3.html

http://www.fda.gov/RegulatoryInformation/Guidances/ucm126832.htm (FDA rules, but Big Pharma certainly uses wordsmiths when it comes to reporting).

What is still missing is a good objective non-Big Pharam funded study of people pre-interferon and people post-interefron, folllowed for some time.  

If CDC data is to be believed (1% to 5% of people with Hep C will die of it, 20% will develop cirrhosis), one may have a very hard time justifying the use of the drugs given the anectodal and medically documented side effects, or at the very least one should feel comfortable with a decision not to treat.  
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1654058_tn?1407162666
Thnx Will n Bill. I have ground my own wheat to make my bread since I was in my late 20's. Mostly veggie protein - occasional home made deserts. I taught aerobics n have weight trained my entire adult life. Till now. Never drank.  I also slept in my classroom after school before I could grade papers n drive home. Literally slept in parking lots n at rest stops.
I did all of this in an attempt to ward off fatigue. Situational depression? Sure, we all experience that.
Curious lady n Rambleon - there are other causes for fatigue for sure - but some of us DO have to fight for every oz of energy because of the virus n it's damage to our body. And part of my fatigue today may be related to grieving. I got out n dressed n am now snoozing in my car. My family  used to lol about it. Not so much now.
Call me the Napper.
Karen :)
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Avatar_f_tn
Not surprising to me that you don't understand the humor Will.  Sad.    
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Avatar_m_tn
Pegasys = $2,454.02 / month.  http://www.drugstore.com/pegasys/box-180mcg0-5ml-kit/qxn00004035239

Ribavrin = $260.00 / month.  http://www.drugstore.com/ribavirin/rebetol/200mg-capsules/qxn00781204316

Merck and Roche are going to "educate health care professionals" about triple combination therapy.  

"Improving treatment outcomes for more patients with chronic hepatitis C is our ultimate goal," said Pascal Soriot, Roche Pharmaceuticals Division, chief operating officer. "Through this extended collaboration and the education of health care professionals, Roche and Merck aim to ensure that appropriate patients can benefit from triple combination therapy."

http://www.merck.com/newsroom/news-release-archive/corporate/2011_0720.html

There's not a scintilla of education about suicidal ideations, depression, joint pain, psoriasis, brain fog, or the pretty high likelihood of thyroid damage, though.  


  :-)  


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Avatar_m_tn
I love humour..   I guess yours is a little different than I am used to.. yes I am sorry you are sad about that.
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Avatar_m_tn
Maybe you're right.  

I'd like to try some of that bread!
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1654058_tn?1407162666
Awake n ready to drive. Here's some humor: I've kept orange ear plugs in my purse for years for napping. One day I walked into a department store with them on. I wondered why people were staring! Got in the car n lmbo. Still lol.
Headed home to make cinnamon rolls w amaranth n whole wheat flour, soy milk n margarine. My big "gonna start that Promacta no matter how scared I am" evening.
Laughing to keep from crying today,
Karen :)
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Avatar_m_tn
Well, one more post.  Sorry.  

I used to have pretty intense night sweats before interferon therapy.   I felt like / assumed it was my body fighting off the disease.  It never really bothered me and I just kind of thought it was a good thing.  

But what some of you say about fatigue from the body fighting may be right, though I never really felt it.  

The sweats have pretty much quit since I've done interferon.  I don't know if that's good or not.  I did not get SVR.  I do get intensely fatigued sometimes now, where I just have to go to bed during the day.  C'est la vie.

I had non-detectable levels of the virus during treatment, but high enzymes.  The docs said the interferon was inflaming my liver (autoimmiune reaction).

My hunch is that the interferon damaged my liver as it damaged my skin, joints and brain.  My other hunch is that it has shortened my life.  Do what I can while I can!

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1654058_tn?1407162666
Way to hang tough. We all just get by best we can w what we know. One of the reasons I'm scared of Promacta is that it causes liver damage.. Hell O! G4/S4 already. Still lol. Just watch me beat this AND live to a ripe old age.
Using the RIBA rage against the virus,
Karen :)
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1833444_tn?1325560662
That's the attitude to have Karen...good luck in your SVR.
Stay strong all
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Avatar_f_tn
It hit me as I started to go into cirrhosis. Yes fatigue is a part of it all. I had a rash for years on my side. I haven't seen that rash since I started and now have finished with treatment and yes the night sweats were horrible. I don't have them any more. The thing is this symptoms can be from so many things, but to me it was all related to the hep c or the liver damage and my liver was still compensated. I think it just filter out the poisons as well and that causes the rashes or itching some get and the night sweats to me seem to be my body fighting this disease. The worse was never waking up feeling well, always feeling sick and getting out of bed and moving was hard. I have to say that is all improved since going through treatment. Of course I'm still waiting the six months out and hoping the 24 weeks was enough.Honestly for me my body just wouldn't take anymore of the drugs. I started out so well but I could tell my body was telling me it couldn't take anymore. I really admire people who can get through it long term.
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Avatar_f_tn
Constant fatigue is what caused me to discover the Hep C as well.
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Avatar_f_tn
Proof is in the pudding. I have three people close to me that have treated successfully and every one of them have told me that I'm going to be amazed at how much more energy I am going to have once I get through this. That is where the truth comes in. I was like Karen, having to nap at 10:30 and 3 to get through my day. I'm 16 weeks into treatment and I am already at a place where I have more energy than when I started. Also, my eyegrows and eye lashes are growing like crazy, hair is turning darker, and my eyesight changed or the better (I now have depth perception).  Seems to me after 27 years of having hep c was quietly taking its toll on me in many ways.
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1639131_tn?1306209531
Not singling anyone out but it just infuriates me when everyone wants to blame every kind of illness/symptom on poor diet and life style these days. Yes that can be the cause of a whole slough of things but does that mean  we are going to say that people with cancer, fybromyalgia, heart disease, diabetis, cronic (chronic) fatigue syndrom (syndrome), thyroid problems, lymes disease, ( I could go on but I don't think I need to ) are all of thier symptoms from poor diet and unhealthy life style?!! As far as heppers symptoms not being lagit or not proven to be actual hepC symptoms. Well I spent many of hours, days, weeks, months looking this up and doing research and there are many well credited medical facilities that beg to differ also a simple pamphlet from the health dep explains all the Hep C symptoms you can experience ( NOT just from cirrosis (cirrhosis) ) I got my pamphlet in the mail right after I was diagnosed. How do you think they pin pointed symptoms to any kind of illness? They connected thousands of people with the same illness reporting the same sypmtoms along with other medical research and it's NOT just heppers that have to go through big farm companies to treat. Anyone with any illness that has to take medication has to go through them. How else would ANYONE get the medciation they need? Yes I agree  they're money hungry and maybe a little corrupt but that doesn't make our symptoms any less real for goodness sakes.Further more I've read about and talked to many people that have led a super healthy life style all there lives even doing  triathlons and marithons and the Hep c just wipes them out with fatigue and other not so fun symptoms. I've been fighting being sick and fatigued for as long as i can remember and once i FINALLY got a doc to take me seriously it took her two apts and two sets of labs in a matter of maybe a few weeks to find out what was going on and wouldn't you know all the not so taken seriously by some people hep c symptoms all matched up with what I had been dealing with for YEARS. Turns out I have had it for about 20/21 years and am in stage 3 fibrosis. Currently treating with tripple tx.

Once again not trying to single anyone out or get into a war of words just putting it out there.
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Avatar_f_tn
You should go to a hepatologist.  Especially if as you say you have cirrhosis.  
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1639131_tn?1306209531
Soo i read back threw my comment and although I feal very strongly on the subject i think I have to say sorry for the huge tangent I whent on. Just a tid bit of good old riba rage lol. I really haven't had any tolerence for anything lately. Thank God I am done as of yesterday!

Prayers and love to everyone : )
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1253246_tn?1332076910
Fatigue was the main reason for soooo many doctor visits for me.Fatigue IS a symptom of hep C.I could fall asleep anywhere and still do.If it wasnt for the fatigue ,I probably not know I had hep C  cindy
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rambleon40
This forum is based on hep C. And it is a well known fact that the main symptom of hep C is fatigue.
Of course it can come from many things but the poster said she has cirrhosis.
I had cirrhosis, blamed my tiredness on menopause. Nope, it was my liver.
If your liver isn't functioning properly, it depletes your energy. Simple and logical.

Curiouslady,
I can tell you without a doubt that after my transplant my energy zoomed.
And because of what I'd been through I felt my energy slowing, between last winter and the summer, when the hep C began actively damaging my liver.
You are lucky because you haven't had the damage from hep C. Please remember to be compassionate to those of us who have had major problems with the virus. Maybe we learned something  from the experience.
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Avatar_f_tn
I get serious fatigue sometimes.  sometimes I feel like I look gray, ha...I do have sleep apnea and just can't tolerate the mask...the fatigue may be from that, maybe from the hep C, maybe both...but I do excercise, and try to eat ok, I am not overwieght and don't smoke and would have a glass of wine with dinner, but have stopped that since the hep C thing.  Still tired, I wake up tired, at 3pm it's all I can do to stay awake long enough to get some tea, by 8:30 or 9 pm I am out like a light.  I am just use to it, don't know what I would do if i wasn't like that, ha...
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1654058_tn?1407162666
Gracie Lue - you're all good. A lot of is share the story. The years of symptoms... Finally diagnosed n it's so much worse than we ever dreamed.
Thank God for the Inhibbies!
Congratulations on being DONE w that! Yay you!
Did you treat for 48 weeks sinnce you're stage 3? Take care n hope the Rx leaves your system fast! Karen :)
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419309_tn?1326506891
It can certainly be frustrating when doctors cannot find the cause of discomfort, but don't give up and don't lose hope.  I'm sorry to hear that you have suffered such terrible loss and received this difficult diagnosis, but know you're not alone, and even if your doctor is not understanding or giving you confidence, it's not the end of the line.  Be it patients or doctors, we're all human, and no one can be 100% right and 100% agreeable all the time.

Whether or not your fatigue is due to hep c and cirrhosis would be hard for anyone to say with absolute certainty... as you can see, lots of differing opinions from both patients and physicians.  Cirrhosis itself does not cause every person who has it to suffer from fatigue, but it should not be discounted completely either, imho.  Generally itching from cirrhosis occurs when bilirubin levels are elevated, but cirrhosis alone does not necessarily cause itching... so it's not necessarily a cirrhosis = cause proposition.  

If your doctor is not inspiring your trust and confidence, always good to consider seeking a second opinion; imho, any physician who cannot utter the words "I/we do not know" should be one to keep at arm's length.  If through the process you treat and cure your hep c and your fatigue and itchiness vanish, you would then have good evidence to challenge your GI. Good luck moving forward. ~eureka
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1639131_tn?1306209531
I did 28 weeks. When I started tx my doc said i would have to do 48 depending on how I responded to it but ended up only having to do the 28 thank God. My body and mind couldn't take much more.
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Avatar_n_tn
Please, before you start disseminating information about what HCV does and does not cause....PLEASE do some real, in-depth research...and realize that the medical profession has been aware for a number of years now that HCV can and very often does cause fatigue, sometimes debilitating fatigue, and it is NOT related to the extent of liver damage.

For a few years researchers were not certain how that could be, then they started detailing two very logical scenarios:  first, the cytokine and immune cell responses to the virus can cause severe symptoms, and also chronic symptoms, one of which is fatigue....(others can include depression, gastric disturbances, joint pain, salivary dysfunction, rashes, etc, etc) all documented as known symptoms of HCV.   Secondly, many researchers started seeing differences in brain physiology when doing detailed scans and MRI's of the brains of HCV positive individuals.  They have compared these results to control groups without HCV and have found significant differences.  Thus, they have theorized that many with HCV may have an actual infection from the virus, in the BRAIN.....or alternatively may have damage in the brain from immune cell disturbances and reactions to the HCV in the body.

Please don't authoritatively tell someone that the fatigue is not from HCV because they don't happen to have advanced liver disease.  That reply is not true, its outdated, and there is PLENTY of documentation of the extrahepatic symptoms of HCV that are totally independent of liver damage.  Sorry for my diatribe, but I just think these kinds of mistaken comments can really lead someone to the wrong conclusions.  I had fatigue for years from HCV, and I was young and 'healthy'!  I also had the joint pains, and the pseudo-Sjogren's symptoms that is often characteristic of HCV.  

Physicians that tell patients that HCV causes NO symptoms are, in my estimation, idiots!  They have not done their homework, and are not at all up to date.

DoubleDose
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901131_tn?1293748153
Physicians that tell patients that HCV causes NO symptoms are, in my estimation, idiots!  They have not done their homework, and are not at all up to date.

I agree 100%, it is crucial to do your homework and find a up to date Doctor because the majority of GIs are not even close to it. Been there done that a few times.....Idiots
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Avatar_f_tn
Here is a study that appears to related directly to the posters' initial question and concern.

http://hepatitiscnewdrugs.blogspot.com/2012/01/fatigue-in-cirrhosis-linked-to.html
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Avatar_n_tn

Here is a copied portion of a HCV website from Australia discussing fatigue in HCV:  






Fatigue and Hepatitis C


Fatigue can be described as a sense of excessive tiredness, lack of energy or total body give out. The majority of people who have hepatitis C may at some stage experience fatigue although it must be stressed that it is not unusual for many people to experience periods of extreme tiredness which may relate to a busy lifestyle, stress or other factors. The term fatigue is commonly used for any symptom associated with tiredness. Fatigue specific to hepatitis C is not associated with the clinical entity known as Chronic Fatigue Syndrome (CFS).

Fatigue may or may not be associated with over exertion or lack of rest, and may or may not be alleviated by rest. There is a wide clinical spectrum of fatigue. The mildest forms are where fatigue is experienced only through over-exertion or lack of rest, and responds well to rest. In its severe form, fatigue is not the result of either over-exertion or lack of rest, and in turn does mot respond to rest.

Factors contributing to fatigue:
Liver dysfunction
Chronic activation
Impaired liver function through alcohol, poor diet and other toxic substances
Poor sleep and lack of rest
Drug use
Stress, distress and other situational problems
Medical treatments such as interferon

Why Hepatitis C causes fatigue

Fatigue does tend to be intermittent and mild, and in general, patients with more advanced chronic active hepatitis and raised liver function tests, (specifically higher ALT levels), tend to experience more severe symptoms of fatigue. This however, is not the rule and fatigue is not a reliable indicator or measure of disease progression or severity. Many people with hepatitis C experience some sort of fatigue and it is the most common single symptom.

The cause of the fatigue experienced in hepatitis C has not been fully determined. There are probably multiple contribution factors towards this symptom and no one single factor can easily be studied without the influence of other factors. Also, the mechanism of how a disease state causes fatigue is not clearly understood. There are two possibilities that could be contributing factors to the fatigue experienced in hepatitis C.

1. The immune system

The major factor in chronic hepatitis C that may contribute significantly to fatigue symptoms is the continuing and long-term response of the immune system to the virus. It is generally accepted that the virus is both directly damaging to liver cells (the direct effect on other cells of the body has not been established) and indirectly damaging to the cells of the liver via the activity of the body’s immune response to the virus.

In other viral conditions such as measles, flu or hepatitis A for example, the response of the immune system rapidly produces antibodies, which eventually defeat the virus. The immune system, after clearing a virus such as measles returns to a less active state. In the majority of patients with hepatitis C (probably up to 90%), the immune system fails to have any impact.

2. The metabolic process of the liver

The liver is the largest organ in the abdomen and is the centre of all the metabolic processes that occur in the body. Liver disease if any kind interferes with the normal biochemical processes in the liver. The liver effectively acts as a filter for any toxic and unnecessary substance in the blood that may interfere with metabolic processes. It has a great deal to do with all substances that enter the body and a large proportion of the chemicals that are produced by other organs. This is why alcohol and certain other drugs are thought to have a strong bearing on the rate of disease progression in the liver.

In chronic hepatitis any number of metabolic processes could be interfered with, resulting in the escape of toxic substances into the body. This has not been proven but fatigue symptoms have been seen to respond favourably to diets and herbal treatments, which address this sort of toxic overload.

The immune system is an intricate and complex part of the whole individual and is intimately related to individual health. With the continuous and ongoing activity of the immune system and the related activity of certain chemicals and molecules as part of the immune response, there is understandably an ongoing effect on the wellbeing of the individual. The intermittent nature and unpredictability of this system could possibly be reflected by the individual nature of each person’s immune response to the virus.
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