svr and alcohol

[hipps]

Hi everybody,
I need your advice and some help. I had 1A type, fibrosis 1, portal inflammation stage 2 before treatment. I had 1 year peg&riba treatment. Now I am 1 year svr. So, the question is next: Can I occasionally take some alcohol (not lot of it, just like small delight)? Second question is: What do official studies say about svr status?When can I consider my hep status cured? After a year svr or after 3 years svr?...I would appreciate your answer very much. Thank you for your effort and advices,
cheers,
Hipp

[NYgirl]

This is one of those personal decisions that cause debate around here for sure.

Personally my doc told me after treatment I could have maybe two glasses of wine a YEAR for the rest of my life, that I shouldn't ever poison my liver again as it was damaged and would continue to be potentially if I did.  So I don't PLAN on drinking at all.

Big change for alcoholic/addict that I am that I even CARE about my liver at all.

I guess that is a good thing.

[sindog]

As far as alcohol, my GI said to never drink alcohol again. Can't answer the other questions.

[FlGuy]

You caught a break and a gift. Take your cure and live your life responsibly.

[jmjm530]

Recent thread on same topic: http://www.medhelp.org/forums/Hepatitis/messages/41568.html

Personally, my doctor allowed me 3-4 drinks a week after I was non-detectible one month post treatment. I was a stage 3 before treating. Congratulations on your SVR!

-- Jim

[jmjm530]

I'm gonna out on a limb here -- and since limbs often break maybe I should put my crash helmet on :) -- but from a number of recent posts on this same never controversial subject ;) it *appears* to ME that those that specialize in the liver and hep c (hepatologists) seem more liberal in allowing alcohol than gastroenterologists (GI's) or  general practioners.

-- Jim

[hipps]

So, instead of taking alcohol (obviously occasional alcohol drinkig is not good idea, right, anyway I dont use alcohol already 4 years so I will not miss it) can I use marihuana? Occasionally of course, just to relax and nothing more.
Thanks.

[NYgirl]

I think the concept is, it's your liver. Alcohol is a KNOWN poison to the liver in all forms. If you want to POTENTIALLY damage your liver further...drink.  If you want to make SURE you don't contribute...DONT.

I don't know that pot is as bad as alcohol but I would think in just being responsible and realizing that liver damage is a serious thing...I'd keep ANYTHING down to the absolute bare minimum possible.

The people who do drink are going to tell you it's Fine. The people who don't are going to tell you it's not.  Who's right? I have no idea but logic tells me...it ain't good for your liver so avoid it if possible.

Does that make sense in a non-judgemental type way?

Trying to just give you an honest reply and not one that is driven by my own personal desires.

[Alady1620]

Smoking is not good for you liver either and marijuana is illegal in most places so be very careful if you do.

My gastro said I could have a glass of wine every now and again with dinner after my treatment if I reach SVR.

[cuteus]

do what you wish, as long as you do it in moderation. Many hepatologists do not ban alcohol for SVRs. In my opinion, if you are SVR, have mild damage and no substance abuse problem, you should be able to handle occassional drinking. Those tropical frozen drinks at the Cheesecake Factory are heaven, as well as the margaritas at my favorite Mexican restaurant.
there are many other things that tax the liver, and we continue using them. It is an amazing organ that can withstand a lot. Just don't abuse it.

[jmjm530]

Alady:Smoking is not good for you liver either and marijuana is illegal in most places so be very careful if you do.
--------------
Good point about smoking. I think sometimes we fall prey to over simplifying things like "drinking is bad for the liver" and forget the big picture which includes a whole complex of lifestyle issues/choices such as diet, weight, exercise, smoking, etc. Drinking in defined moderate quantatites actually has been shown to have cardiovascular benefits. Of course, and this has been repeated in other drinkingthreads, if anyone has had a drinking problem in the past, that's a different story because there could always be the risk of relapse.

[jmjm530]

Cuteus: Those tropical frozen drinks at the Cheesecake Factory are heaven, as well as the margaritas at my favorite Mexican restaurant.
-----------------
Thanks for so poetically pointing out that there can be life after SVR :)

[FlGuy]

When I get svr I had planned to resume my old drinking habits - about a six-pack a year.  I might change that to a five-pack a year and a Cheesecake Factory tropical drink.  Sounds good.

[hipps]

So, if I am "cured" and I had fibrosis 1 stage (minimal damage), isn't it logical to presume that liver SHOULD recover some day?This fibrosis should "vanish" some dday due to liver ability to regenerate(?) So, lets presume that some day my liver will be COMPLETELY curerd, without ANY sign of fibrosis, what differece does it make to drink few drinks occasionally for ME and for someone with healthy liver? This alcohol and pot taking I DONT plan to abuse, just VERY MODERATE using...

[Kalio1]

If you have sustained liver damage either from Hep C or any other cause it is not advisable to continue to drink even small amounts of alcohol.
Continuing to drink even small amounts of alcohol with a damaged liver is a major health risk. It is FAR different for someone with an already damaged liver to drink than a person who does not have a damaged liver regardless of how the damage was caused. No doctor worth his salt would advise a patient with a damaged liver to drink at all in my opinion. I guess it is possible to find a doctor to tell you what you want to hear if you look hard enough for one but it is well established fact that any alcohol consumption with a damaged liver is a very bad idea. So is smoking, taking medications that stress the liver or eating poorly or lack of exercise for that matter. With a damaged liver you have to take all steps to maintain the part of your liver you have left.
It is a misconception that small amounts of alcohol can't be harmful.

[NYgirl]

Said:  No doctor worth his salt would advise a patient with a damaged liver to drink at all in my opinion.


That is how I feel.  

But like the hypocrite that I am...I DO smoke.  Tried to stop and can't.  I thank God every day that the desire to drink was completely removed when I saw what a stage 3 liver looks like compared to someone without any liver damage.  LIFE changing.

I don't feel good about smoking but I'm addicted and weak.  It's not so much a "choice" to smoke really.  I was able to quit hard core drugs years ago and can't quit smoking.  I was able to quit alchol and I've been an alcoholic all of my life.

So to me it's really a. having a good drink (and DAMMM I want a frozen drink from the Cheesecake Factory RIGHT NOW so MUCH LOL they are so TASTY!) is a choice and smoking is an addiction.

Like I said...hypocrite.

(Then again I don't think fried chicken is good for my liver but I"m going to eat it anyway hahahahahahahaha)

[Kalio1]

I guess it's a "pick your poison" situation. We are all adults, we all make our choices in life. You aren't kidding yourself that smoking isn't harming you and you don't go round saying it is ok to smoke "moderately". People can drink on their damaged livers if they chose to do so but telling themselves (or others)there aren't consequences and health risks of such behavior is a bit ostrich like.
True enough smoking isn't good for your liver or any part of your body for that matter but alcohol has a DIRECT impact on our livers, particuarly damaged livers. Addiction is a wily game and people will fool themselves into thinking a little bit is ok. So many people think they have to drink a LOT to cause them harm and that is a myth.
Did't you quit smoking i the past? Maybe I have it wrong but I thought you had quit in the past. So see, you can do it! Quitting on tx is a entirely differet story, tx is so incredibly stressful it seems like the worst time to attempt it psychologically even though health wise it is probably the best time.
We are heading towards the end of this long treatment! When is your "last shot?" date? Mine is the beginning of March. We are about 2/3's of the way thru now!!

[Mister beagle bailey]

Congratulations on being SVR!!!

I think having a drink here or there is a personal choice.  I don't think the medical staffs know much about it after someone is SVR, but for me I won't chance it.  I don't ever want to go through this he!! again.
I have a friend who is SVR for about 10 years now and he's not even allowed to take Lipitor for the rest of his life, so the dr said.

Beagle

[jmjm530]

Hipps:... "So, lets presume that some day my liver will be COMPLETELY curerd, without ANY sign of fibrosis, what differece does it make to drink few drinks occasionally..."
======================
I had stage 3 liver damage prior to treatment.

Now that I've treated -- let's say for arguments sake that I have stage 2 damage. My hepatologist still allows me to drink in moderation. So does another I recently consulted with. Both are well published and are involved with important Hep C trials.

Others here have posted the same advice from their doctors. And I'm sure most of them have some degree of liver damage.

As you can see lots of different opinions here, but in the end it's your opinion that matters for you.

Again, I raise my glass to your SVR -- with or without alcohol in it.

-- Jim

[Dale_Ray]

If you had to ask the question you probably already knew the answer. It's your liver treat it the way you want. Dale

[jmjm530]

BB:I have a friend who is SVR for about 10 years now and he's not even allowed to take Lipitor for the rest of his life, so the dr said.
-----------
If your friend has cardiac risk factors, I'd recommend he seek another medical opinion. The risk of not taking Lipitor may outweigh whatever risk may be involved in taking it. My hepatologist has already given me the green light for Liptor (liptor). Hope this finds you feeling better post tx.

-- Jim

[Kalio1]

Your friend's doctor gave him good advice. There are other colesterol lowerig medications that might be better. Lipitor is contraindicated for those with liver damage and even if you do not have liver damage patients on this drug should monitor their liver closely. Scary stuff, Lipitor, especially if you consume any alcohol.
MBB so how are you feeling now? Getting better every day? Hope so!
mushttp://www.all-about-lowering-cholesterol.com/lipitor-side-effects-liver.html

[Kalio1]

not sure the other link worked.

http://www.all-about-lowering-cholesterol.com/lipitor-side-effects-liver.html

[Mister beagle bailey]

That's good to know, I guess it depends on the Dr.  What do you think about having a drink from time to time?

I'm doing well post tx and hope your doing the same.

Beagle

[Mister beagle bailey]

Hey, I'm doing fine and getting better each day.  my hgb is in the 12.0+ and for me that's good news.

How are you feeling?  I hope this round of tx is kinda on you my friend.

Stay well

Beagle

[can-do-man]

That figures my HGB makes it up to 10 and yours go to 12. Never could catch you beagles.

Sounds like things keep getting better for ya. Take care or should i say RUFF RUFF

[cuteus]

NYG; when you get your SVR, dinner at the Cheesecake Factory is on me, and you can have the frozen drink however you feel comfortable, alcohol with me or non alcoholic with my daughter. She seemed to enjoy it just as much as me!

FLguy; maybe a 5 pack AND a mojito(they make it real good also!)kind of pricey, though.

chevy, weren't you supposed to have that one with me at Times Square? couldn't wait one more yr, huh?

[Mister beagle bailey]

You'll be up there soon, in a couple of weeks your hgb will be in the 12's too.  Then we'll see who's catching who.

Ruff Ruff

Beagle

[honey11]

The main thing is to stop the virus from doing damage to the liver.  After that is accomplished,,,the liver does heal. There is many things toxic to the liver in our everyday lifes.  You can say,,,,you won't drink but filling the body with the wrong kind of foods,,,smoking,,,and taking certain drugs would have to be stopped for life also.  Is everyone willing to do that?  I don't think so because there will be other things that will crop up in your life down the road such as maybe high cholestrol etc and having to get on medication for that.  Are you going to die of a heart attack because you refuse the medicine because its not great on the liver. Everything is moderation and of course I want to live my life also so in my opinion,,,,having a glass of wine is up to the individual.  Actually,,,I'm enjoying it! :)

[NYgirl]

Said:  Lipitor is contraindicated for those with liver damage

You know it's amazing absolutely AMAZING how many of the drug commercialized on tv these days say "do not take with liver damage".  I mean honestly 99% of them have this at the end of the message.

It's our responsibility to make SURE that a drug is NOT on this list.  You are so smart to bring that subject up.

DALERAY - I think your post said it all.  Nobody can say alcohol does not hurt your liver. End of subject ;) (NEver gonna happen)

PS Just for the newbies it is NEVER OK TO DRINK WHILE ON TREATMENT...MAKE NO MISTAKE ABOUT IT AT ALL. NO ALCOHOL AT ALL. NOT DEBATABLE SUBJECT.

(just wanted to post that just in case)

[honey11]

You are right,,,,not one person could state that alcohol is not bad for liver.  
With all due respect,,,I'm a little confused,,,,you state therefore "end of subject,,Never Gonna Happen".  But,,,,
We do know for a fact that Alcohol is bad,,,,Smoking is bad,,,Overweight is bad,,,,all for the liver.  In fact for a person that drinks all the time,,,,6 fold chance for liver cancer,,,,for a smoker,,,5 fold chance for liver cancer,,,and then obesity,,,comes in 4 fold chance,
So just wondering why you are so dead set against having a drink after reaching SVR but the smoking is not such a immediate reaction even though it plays as big of a part in liver damage.

Hey,,,,I'm not trying to give you a hard time because I once upon a time,,,did smoke so I know how hard it is to quit  so smoking overall isn't the issue for me here,,,,,its your definite reasoning for not having an alcohol beverage. :)

[jmjm530]

NY,

Since so many drugs are metabolized through the liver, it's not surprising of all the warnings. That doesn't mean drugs like Lipitor are bad even for those with liver disease, just means it's metabolized through the liver. Just like Tylenol isn't bad (also liver warnings) if taken in approriate doses as recommended by your doctor. Did you realize that Pegasys can also be bad for the liver but that doesn't mean you shouldn't treat with it :)

From the Pegasys website:

"PEGASYS (Peginterferon alfa-2a), like other alpha interferons, can cause fatal or make life-threatening problems worse (like mental, immune system, heart, liver, lung, intestinal and infections). Your doctor should monitor you during regular visits. If you show signs or symptoms of these conditions, your doctor may stop your medication. In most patients, these conditions get better after you stop taking PEGASYS (see medication guide for more information and warnings)."

BB,

Two hepatologists I spoke to said moderate drinking was OK. One said it beneficial in terms of my heart. I think this is one of those black and white issues that isn't black and white at all :) So glad you're feeling better after treatment.

-- Jim

[mikesimon]

I heard at transplant - not from my surgeon but from a transplant nurse - that an occasional drink by a T recipient, not transplanted for alcohol and with no history of substance abuse and with minimal liver damage, wouldn't be hazardous to the patient. Although she wasn't a doctor she intimated that she had spoken with the surgeons and that they agreed on this point but wouldn't comment because the center has a "no alcohol policy". As a matter of fact, I recall that she said she overheard a respected surgeon say this to a patient though she asked me not to mention it to the surgeon. But, I can't say that she or the surgeon(s) are with their salt except that one put a liver in me and he must have done a decent job - I hope. Mike

[scooz]

It's your choice.sounds really yummy to me..You only live once.enjoy it while ya can..

[Forseegood]

Jim: Thanks for so poetically pointing out that there can be life after SVR :)

Gee, I thought I was already *pretty much* living a happy life without alcohol, well, there you go....:)

Like ole Willy Boy said, there's the rub...my doc said "if you don't have any real damage pre-tx, then yeah, a very occasional drink after SVR (and to wait sometime after SVR, for a healing process to occur in the system) would be okay....if you do have real damage before SVR, not a good idea...until they can better define what SVR is and how it impacts a damaged liver's future" (he's a renown hepatologist)....

It looks to me there are people who find the occasional drinking of alcohol pretty darn important to them, or perhaps they wouldn't even take the risk of drinking alcohol post SVR (with liver damage, I'm not talking about no liver damage)...if it is indeed this controversial "even" among docs...

To me at least...if the docs are divided about this issue, that maybe says "something" right there, that this question hasn't really been answered definitively (although in the past I've posted some studies re this issue about alcohol replicating the virus, I also see that we can choose what studies to listen to as well)...

So we have to calculate our own risk/reward values as patients...

To the people who want to listen to something that will support their own wants and needs, no amount of naysaying will make any difference one would suspect....that's evidenced enough by how often this is argued right here on this board alone...with the same arguments for and against, over and over...

It all comes down to the fact that we are all masters of our own ship, and individually, we can choose *who and what* we want to listen to, and what we should ultimately to do regarding this question...

[mikesimon]

Forsee, I'll drink to that! Here's to what ails you. Mike

[NYgirl]

I'll ask Dr. Jacobsen what he thinks when I go on the 7th of August - I figure he's the most (at least one of) the most respected reknown hep doctors in the world.  HE should have a good and fair unbiased answer.  :)

[HepCBoy]

>One said it beneficial in terms of my heart

That Doctor may wish to revisit the subject.

"Any coronary protection from light to moderate drinking will be very small and unlikely to outweigh the harms.

"While moderate to heavy drinking is probably coronary-protective, any benefit will be overwhelmed by the known harms.

"If so, the public health message is clear. Do not assume there is a window in which the health benefits of alcohol are greater than the harms - there is probably no free lunch."

http://news.bbc.co.uk/1/hi/health/4491314.stm

[Mister beagle bailey]

Well, we can debate this subject to dooms day.  As many here have said that drs disagree on this topic, so that tells me that the jury is still out.  All I know is my 2 hepatologist, internist and hemotologist have told me no alcohol except for an occasional glass of wine, which BTW I don't like.  So for me there will be no alcohol.  Who knows, 5 or 10 years down the road we may hear it was not good to drink after SVR, then again it may say it's alright.  But I tend to believe that is's not OK.  Like I said it's a personal choice for all.  Would hate to think that somewhere down the road they blame drinking for some of the relapses, I won't take that chance.

Beagle

[jmjm530]

A more recent article seems to suggest a different conclusion
http://www.medicalnewstoday.com/medicalnews.php?newsid=44143

plus I don't think the article you cite is original research stating moderate drinking is bad but rather a critique of older studies plus speculation.  It's important to note that the article you quote also says: "The good news is that people can still enjoy alcohol in moderation, especially during the festive period. There is no evidence to suggest that light to moderate alcohol consumption will actually harm the heart. However over indulging can have an adverse effect on your health."
http://www.medicalnewstoday.com/medicalnews.php?newsid=44143

Is moderate drinking good for you and your heart? Probably the full answer isn't in yet and maybe will never, be but nothing I've read or heard proves otherwise or even suggests that moderate alcohol  is bad for you. So...if it *might* be good, and if it ain't bad...then what's left of my mental computer says why not if you enjoy it?

-- Jim

[jmjm530]

The second link is the same as the first link and obviously was typed by Brian Fog.  The passage quoted was from HepCBoy's last post and not those links.

[Pdilly]

I agree with some that it is a personal choice.  Obviously doctors will also have their own opinions.  You have to make your choice.  You have see a variety of posts here from A-Z.  You have to make that decision the is right for you as you ultimatly will have to live with it.

[Forseegood]

Hi, it was just a note of fondness and well wishes to a fellow member, didnt mean to start any rumors...

Hope youre doing well and have a great weekend...

[Forseegood]

Hope a certain someone won't be offended so I'll guard against that by not menioning her by name, she is a private person, but I just wanted to thank you for being such a good friend to her, she says such nice things about you for all the kindnesses you display here and elsewhere, God speed to you and I hope you'll start to do better soon...

[HepCBoy]

>It's important to note that the article you quote also says:

I think sometimes we see what we want to see. The quote you reference is from the British Heart Foundation and it states very clearly that light to moderate drinking does not damage the heart. I agree.

What you are saying is that there are health benifits to the heart which outweigh the damage to the liver. I think you are wrong.

For someone post SVR with none, light or very moderate liver damage I really don't think it matters one jot, your heart will stop before your liver. For those with anything more, and your judgement may be different to mine but I say stage 2 and above, I think it matters.

Regardless of liver damage the message is clear "Do not assume there is a window in which the health benefits of alcohol are greater than the harms - there is probably no free lunch". That doesn't say don't drink, that says don't kid yourself.

[honey11]

HepC,,,,I think so true! You can't kid yourself!  If you want to keep liver protected,,,no alcohol at all and don't smoke and don't eat a fatty diet!  If you go by the book,,,,hopefully you will live a long life or at least you know that you did everything you could to prevent liver,,heart,,and every other kind of disease.  
For us to ask our drs if we should have a drink,,,,well,,,Grrrr,,,I think any good dr would promote only good health and stradegy and say absolutely no alcohol.  Mine said that but then under his breath said there was no studies that showed a drink occassionally would not hurt. But be beware! ha
We have to use our own choices and feel good of course by that choice.  And anyone that has problems with alcohol before starting the tx,,,,,of course,,,,I think let it go!  Don't get it started.  Its hard,,,,if you want to have a social drink but scared it will do more damage,,,,then don't,,,it wouldn't be worth it.  If you smoked and asked your dr if you can or should,,,,any good dr will hand over the patch and tell you to quit today.  There is too many studies showing that it doesn't only promote lung cancer but effects you in many ways.  You are obese and ask if you can have a cupcake or two,,,,haha   hmmm Probably he would hand you a piece of fruit!  I mean,,,think about,,,,if you are a professional in your field,,,that is your job to help people to live the healthiest they can!  Trying to live a healthy life can be very hard at times and we all can be very bad at times and get off the path!