Hepatitis B Community
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Avatar universal

Best Treatment for HBv

I am 53 years old last month I have went for preventive health check up and based on the report findings the followings noted; SGOT 83 IU/L ,SGPT 200 IU/L , Doctor recmended me to see the Gastro.consultant , the gastro.consultant advised me to go for others test the result are as follows: Anti-dsDNA 16.6 IU/ml. , HBsAg test value 9520(Reactive) ,HCV,IgG test value 0.12 ( non Reactive) ,Anti Nuclear Antibody ( ANA) 0.12 , Immunoglobulin IgA 279 mg/dl , Tissue Transglutaminase antibody IgA 0.40 U/mL , Anti Mitochondrial Antibody , Serum 0.26 UL/ml , ASMA 2.70 U/mL , LKM Antibody 0.02 U/ml , Hepatitis B envelope Antibody test value (Ab) 43.0 ( Reactive) , Hapatitis Be Antigen ( HBeAg) 0.15 ( Non reactive),AFP 4.38ng/ml  , HBV DNA Quantitative,Real Time PCR 5156250 IU/ml. Based on this the Doctor advised me for the treatment  Tab.Entavir 0.5 mg one daily. Here i went for second opinion with Lever specialist consultant and he advised me to go for Fibroscan which the result is 5.91 Kpa ( Negative for fibrosis).Now the lever specialist advised for Viraferon Peg 80 mg once in a week and monitor CBC & S creatin every 15 days.I have not started the treatment yet as I am going out of India for 1.5 months as Doctor told me that this treatment will be given under there supervision , please suggest which treatment is suitable under these report.Also with vaccine this problem will be solved and how long i have to take this treatment.
170 Responses
Avatar universal
Thank you Stef,
I am taking Vit K2 MK7 100mcg daily ,it is 1 cap.having 100mcg, can i take 2 cap.so it make 200mcg please suggest.
last 3 days I am not taking D3 , I used to take it daily 10K & Sat.60K.
As suggested by you I will restart D3.
Also as suggested vit k2 mk4 I will purchase it .
I am meeting Endocroligst next week.
Avatar universal
yes go for 2 or 5 caps if you can afford

this is 200mcg per pill
Avatar universal

Vitamin D3 started in the month of June 2014 and the test for calcium done on 28/5/2014 the result was 9.8 mg/dl ( Ref range 8.8 - 10.6)
Now the calcium is 10.6 mg/dl.
So i would it increased but if i see earlier also the result was borderline case can not say it is increased after started D3.
I have stopped all dairy product and drink water almost 4-5 Ltrs per day. I only take glass of double tone milk morning & evening with a mix of turmeric.
Avatar universal
to be sure check also all supplements ingredients, i have found many brands putting calcium among the ingredients of many supplements
Avatar universal
Hi Stef
As posted earlier my meeting with Endocrinologist , he suggested followings test to understand the calcium serum result , followings test conducted:

Dated 23/2/2015:
= Albumin Serum - 4.46g/dL ( Ref.Range 3.50-5.20)
= Alkaline Phosphatase (ALP) Serum - 153 U/L ( Ref.Range 30-120)
= Calcium Serum - 10.60 mg/dL ( Ref.range 8.80-10.60)
= Phosphorus serum - 2.00 mg/dL. ( Ref.Range 2.40-4.40)

Dated 7/3/2015:
=Calcium serum 10.50 mg/dL.
= Phosphorus serum 2.20 mg/dL.
= PTH Intact serum ( CLIA) - 86.60 pg/mL ( Ref.Range 14.00 - 72.00)
= Vitamin D,25-Hydroxy serum 164.50 nmol/L .

Doctor suggested me to take some holiday for Vitamin D3 to understand the base line of increasing Calcium  & PTH, however he mentioned that you start vitamin D3 after 2 weeks and suggested next blood test within 2 weeks.

Already I am on vitamin D3 holiday since 22/2/2015.
Doctor also asked me to go for Parathyroid scan.

I shared my experience with Doctor on this forum  and he appriciated that but when i asked him question related to Vitamin k2 MK7 he suggested to take 1 daily which I am taking almost 2 months now.
I told Doctor that i am still insufficient on D3 in my cell / tissue.
Please suggest your opinion on these result .
Thank you,
Avatar universal
are you on a strict diet on no high calcium foods?dairies, nuts, banana (increases ca absorption)?are you on 2.5-3.5L of low ca water (ca about 2mg/l and no more than 5mg/L)?

if you stop vit d the pth will go sky high, on chronic diseases pth is very high nad vit d low to keep immune suppression, this is one of the strategies of pathogens and this high pth is normal on most hbv carriers together with very low vitd25oh and high 1.25oh

this said there are other reasons for high pth too like your doctor wants to double check

you can follow your doctor's advice but i dont thik it is vit d to increase calcium because in that case pth would be low
Avatar universal
the first thing i would do is:
the no ca diet
3.5l of water to wash out ca
i d check urine ca  and creatinine clearance too (to rule out kidneys problems)

i also had very high ca before starting high dose vit d, i remember i was 10.1-10.5, which is still a normal value but not optimal.when i started the low ca diet and high water, plus vit k2 mk7, it went down in the 8.4-9.4 range despite high dose vit d

we have also to check for tumors in the parathyroid, this must be ruled out
Avatar universal
Thank you Stef,
I am also thinking to start Vitamin D3 daily dose 1000IU.
Doctor suggested for Parathyroid scan that i will do to check for any tumor etc.
I am not taking any diet which have high calcium , daily i am taking 3-4 litres water but not checked the Ca in the water although the water is treated .
Only I am taking double toned milk with turmiric add on it. plus daily dose of Vitamin k2 mk7.
Agreed with you that i need to take high dose of D3 to keep my level upto 100.
I am monitoring my Cretinine level as well on 20 Feb.2015 the result was 1.02 mg/dL. slightly on higher side. As suggested by you i am taking baknig soda with lemon once in a day.
Avatar universal
Only I am taking double toned milk with turmiric add on it.

no milk must be banned, also any milk used in processed foods.milk  and cheese have too much calcium

the diet with no calcium is a must, also check ca in the water, if it has more than 2-5mg/l is not good

check also all supplements because many drugs and supplements have calcium

Avatar universal
Hi Stef

Last 2 months i am evaluating Vitamin D ,PTH , Calcium , Phosphorus and this time routine urine also . Urine report is okay rest of the test as follows:

Vitamin D,25 Hydroxy:
- on 8 Nov.2013 : Vitamin D , 25 - Hydroxy ,Serum ( CLIA ) 41.05 nmol/L.
- on 22 June 2014Vitd25oh :18.22 ng/ml.
- on 24/8/2014 : 51 ng/ml.
- on 8 Nov.2014 : 51.2 ng/ml.
- on 5 Feb.2015 : 157.55 nmol/L ( Sufficient range 75-250 nmol/L )
- on 7 march 2015 : 164.50 nmol/L (CLIA method) Range 75-250 sufficient)
- on 3 April 2015: 174.12 nmol/L ( CLIA method - Ref.renge 75-250 sufficient )

PTH ( Parathyroid Hormone) Intact, Serum :
- on 5 Feb.2015 : 73 pg/mL ( Ref.Interval 14 - 72 )
-on 7 March 2015: 86.60 pg/mL ( CLIA method Ref.range 14-72 )
-on 3 April 2015: 73.60 pg/mL.

Calcium, Serum:

- on 23 Feb.2015: 10.60 mg/dL ( Ref.range 8.8 - 10.60)
-on 7 March 2015: 10.50 mg/dL .
-on 3 April 2015: 10.50 mg/dL.

- on 23 Feb.2015: 2.00 mg/dL. ( Ref.Range 2.40-4.40)
- on 7 March 2015: 2.20 mg/dL.
- on 3 April 2015 : 2.40 mg/dL.

It looks like the Vitamin D is in sufficient range but others like PTH , calcium & Phosphorus are beyond reference range.
As per Doctor Endocrinologist i have stooped taking vitamin D for 3 week effective 15 Feb.2015 to 10 March 2015 as he suggested to go for Parathyroid scan which i have not done yet but I started taking Vitamin D and taking 5K x 2 soft gel so became 10k daily after breakfast along with 1 capsule Vitamin k-2 mk-7 .

Others test like qHbsag , HBV DNA and kidney test , LFT will be done next month as a routine six monthly.

What i understood on these test that my Vitamin D 25 hydroxyl is still low as phosphorus level is still LOW.

Calcium is within reference range but I noticed last few months its on upper range although not very high but still concern.

PTH not coming down looks like low level of Vitamin D.. Plese suggest.. Doctor was doing the scan for same reason , I told him till the time my Vitamin D not go on upper range i need to observe it..

Looking forward to have your comments in these test result.

Thank you,
Avatar universal
174.12 nmol/L still low, it is 70ng/ml.do not refer to ranges they are meanless because vitd25oh cannot tell if there is sufficiency in the tissues if not confirmed by intact pth, you have to go for 100-150ng/ml range at least

your intact pth confirms you are severely deficient on D, if you like you can stop using vitd25oh test and just refer to intact pth and calcium, i do so because vitd25oh is useless for me too
Avatar universal
Calcium, Serum

are you on low calcium diet?since then?are you on 2.5l of low ca water (ca 2mg/l or at least less than 5mg/l)?
Avatar universal
not sure how in other countries but here vit d 25 is in ng/ml
here's a coverter if someone needs it http://www.endmemo.com/medical/unitconvert/Vitamin__D.php

75-250 nmol/L = 30-100 ng/ml
Avatar universal
you may also check
urine calcium by 24hrs urine collection
ionized calcium

this will tell you more about calcium kinetics, before you get rise of ca in blood  you get rise of ca in urine.maybe there is a problem with kidneys, if there is low kidneys function you may have problems in ca, pho etc
Avatar universal
Certainly Stef I will go for 24 hours urine test , regarding water i take 4-5 litres daily .I got the water test report for my home & the result was Calcium NIL but  my office water the value is around 10-20 .. looks high..
KFT test i am plannig to do next month & shared the result with you.

Thank you..
Avatar universal
Thanks Sorte , noted its quite useful..
Avatar universal
when you  go for 24hrs urine collection add also creatinine clearance, urine phosphorus, these tests are very cheap, follow instructions on how to collect

4-5l is too much, go for about 3l, also too much water can be bad

the strange thing of your intact pth is that it regulates calcium too, so if ca is too much in blood pth must go down and kidneys filter ca to go in urine.the glands lose control of making pth when there is a tumor
so when we have all tests we should be able to have an idea about this ca in blood and where from
Avatar universal
Thanks Stef ,
i checked with the lab. for the 24 hours collection of urine sample and taken the instruction from them. I will do this test soon with creatinine , urin phosphorus as well.
Fiine i will restrict water intake to 3 L.
I am taking trivia at 10 PM daily , is it correct to take in the night ?
Morning after breakfast i am taking Vit.D & Vitamin K-2 daily.
Also one more tablet for prostate enlarge i am taking at 11 PM daily.

I feel continues pain on my upper back behind chest.. Don't understand the reason.
Also reducing my weight as well.
Please let me know your views on it.
Thank you,

Avatar universal
i dont know trivia and i cannot help on other drugs i dont know, you should check with the doctor if they have potential for kidneys damage or interference with calcium/pth

the lower back pain is also experienced with kidneys issues (although many go to kidneys failure with no symptoms).i suggest check with doctor about kidneys issues too, the problem with the kidneys is we dont have tests showing damage when it is happening but only tests showing damage has been done.......for example when creatinine in serum goes up most kidneys are lost already (and this does not happen to all, many dont even experience any change in creatinine in blood)
creatinine clearance will tell you how kidneys function is, studyforhope suggested some other tests to see damage at early stage but i dont remember exactly, i think one was maybe urine microalbuminuria/creatinine ratio
Avatar universal
how about USG when it comes to kidneys test, reliable ?
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