antihbs are ok, vit d too low
later today i ll post a study just published about centenarios it happens that they have good vdr or high vit d while others dying younger bad vdr and bad vit d levels
nicotinamide riboside works at 300 to 500mg daily, start 300mg and see the effect
take 200mg with breakfast and 100mg before bed
maybe you have some genetic difference that makes use of vit d/pth different, where did you send the report?
you may try nicotinamide riboside for boosting energy, i take NR plus liposomal resveratrol and pterostilbene as antiage supplements and i got a very potent boost of energy like in my '30, i have no idea if this can work for anybody but definitely worths a try after reaching 35-40yo
keep this therapy and recheck hbsag every year, usually tdf lowers hbsag on 50% of patients to 1000iu/ml by year 5, dont remember if this was hbeg os or neg
as long as creatinine and gfr are within limits it is ok to keep tdf
avoid use of drugs that make kidneys damage, in feb 2015 i had t use antibiotics for 2 weeks and gfr went less than normal and creatinine borderline high and i have not fully recovered to high gfr and very low creatinine like i was before, antibiotics are for sure kidneys killer when using other heavy drugs on kidneys
Hi Stef
Thank you for your kind suggestion , in fact i would like to continue with Tiravir 300 mg. I agreed with you the Sebivo is very weak profile for resistance.
Actully i am travelling to Maldives and have to stay there for 6 months so i am carrying these medicines along with me.
If any issue comes up during my stay at maldives , i shall share with you.
Thank you once again.
sebvivo has a very weak profile for resistance
i'd try the combo tdf plus sebvivo, this combo showed to solve the kidneys problems issues
or much better why not use entecavir?
Hi stef
Looking foward your comments on Tiravir 300 mg vs Sebivo 600 mg. as doctor suggested , and also the reports stated in previous mail.
Thank you
Hi stef
Looking foward your comments on Tiravir 300 mg vs Sebivo 600 mg. as doctor suggested , and also the reports stated in previous mail.
Thank you
Hi Stef
Hope you are doing good , it has been long time we haven't communicate. i have done some test in-between ,i will attach these along with the previous one.
Vitamin D,25 Hydroxy:
- On 9 Dec.2015 : 71.69 nmol/L.
- on 10/10/2015 : 44.6 ng/ml.
- 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 )
- on 1 May 2015 : 65.2 ng/ml
- On 13/6/2015: 41.1ng/ml
- On 8/8/2015: 26.01 ng/ml ( Insufficient range)
PTH ( Parathyroid Hormone) Intact, Serum :
- On 12 Dec.2015: 77.3 pg/ml.
- on 10/10/2015 : 89.5* H pg/ml.
- 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.
- On 1 May 2015: 83.80 pg/mL.
-On 13/6/15: 63.45 pg/ml.
-On 8/8/2015: 95.40 pg/mL. ( HIGH)
S.Creatinine:
- On 12 Dec.2015 : 1.11mg/dl.
- On 10/10/2015 : 0.90 mg/dl.
-On 10 May 2015: S.creatinine : 1.4 mg/dl.
-On 13/6/2015: S.creatinine : 1.09 mg/dl (HIGH)
-On 8/8/2015: 1.00 mg/dL
L.F.T.-
-On 12 Dec.2015:
ALT : 39 IU/L. , Serum Alkaline Phosphatase :135 IU/L , GGT: 20 IU/L , S.Total Protein: 7.2g/dl. , S.Albumin: 4.2g/dl. , S.Globulin:3 g/dl., A\G:1.40.
- On 10/10/2015:
AST/SGOT: 29 IU/L.
ALT/SGPT : 43* H IU/L.
Serum Alkaline Phosphatase: 115* H IU/L.
GGT: 19 IU/L
A\G Ratio: 1.46* L
- 28 Jan.2014
SGOT / AST 48 U/L.
SGPT / ALT - 106 U/L.
ALK . Phosphatase - 139 U/L.
L.F.T.-
- 27/4/2014-
SGOT / AST 40 U/L.
SGPT / ALT 65 U/L.
Alkaline Phosphatase ( ALP ) 143 U/L.
L.F.T :
9 August 2014:
Serum billrubin total ( Jendrassik- Grof) 0.8 mg/dl ,
Serum Billrubin direct ( Jendrassik - Grof) 0.1 mg/dl,
Serum Billirubin Indirect 0.70 mg/dl ,
AST/SGOT ( kinetic-Henry) 10 IU/L ,
ALT / SGPT ( kinetic-Henry) 26 IU/L ,
Serum Alkaline Phosphatase ( Kinetic) 110 IU/L ,
GGT 22 IU/L , S.total Protein ( Bluret) 7.3g/dl ,
S.Albumin 4.1 g/dL ,
S.Globulin 3.20g/dL ,
A\G Ratio 1.28.
L.F.T
- on 8 Nov.2014:
Serum Biluirubin indirect 0.50 mg/dl ,
AST/SGPT ( kinetic - Henry) 24 IU/L. ,
ALT/SGPT ( Kinetic Henry) 34 IU/L. ,
Serum Alkaline Phosphatase ( Kinetic) 136 * High IU/L. ,
GGT 17 IU/L. ,
S.total protein 7.8 g/dl. ,
S.Albumin 4.1 g/dl. ,
S.Globulin 3.70*High g/dl ,
A\G Ratio 1.11* Low.
LFT: On 25Jan.2015:
SGOT/AST: 12.8IU/L ( Ref.range 0.0 -37.0)
SGPT/ALT : 24.7 IU/L ( Ref.range 0-41 )
LFT : On 20 Fe.2015:
ALT : 26 IU/L ( Ref.Range 10-40)
Serum Alkaline Phosphatase 112* High IU/L ( Ref.Range 32-92)
GGT : 21 IU/L ( Ref.Range 7- 64)
LFT On 13/6/2015:
ALT 32 IU/L.
AST 19 IU/L.
Serum Alkaline Phosphatase 104 IU/L ( HIGH)
A|G ratio 1.34 (LOW)
GGT 17 IU/L.
LFT on 8/8/2015:
AST: 22 U/L.
ALT: 30 U/L.
GGTP: 22 U/L.
Alkaline Phosphatase ( ALP): 143 U/L.
Phosphorus: 2.00 mg/dL.
HBV DNA Quantitative , Real time PCR : Plasma
- on 28 Jan.2014- 5156250 IU/mL.
- 1 May 2014: - 33181 IU/mL.
- 9 August 2014: = 5.72x10^2 IU/ml.
- 8 Nov. 2014: 47.5 IU/ml.
- 20 Feb.2015 : 6.04 IU/mi.
- 13/6/2016: HBV DNA NOT DETECTED.
HBsAg Quantitative:
- On 12 Dec.2015: 6485 IU/ml.
- On 10/10/2015: 6858 IU/ml.
- on 28 Jan. 2014: : 7767.68 IU/mL.
- on - 1 May 2014: 6812.40 IU/m
- 9 August 2014: 3585 IU/ml.
8- Nov.2014: 4633 IU/ml
- 20 Feb.2015 : 5174 IU/ml.
- 13/6/2015: 5431 IU/ml
FibroScan:
- On 10/10/2015: 3.8 (E kpa) , CAP ( dB/m) 272.
On 26 Dec.2014 : 4.7.
On 9 August 2014 : 4.9.
on 13/6/2015: CAP ( dbm) Median 270 , IQR 21. , E(kpa) Median 3.5 , IQR 0.5 , IQR/med 14%
Todays I showed all report to Doctor , he advised to change TIRAVIR 300mg with Sebivo 600 mg , his idea to change the medicine is to control the creatinine level. I checked the web site the salt is almost same in both the medicine . please suggest as per your experience.
Looking forward your reply.
Thank you,
you know my concern is that there is something not working like high calcium with vitamin d within ranges and at the same time high pth with high calcium
before starting all that vit d i would go with low dose daily like 2000iu and take all vitamins correlated with vit d pathways to see if this gets solved.magnesium, vit A, vit k2 all work together with vit d and if there are deficiencies of these vits increasing vit d may not be good
gcmaf is the vitamin d transporter to receptors and nagalase made by hbv blocks gcmaf...i d be curious to see what your nagalase is but this is a research test and too difficult to get this in asia
Hi Stef
I have not tried Vitamin A supplements as yet but will find out & start taking it as well, what should be the dose.
Doctor suggested me multi vitamin named : Lycopene,vitamin,methylcobalamin,folic acid,chromium & sodium soft gelatin capsules( Make Medoscha gold) he asked me to take for 2 months. I noticed this is quite useful i feel more energetic now , last 1 month i am taking 1 capsule daily. Whats your opinion ..
Thank you Aduiski ,
Yes I am eating healthy diet and takes green tea 2 times on daily basis. I treatment 1 tab.of Tiravir daily after dinner and it has been started since Jan.2014 so almost 2 years now, Doctor advised to continue it further.
I am meeting Doctor next week and share the outcomes.
Thanks Stef ,
I have stopped taking Vit.3 supplement as my calcium level both in serum & 24 hours urine was high so the vit D3 was stopped almost 3 months , now i have started weekly 60K as per doctor advice , and it showed increase in the result but PTH way high ,
24 /10/15 I am going for calcium check both in serum & urine then will see the result and increase the Vit D3 dose.
I also checked the Parathyroid and found no tumor its normal report.
If my calcium level within normal range i will increase the Vit D3. What you suggest how much Vit D3 should take.
Stef one more question i noticed upper back ach gone through the MRI found all normal but some time the pain is quite severe , it could be related to Vit D diffiency also .
I also lost 10 Kg.weight within 12 months, is it normal or related to HBV .I am concerned on it, please suggest as i am taking overseas job effective 25 Dec.2015 , in Maldives if health permit me i will join there.
My last meeting with Doctor advised me to eat healthy food as normal diet no restriction to any food product.
I am meeting with Doctor next week .
another thing doctors should consider is possible kidneys damage from hbv but this is very hard to see from the tests only by using antivirals you may see improvements in creatinine clearance and serum creatinine after 1 year therapy
i think alt and hbsag are not so important now we need to understand why you have problems with vitamin d pathways (severe vit d deficiency confirmed by abnormally high pth which is usually named secondary hyperparathiroidism but this has to do with vit d deficiency or some kidneys issues).what did the doctor say about this?any clue about the disease?
did you try vitamin A supplements the natural type from fish oil?carlson, nordic naturals are very good brands but also nowfoods although they dont have ifos certification
Hi Stef
Its long time , hope this note will find you in good health ,
I have gone through some test , please find the report along with the previous one , some of the result had increased a lot , please give your expert opinion .
Vitamin D,25 Hydroxy:
- on 10/10/2015 : 44.6 ng/ml.
- 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 )
- on 1 May 2015 : 65.2 ng/ml
- On 13/6/2015: 41.1ng/ml
- On 8/8/2015: 26.01 ng/ml ( Insufficient range)
PTH ( Parathyroid Hormone) Intact, Serum :
- on 10/10/2015 : 89.5* H pg/ml.
- 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.
- On 1 May 2015: 83.80 pg/mL.
-On 13/6/15: 63.45 pg/ml.
-On 8/8/2015: 95.40 pg/mL. ( HIGH)
S.Creatinine:
- On 10/10/2015 : 0.90 mg/dl.
-On 10 May 2015: S.creatinine : 1.4 mg/dl.
-On 13/6/2015: S.creatinine : 1.09 mg/dl (HIGH)
-On 8/8/2015: 1.00 mg/dL
L.F.T.-
- On 10/10/2015:
AST/SGOT: 29 IU/L.
ALT/SGPT : 43* H IU/L.
Serum Alkaline Phosphatase: 115* H IU/L.
GGT: 19 IU/L
A\G Ratio: 1.46* L
- 28 Jan.2014
SGOT / AST 48 U/L.
SGPT / ALT - 106 U/L.
ALK . Phosphatase - 139 U/L.
L.F.T.-
- 27/4/2014-
SGOT / AST 40 U/L.
SGPT / ALT 65 U/L.
Alkaline Phosphatase ( ALP ) 143 U/L.
L.F.T :
9 August 2014:
Serum billrubin total ( Jendrassik- Grof) 0.8 mg/dl ,
Serum Billrubin direct ( Jendrassik - Grof) 0.1 mg/dl,
Serum Billirubin Indirect 0.70 mg/dl ,
AST/SGOT ( kinetic-Henry) 10 IU/L ,
ALT / SGPT ( kinetic-Henry) 26 IU/L ,
Serum Alkaline Phosphatase ( Kinetic) 110 IU/L ,
GGT 22 IU/L , S.total Protein ( Bluret) 7.3g/dl ,
S.Albumin 4.1 g/dL ,
S.Globulin 3.20g/dL ,
A\G Ratio 1.28.
L.F.T
- on 8 Nov.2014:
Serum Biluirubin indirect 0.50 mg/dl ,
AST/SGPT ( kinetic - Henry) 24 IU/L. ,
ALT/SGPT ( Kinetic Henry) 34 IU/L. ,
Serum Alkaline Phosphatase ( Kinetic) 136 * High IU/L. ,
GGT 17 IU/L. ,
S.total protein 7.8 g/dl. ,
S.Albumin 4.1 g/dl. ,
S.Globulin 3.70*High g/dl ,
A\G Ratio 1.11* Low.
LFT: On 25Jan.2015:
SGOT/AST: 12.8IU/L ( Ref.range 0.0 -37.0)
SGPT/ALT : 24.7 IU/L ( Ref.range 0-41 )
LFT : On 20 Fe.2015:
ALT : 26 IU/L ( Ref.Range 10-40)
Serum Alkaline Phosphatase 112* High IU/L ( Ref.Range 32-92)
GGT : 21 IU/L ( Ref.Range 7- 64)
LFT On 13/6/2015:
ALT 32 IU/L.
AST 19 IU/L.
Serum Alkaline Phosphatase 104 IU/L ( HIGH)
A|G ratio 1.34 (LOW)
GGT 17 IU/L.
LFT on 8/8/2015:
AST: 22 U/L.
ALT: 30 U/L.
GGTP: 22 U/L.
Alkaline Phosphatase ( ALP): 143 U/L.
Phosphorus: 2.00 mg/dL.
HBV DNA Quantitative , Real time PCR : Plasma
- on 28 Jan.2014- 5156250 IU/mL.
- 1 May 2014: - 33181 IU/mL.
- 9 August 2014: = 5.72x10^2 IU/ml.
- 8 Nov. 2014: 47.5 IU/ml.
- 20 Feb.2015 : 6.04 IU/mi.
- 13/6/2016: HBV DNA NOT DETECTED.
HBsAg Quantitative:
- On 10/10/2015: 6858 IU/ml.
- on 28 Jan. 2014: : 7767.68 IU/mL.
- on - 1 May 2014: 6812.40 IU/m
- 9 August 2014: 3585 IU/ml.
8- Nov.2014: 4633 IU/ml
- 20 Feb.2015 : 5174 IU/ml.
- 13/6/2015: 5431 IU/ml
FibroScan:
- On 10/10/2015: 3.8 (E kpa) , CAP ( dB/m) 272.
On 26 Dec.2014 : 4.7.
On 9 August 2014 : 4.9.
on 13/6/2015: CAP ( dbm) Median 270 , IQR 21. , E(kpa) Median 3.5 , IQR 0.5 , IQR/med 14%
I noted that the ALT , PTH & HBsAg result had fluctuated a lot from the previous report , please let me know the reasons.
24 hrs urine & serum test is due for next week , i will share with you the result latter.
Thank you,
I will be going 3 years with teravir then may be plan for IFN, aagin depends upon the result & Doctor opinion.
You are about to complete 2yrs of tdf treatment. U can try IFN now. Is it sure that hbsag will go down to 1500iu after 2-3yrs of tdf. IFN must be tried in young age and works different in different individuals.
Thanks Stef ,
Shall try to bring down the calcium first and then planned for Vit.D3 and Ultra Thistle.
what is your say on it?
i know it helps with liver fibrosis, dont know if it has ny effect on kidneys
which is the best time to take this combo.
now to see if calcium goes down fast
I was thinking to bring back the Vit D3 to sufficient level
not now, bring calcium down fisrt
Thank you Stef for your revert,
I was looking in the website and you also suggested some time back milk thistle now it is available ULTRA THISTLE 360 mg. what is your say on it?
As suggested by you i will go for vit A from cod liver oil , i am already taking vit k2 mk7 100mcg last 6 month. which is the best time to take this combo.
I was thinking to bring back the Vit D3 to sufficient level , if i take 60K vitmin D3 weekly it helps need your clarification.As you may have noted my PTH is very high beyond the range in this way i can bring down the PTH as well.
Looking fowar your suggestion as always,
Thank you,
TrY the combo of vit A from cod liver oil 10.000iu daily and vit k2 mk7 200mcg daily and see if calcium declines even more, stay at least 3-6months away from vit d and ifthis combo works protecting you may restart vit d to keep at least min sufficiency