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394687 tn?1290924440

Can suppliments and other meds effect SOC?

So my battle begins next Monday...yippi. But had another question for my fellow warriors.

Are any of my current suppliments/drugs "not good companions" with SOC and when should I take them if I am taking the riba at breakfast and dinner?

I am 2b, Stage 2ish, 3 mil VL, Severe RA, Ostio, TMJ, Scoliosis, IBS, PVC, Migrains etc.

I take Enbrel injections 2 shots per week. The Biogenetic TNF blocker for Rheumatoid Arthritis
And the following in the AM
Prednisone 5-7 mg for RA pain and inflamation
Sulindac - anti-inflamitory 1/2 tab
Prilosec - for IBS
Protien drink - with probiotics and oatmeal with flax seed every morning
Calcium - magnesium - RA
Centrum Silver 1/2 tab
Stress Tab 1/2 tab - energy
Vit C 500 - antiox
Biotin 1000 - hair/skin
Q-10 for migrans/heart

Mid day - when lots of pain - Darvacette or more prednisone

PM - with dinner - Hylaronic Acid - joints
PM - later to sleep - Zoloft - only 25 mgs plus 1/2 xanax or full lorazipam
If night pain and can't sleep by 1 am then Soma

So my doc just said to keep the steroid under 10mg and everything else was OK - he didn't indicate whether to take with the riba or not. I'm pretty serious about doing this just once so load on the advice please...I understand it is mostly opinion but hey you've been there done that and I have not.

Thanks for being patient with me...Lady you were right about all the worry ahead of tx out weighing the symptoms lol

mikkimoe

15 Responses
394687 tn?1290924440
You forgot to mention you are also on Mercette BC pills in the am - due to not being in the change, active with un-fixed hubby and cysts on uterous and ovaries.

After midnight i revert to the third party...don't ask what happens at 2.
394687 tn?1290924440
Also forgot to mention Cranberry pills in the AM
This may be a hard one to get info on...but I'm trying.

Just need to know if the riba needs to be taken aone or not.
Avatar universal
I would be reluctant to take any supplements that havent been specifically studied with Interferon. You dont know what any possible interactions might be.

The only ones I would take are the anti-oxidants.

All the Best
CS
Avatar universal
what are SOC?
87972 tn?1322664839
Hi Deb,

The SOC (Standard Of Care) refers to the minimum level of care a patient is entitled to by the health care industry. For Hep C, this currently consists of some form of interferon combined with the drug ribavirin. However, a doctor isn’t necessarily restricted by SOC; he can *add* to it if he feels it’s in the patient’s best interest.

Best,

Bill
96938 tn?1189803458
How you doing?  81 now I see. I was interested to see that it's 96 at the end.  Wasn't it 102?
87972 tn?1322664839
Ah, observant as usual!

I’m doing well, thanks for asking. Just motoring through, so to speak. When I spoke to the Hepatologist, he verbally suggested “taking it two years”, which I assumed to mean two calendar years. About a week later, I received a copy of the clinical notes from the meeting, in which he dictated “I’d be in favor of the patient continuing treatment for an additional 24 weeks”, which translates into a total of 96 weeks, or two eleven-month treatment years, sort of :o). I probably won’t split hairs with him; nothing to base it on. As it is right now, I have no science supporting me; I’m just running on intuitive speculation at this point.

Have you made any progress addressing DM lately? Living on twigs and roots like me (no roots, BTW; too many carbs)?

Thanks for asking, my friend—

Bill
96938 tn?1189803458
Have a doc appointment in the am.  Did all the blood work two weeks ago.  Nurse called and asked me what I wanted to know.  I told her all I wanted was platelets and a1c, save the rest for the appointment, including the 6 month post pcr!  Good news is platelets continue to rise, up to 140 now.  On the other hand, a1c is 8.4 so looks like I might be looking forward to a smidge of Lantus daily.  Current diet and temptations aren't cutting it. Am controlling the weight, less than pre-tx but was never overweight anyway.  The Dm will be an ongoing challenge, I suppose.
131817 tn?1209532911
Ahhhh,  quite a pack of pills, huh?  Sorry to hear you have so many pre tx afflictions. I have/had migraines big time on tx. Darvocet didn't cut it. Some take imitrex or fiorcet w/ codiene like me. These aren't so harsh on the liver I am told. I would keep in reserve, if needed. Steriods are really not good on tx. I understand you have RA. Is this for the RA?  I had terrible bone pain during tx and severe migraines, especially with the Neulasta. Hopefully you can avoid that drug!  I was in so much pain, my hemo gave me steroids for a short time. It reduces the amount of interferon you get into your system, so if possible, I would try to NOT take it, or take more interferon. Especially at the beginning of tx. You need to rid yourself of the virus and vl, before you start taking steroids IMO.  I am saying this as I didn't clear at week 12. Possibly, I would have, if not for the steroids. Is there a way you can not take them for a while?  
Of course, your body and system could handle them both fine. From what I have heard and experienced it didn't work very well.

Best to you Monday!  
Linda
394687 tn?1290924440
Linda - wish I could forgo the prednisone but after 14 years the adrenal glands don't know how to act without them...I would probably die if I stop them. But I have titrated down to 5 mg from 10 (body produces 4 p/d - mine use to). More pain came with the cutback. Also cut the anti-inflam in half - also more pain - ugh.

I'm thinking of doing my normal morning routine with the steroids etc at like 7am - when I have my major morning stiffness - then at 11 take the riba and fatty lunch stuff (is yogurt good?) Then I'll take the other riba at 11pm before trying to sleep...can I take it with the zoloft and sleep pills? Maybe this is not good to lay down after taking them huh? Thinking of my IBS...gee this should not be so difficult.

Bill and Guy - DM?
96938 tn?1189803458
DM = Diabetes Melllitus = Type 2 diabetes = whacked blood sugar = pain in the butt = effect of long-term HCV with significant liver involvement ?
Avatar universal
Have you considered insulin? I use it and am tightly controlled - A1c is 4.2.
I have heard people say that "I'm not so bad that I have to take insulin" to which I generally respond "how's your glucose level?". Although in this country diabetes seems often defined as good or bad by whether or not one takes insulin I think of it solely in terms of glucose control. I was on oral meds and I wasn't out of range but when I was on the endless TX road I was nauseas a lot of the time and simply couldn't eat. I asked my doctor if I could shoot some insulin and eat a donut in the morning and he said that would be alright. I never had a weight problem so obesity wasn't a factor in my diabetes. I too think HCV and the bolus steroid treatments I took for organ rejection caused my diabetes. To make a long story short after long consideration and discussions with my doctors I decided to use insulin exclusively for my glucose control.Anyway, with insulin I can pretty much eat what I want and cover with Humalog which is a fast acting and fast clearing insulin. It acts like a normal person's bolus insulin acts when they ingest carbohydrates. It starts working in about 15 minutes and stops in about 2 hours or less. I have been in fancy restaurants and after I ordered I would spread my shirt buttons and slip the needle of my injection pen into my stomach and pump in the appropriate amount to cover my meal. It takes seconds and I'm ready to eat. I looked at all of the available meds for diabetes and when I considered the side effect profiles and the fact that many of the oral meds lose effectiveness over time I chose insulin. I also brought up with my doctors the idea that being a transplant recipient I wondered whether the oral meds which either stimulate the pancreas or inhibit the liver or both might not be the best choice for me. They tended to agree that insulin was a safe approach. I don't own any insulin stock so I am not trying to push insulin for an other reason than it is simple, the dose is easily adjustable according to carb intake and it controls blood sugar extremely well. I am sure you realize that an A1c of 8.4 is way out of line. Poor blood sugar control leads the dangerous conditions which we want so desperately to avoid. You know the risks and they are not worth tempting. If you can achieve a good and healthy glucose level with diet and exercise and oral meds I think that's great. But, if you can't or aren't then I would consider insulin as a viable approach. I hope that you get this issue under control soon. Good luck, Mike
96938 tn?1189803458
Just went to the doc (pcp) and had a long talk. At first, told him I'm ready to go back to the insulin.  After a while, and considering many factors; home life, kids going in all directions but some stability around meals, some diet revision etc  we decided to go with oral metoformin (sp?) with me taking regular readings and a follow-up in 90 days.  I realize that there will be some vigilance and expertise at arriving at equilibrium and, without hcv a focus, I can spend more time and energy on the much longer view.  He was not too concerned with liver interaction. Around  tx#2  managed to get a1c to 6.3, but think tx influenced that.  Now, 6 months post, we have an unobstructed view.  So, I'll continue the diet focus and see what the metoformin can do.  If it comes to insulin, I can deal with that now that there is a reason to view a wider, longer horizon.   By the way, 6 month pcr is back and I am svr. Finally!
Avatar universal
That is really wonderful news my Friend. Congratulations!!!
Yes, I would never trust an HbA1c while taking ribavirin. Early in my first treatment I had an A1c of 2.4. After thinking long and hard about it I surmised that the premature destruction of red blood cells invalidated that number. The lab was looking at RBCs that were perhaps 30 to 45 days old while assuming that they were 90 to 120 days old and thus the A1c extrapolation was based of a false assumption. I didn't find any supporting literature for this theory for a year or longer but finally it started to trickle out and I believe that now most informed practitioners know this and realize that HbA1c while a person is treating is likely to be inaccurately low. I know that, though I was controlled during treatment, I certainly wasn't anywhere near 2.7.
I think Metformin is a good choice. I know people who control their glucose very well with this drug.The pharmacologic mechanism is different from most diabetes drugs.
"Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, Metformin does not produce hypoglycemia in either patients with type 2 diabetes or normal subjects (except in special circumstances, see PRECAUTIONS) and does not cause hyperinsulinemia. With Metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin response may actually decrease."
From: http://www.drugs.com/pro/metformin.html
I like insulin because I like the freedom it allows me when deciding what to eat - and how much to eat. It's a lazy man's approach really because, aside from the injection part, there is little else involved. If I don't want to eat I don't and I don't use any insulin. If I want to eat light I use none or very little. And if, like 30 minutes ago, I want to eat a turkey sandwich with fires and gravy I adjust the dose up to cover it. It's probably not the smartest approach to overall health but at least I do have very tight control over my blood sugar. I really don't eat like that often but once in a while I get the urge.
Once again, congratulations on your SVR and good luck with the other stuff too. I am really happy for you.
Mike
96938 tn?1189803458
Thanks for the good wishes and the good information.  The turkey, gravy and fries sound good
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