Aa
Does Smoking effect Treatment?
Yes, I smoke about 1 pk every 4 days. I know it's a nasty, vile habit. I've smoked since I was 25 years old so that's over 25 years of smoking. I've never been a heavy smoker and quit with both pregnancies and a couple of times through out the years. Never smoke in my house, car, or at work. It's after dinner, and during the evening hours. As a matter of fact, I had quit for a year prior to dx of hepc. Cold turkey - no patches, no pills. The logic is why am I even bothering with tx when the smoking is going to kill me anyway? True that, and I know every reason in the world why I should quit right now, this minute. I've mentioned coping mechanisms in the past that help us to keep ourselves in check when the sx get overwhelming. I've tried AD's before - the sx from them are worse for me than the actual depression. I don't get the benefit from them that most do and I really gave it an honest try. So, when I get to the boiling point, I smoke a nasty cig and life becomes tolerable again for a while. My question is, does smoking effect the chances of SVR? If I was not a smoker, would I have possibly gotten UND at 12 wks instead of the 793 IU/ml? I haven't seen any studies on this but I haven't made a great effort to find any either. What are your thoughts on this - BTW - I already know what a knucklehead I am for smoking so please don't give me to much grief about that. :)
Trin
Trin
CoWriter
Yeh I had already found the linkage between smoking and high Iron.
The following link references that Egyptian study. Its free.
Appears smoking can cause iron overload. Learn something new every day, here.
Impact of cigarette smoking on response to interferon therapy in chronic hepatitis C Egyptian patients
http://www.psic.info/smoking_liver_2006.pdf
This is the bit that interests me.
Several mechanisms have been implemented in resistance to IFN therapy in heavy smokers which are summarized in Figure 2.
First, heavy smoking causes immunosuppression such as reduction in CD4+ cells, impaired NK cytotoxic activity and recognition of virusinfected cells, and induces apoptosis of lymphocytes. Second, heavy smoking increases hepatic iron overload which is involved in resistance to IFN. Third, smoking induces pro-inflammatory cytokines (IL-1, IL-6, TNF-α) that mediate necroinflammation and steatosis.
Fourth, smoking directly modifies IFN-α-activated cell signalling and action.
As for Metabolic syndrome also being implicated in some of the side. Not really arguing there. But does it also suppress 2A1?
Found this interesting
caffeine intake, mood changes caused by alterations in blood sugar, stress, etc.
And according to this new study, symptoms of depression can also be caused by the Metabolic Syndrome (insulin resistance),
Now last Tx I consumed caffeine in quantity, I did go off coffee though. I didn’t become depressed although I wasnt the most tolerant B@stard in the world. But I did become Insulin Resistant kinda had the unquenchable thirst, which I then tried to quench by drinking Diet Pepsi. Might have got myself into a bit of a vicious circle there.
I also consumed ice-cream in quantity.
Funny thing haven’t had any ice cream for well over a year now, still cant stand the sight of it, and I have gone off cola and hardly touch the stuff now.
Guess I musta over did both of them. And I wont be going anywhere near cola next tx.
CS
Yeh I had already found the linkage between smoking and high Iron.
The following link references that Egyptian study. Its free.
Appears smoking can cause iron overload. Learn something new every day, here.
Impact of cigarette smoking on response to interferon therapy in chronic hepatitis C Egyptian patients
http://www.psic.info/smoking_liver_2006.pdf
This is the bit that interests me.
Several mechanisms have been implemented in resistance to IFN therapy in heavy smokers which are summarized in Figure 2.
First, heavy smoking causes immunosuppression such as reduction in CD4+ cells, impaired NK cytotoxic activity and recognition of virusinfected cells, and induces apoptosis of lymphocytes. Second, heavy smoking increases hepatic iron overload which is involved in resistance to IFN. Third, smoking induces pro-inflammatory cytokines (IL-1, IL-6, TNF-α) that mediate necroinflammation and steatosis.
Fourth, smoking directly modifies IFN-α-activated cell signalling and action.
As for Metabolic syndrome also being implicated in some of the side. Not really arguing there. But does it also suppress 2A1?
Found this interesting
caffeine intake, mood changes caused by alterations in blood sugar, stress, etc.
And according to this new study, symptoms of depression can also be caused by the Metabolic Syndrome (insulin resistance),
Now last Tx I consumed caffeine in quantity, I did go off coffee though. I didn’t become depressed although I wasnt the most tolerant B@stard in the world. But I did become Insulin Resistant kinda had the unquenchable thirst, which I then tried to quench by drinking Diet Pepsi. Might have got myself into a bit of a vicious circle there.
I also consumed ice-cream in quantity.
Funny thing haven’t had any ice cream for well over a year now, still cant stand the sight of it, and I have gone off cola and hardly touch the stuff now.
Guess I musta over did both of them. And I wont be going anywhere near cola next tx.
CS
If you are UND at 3 months post the chance of you not being svr are pretty darn slim.
So diont worry about it.
CS
So diont worry about it.
CS
I smoke. I don't condone it but certainly can't condemn it either. I thought the first thing my doc would tell me to do would be to quit but he said "not now, work on that later this will be hard enough". Thank God cause he was right. I smoke just under a pack a day (but I only smoke half a cigarette then put it out because somehow I convinced myself that would help me...so I guess maybe I really smoke a half a pack a day hahahaha - what great brains I have to help me ease my mind on anything!)
I had geno1A and 1B and whacked them both. Is it helping my liver. No. But do I think that matters with the interferon and riba doing their job - no. Not at all. Of course the studies might tell different but I haven't seen anyone in here fail BECAUSE of cigs - not that I know of anyway.
I know we aren't supposed to go through any heavy duty like withdrawl during treatment though because it can affect us chemically however..........does it apply to cigs again not sure on that but cigs are the most addictive thing I've run across in a long long time.
I would worry about one problem at a time truthfully - I'm not a superhuman and it would have been too much for me to do at both. Which leaves me what excuse right now I'm not sure..........nerves, yeah my nerves that's it!
I had geno1A and 1B and whacked them both. Is it helping my liver. No. But do I think that matters with the interferon and riba doing their job - no. Not at all. Of course the studies might tell different but I haven't seen anyone in here fail BECAUSE of cigs - not that I know of anyway.
I know we aren't supposed to go through any heavy duty like withdrawl during treatment though because it can affect us chemically however..........does it apply to cigs again not sure on that but cigs are the most addictive thing I've run across in a long long time.
I would worry about one problem at a time truthfully - I'm not a superhuman and it would have been too much for me to do at both. Which leaves me what excuse right now I'm not sure..........nerves, yeah my nerves that's it!
"How the hell does phlebotomy improve response rate.
Unless smoking raises your iron level that is."
Yes, it does. The first study I posted explains how.....
"Heavy smoking is associated with increased carboxyhaemoglobin and decreased oxygen carrying capacity of red blood cells (RBCs) leading to tissue hypoxia. Hypoxia stimulates erythropoetien production which induces hyperplasia of the bone marrow. The latter contributes to the development of secondary polycythemia and in turn to increased red cell mass and turnover. This increases catabolic iron derived from both senescent red blood cells and iron derived from increased destruction of red cells associated with polycythemia. Furthermore, erythropoietin stimulates absorption of iron from the intestine. Both excess catabolic iron and increased iron absorption ultimately lead to its accumulation in macrophages and subsequently in hepatocytes over time, promoting oxidative stress of hepatocytes"
"I don’t know about you but this is the first time I have seen anything that gives any indication of why some of us go thru Tx without any sides while others suffer them severely."
It is very interesting. But there are so many other things that can cause the same side, that it will be hard to figure out what's doing it. For example... depression can be caused by anemia, insomnia, caffeine intake, mood changes caused by alterations in blood sugar, stress, etc.
And according to this new study, symptoms of depression can also be caused by the Metabolic Syndrome (insulin resistance), which many HCV patients have (even genotype 2/3).
Biol Psychiatry. 2008 Jun 30.
Depressive Symptoms and Metabolic Syndrome: Is Inflammation the Underlying Link?
BACKGROUND: Behavioral alterations, including depression, are frequent in individuals with the Metabolic Syndrome (MetS). Recent findings suggest that chronic activation of innate immunity might be involved. The objective of this study was to examine the relationship between Metabolic Syndrome and depressive symptoms and to elucidate the involvement of inflammation in this relationship. METHODS: Participants were 323 male twins, with and without Metabolic Syndrome and free of symptomatic cardiovascular disease, drawn from the Vietnam Era Twin Registry. Depressive symptoms were measured with the Beck Depression Inventory (BDI). Inflammatory status was assessed using C-reactive protein (CRP) and interleukin-6 (IL-6); twins with both CRP and IL-6 levels above the median were classified as having an elevated inflammatory status. Factor analysis was performed on individual BDI items to extract specific symptom dimensions (neurovegetative, mood, affective-cognitive). RESULTS: Subjects with Metabolic Syndrome had more depressive symptoms than those without. Depressive symptoms with neurovegetative features were more common and more robustly associated with Metabolic Syndrome. Both the BDI total score and each symptom subscore were associated with inflammatory biomarkers. After adjusting for age, education, and smoking status, the Metabolic Syndrome was significantly associated with the BDI total score and the neurovegetative score. After further adjusting for inflammation, the coefficient for Metabolic Syndrome decreased somewhat but remained statistically significant for the BDI neurovegetative subscore. When controlling for the Metabolic Syndrome, inflammation remained significantly associated with the BDI mood subscore. CONCLUSIONS: The Metabolic Syndrome is associated with higher depressive symptomatology characterized primarily by neurovegetative features. Inflammation is one determinant of depressive symptoms in individuals with Metabolic Syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/18597739?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Unless smoking raises your iron level that is."
Yes, it does. The first study I posted explains how.....
"Heavy smoking is associated with increased carboxyhaemoglobin and decreased oxygen carrying capacity of red blood cells (RBCs) leading to tissue hypoxia. Hypoxia stimulates erythropoetien production which induces hyperplasia of the bone marrow. The latter contributes to the development of secondary polycythemia and in turn to increased red cell mass and turnover. This increases catabolic iron derived from both senescent red blood cells and iron derived from increased destruction of red cells associated with polycythemia. Furthermore, erythropoietin stimulates absorption of iron from the intestine. Both excess catabolic iron and increased iron absorption ultimately lead to its accumulation in macrophages and subsequently in hepatocytes over time, promoting oxidative stress of hepatocytes"
"I don’t know about you but this is the first time I have seen anything that gives any indication of why some of us go thru Tx without any sides while others suffer them severely."
It is very interesting. But there are so many other things that can cause the same side, that it will be hard to figure out what's doing it. For example... depression can be caused by anemia, insomnia, caffeine intake, mood changes caused by alterations in blood sugar, stress, etc.
And according to this new study, symptoms of depression can also be caused by the Metabolic Syndrome (insulin resistance), which many HCV patients have (even genotype 2/3).
Biol Psychiatry. 2008 Jun 30.
Depressive Symptoms and Metabolic Syndrome: Is Inflammation the Underlying Link?
BACKGROUND: Behavioral alterations, including depression, are frequent in individuals with the Metabolic Syndrome (MetS). Recent findings suggest that chronic activation of innate immunity might be involved. The objective of this study was to examine the relationship between Metabolic Syndrome and depressive symptoms and to elucidate the involvement of inflammation in this relationship. METHODS: Participants were 323 male twins, with and without Metabolic Syndrome and free of symptomatic cardiovascular disease, drawn from the Vietnam Era Twin Registry. Depressive symptoms were measured with the Beck Depression Inventory (BDI). Inflammatory status was assessed using C-reactive protein (CRP) and interleukin-6 (IL-6); twins with both CRP and IL-6 levels above the median were classified as having an elevated inflammatory status. Factor analysis was performed on individual BDI items to extract specific symptom dimensions (neurovegetative, mood, affective-cognitive). RESULTS: Subjects with Metabolic Syndrome had more depressive symptoms than those without. Depressive symptoms with neurovegetative features were more common and more robustly associated with Metabolic Syndrome. Both the BDI total score and each symptom subscore were associated with inflammatory biomarkers. After adjusting for age, education, and smoking status, the Metabolic Syndrome was significantly associated with the BDI total score and the neurovegetative score. After further adjusting for inflammation, the coefficient for Metabolic Syndrome decreased somewhat but remained statistically significant for the BDI neurovegetative subscore. When controlling for the Metabolic Syndrome, inflammation remained significantly associated with the BDI mood subscore. CONCLUSIONS: The Metabolic Syndrome is associated with higher depressive symptomatology characterized primarily by neurovegetative features. Inflammation is one determinant of depressive symptoms in individuals with Metabolic Syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/18597739?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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