Harvoni low grade fever

[virt111]

Two weeks on Harvoni and have had a low grade fever for a week.  i've also had a brutal case of gout in both feet for about the same time for which I cannot take pain medication. don't know if the gout is causing the fever or the tx.

currently bedridden and cannot walk at all. kidney doc said I can't take anything for the gout or fever and I'm in pure misery. only sleep a couple of hours a night.

[patra_]

Funny, after our discussion on cherries and gout, earlier this week baba-mail, had an entry that said that Michigan State Univ found that 20 cherries a day is highly beneficial for treating inflammation of joints, etc.  

Yes, it is not all 1 easy answer, but the more we can help by eating, the lesst meds we will need.

Blessings,

Pat

[virt111]

You're not kidding about things not being simple, Randy. So many components  to consider when you've got multiple systems involved.

I'm so thankful to be in treatment right now and feel very optimistic about that path that I'm on. The gout problem is just an annoyance more than anything.

Thanks and best wishes to you, my friend!

Marc

[Rbeth]

Hey Marc,
So glad you posted all your stuff. It's quite a challenge to do what you're doing! And you're well informed. Glad you are, not glad about gout & ETC!

Things are not always one answer or simple, huh?

Keep up the good work & positive attitude buddy.

Prayers(as usual :) & blessings

[virt111]

My diet has been turned on its ear since my kidney function began to rapidly decline in January. I'm on a very low potassium/low sodium diet. It's amazing how much potassium is in most of the foods we eat, thereby making the low potassium diet a real challenge. I have to weigh out everything so I can track and manage my daily allowance. Most fruits and vegetables have a lot of potassium, coffee, meats, romaine lettuce, you name it and it's probably on my hit list.

So the odds of me being deficient in certain vitamins is fairly high.

I've always been fit and into weightlifting. In January, I was 188lbs and had a lot of muscle. I'm down to 160 right now with a lot of muscular atrophy.

I'll look into good sources of vitamin c that aren't loaded with potassium.

Thank you for the advice. I was not aware of the connection between vitamin c and gout.

[keepingOnkeepingOn]

Gout is from a vitamin deficiency namely vitamin C. Try some other citrus fruit if cherries bother you.

[virt111]

Hi Linda,

I was in the 99.6 wheelhouse a lot myself. But usually before bed is when it would shoot up to the 100.4 to 100.7 range. Accompanied by chills and 'that feeling' you get on your skin when you're feverish.

Today I'm good with no fever. Gout seems a little better as the day has progressed as well. Not ready to do a tap dance by any means, but I don't have that constant throbbing intense pain that I've had for the past week.

Thanks for your reply!

Marc

[virt111]

Hi Kim,

I guess I tend to procrastinate about calling the dr most of the time.

Another thing that I probably should have mentioned is, I had Pneumonia just prior to beginning Tx. (I'm a wreck lately, lol) Took a course of antibiotics which ended two days after my first dosage of Harvoni (3/28). I had a low grade fever during that time as well. Maybe that has not fully left me. I have a follow up appt on the 21st of April with a pulmonologist.

Having said that, this morning I didn't have a fever, nor do I right now. I'll see if it comes back tomorrow, and if so, I'll put the call in.

Thanks for your reply and great advice.

Marc

[hepcandme]

I'm taking my temp right now!

99.6

That's not so high but Marc, yours sounds more serious to me. Let us know what the doc says

~ Linda

[Livelife777]

A fever over 100.4 needs be be investigated.  Marc I do believe you need a call in to your Doc as well as Linda.  Normally your temp will go up between the hours of 4-6.  Regardless, a low grade persistent fever could be from other complications including infection.  Having a suppressed immune system and taking a relatively new med warrants further action.  Not trying to worry anyone as this can be a common side effect, but clearly your Dr should be informed.  
If its nothing, at least it's piece of mind.
.....Kim

[Rbeth]

Marc, sounds like a plan!! I'm sure you'll be fine & I understand hepa's that shrug & are hard to reach. :-/

I'm sure the phone call will be productive. I'm really hoping your out of pain & toute de suite!!!!

All best to you my friend!

Randy

[virt111]

Hi Randy,

The hepatologist saw all of my records and didn't comment on the dozen or so kidney related flags in terms of Tx. And yes, my neph and hepa are communicating, thankfully.

I'm going to try and talk with my hepa, albeit, he's not the easiest guy to get a hold of. Don't really have any upcoming appointments with either doctor, so the phone call will have to serve the purpose.

In the meantime, I'm just staying off my feet whilst trying to continue to work as much as possible. Luckily, I can do my work from anywhere.

Thanks again for the thoughts and brainstorming. I truly appreciate it.

Best to you!

Marc

[Rbeth]

Hi gf,

Cherries are the best answer to gout I found after I saw your post!!
Brilliant...! So never knew this!!

Thanks buddy sis for that USEFUL & natural info!

Love ya, you are a blessing!
Ran

[Rbeth]

Hi again Marc,

Well, this is where I'm not a doctor :(  & why we need them!
Wish I knew the answers to( your) specific proteinuria & low albumin... Have you spoken with hepa about the low albumin & Tx & KFT's? Are your nephrologist & hepatologist communicating? If not, that's a thought.

I have been digging through contraindications & AE's with sofosbuvir, We know that it's it primarily metabolized in the liver & 80% excreted in urine(78% as GS-331007) so renal pathway is major elimination pathway for clearance. My uneducated 'guess', for sure, is that these meds invade cells & purines(anthocyanins in) also broken down in cells & 8 million other things happen in our body(incl drug/drug plasma elevations of SOF/LDV, is that surely anything is possible!! HOWEVER, I do not know ANY hard facts regarding this & your current chronic kidney conditions.... So, I'll keep digging BUT ask your DOC's who 'should' know or at least research & make sense of it for you.... I'm so sorry I don't have more than perhaps a few questions for you to bring. And sorry to hear gouty junk is attacking nearby joints( more acute), not uncommon. Please make sure you get checked out 1. Your health( which you will be fine....) & 1. Your pain which just stinks
Yes, I personally believe there is no way there isn't some interaction, but that JUST my opinion..... which could be meaningless, nevertheless not expert!! CHECK WITH DOC please Marc, not worried, but they could have knowledgable answer....

Answers & blessings,
Ran

[virt111]

Hi Linda,

I'm glad that your fever is not rising. And I know what you mean about explaining to your PCP how HCV affects so many aspects of our systems.

Hope your fever continues to drop...it's just one more thing that you don't really need in the grand scheme.

On the upside, Harvoni has been doing quite well for me and am thankful to be on it.

Thanks so much and best wishes to you!

Marc

[virt111]

Hi Randy,

Thank you so much for all of the information. Unfortunately, I'm still in misery here. Oddly enough, the original toe that was affected a week ago has had a relapse. It's moved through multiple toes and an ankle. You mentioned having an attack during your treatment and I was wondering if there was a component to Harvoni and gout. As in, does Harvoni raise uric acid levels or affect the kidneys in a way that prevents the excretion of uric acid?

My kidney doc never mentioned fluid restriction. However, I'm losing large amounts of protein in my urine do to my malfunctioning kidneys. Blood albumin levels are extremely low as well.

Thanks for the list of foods as well. Also, I was not aware of anthocyanin being the active component. That's great info. I've been drinking tart cherry juice and took Pat's advice and had my wife pick up some cherries yesterday. It does seem to help, but maybe the affects are short lived in my case.

The fever is still present rising up to 100.7 at its highest to date. Agree it's probably gout related.

Having gout yourself, you're well aware of how excruciating an affliction this is. It's really trying.

Thank you again for your well wishes and all of the information. Best wishes to you, too!

Marc

[patra_]

Randy, Hi!  Thanks for the correction on the thingy in the cherries that makes them so helpful!  Wow, I love that list of things that contain theanthocyanins, And antioxidants, too.  A bonus.

I have eaten blueberries and cherries steadily through my tx, & beyond - and a LOT of the veggies, too.  Nice to know how good they are for us.



Johnny:  I sorry I told you the wrong thing, but glad that it may may a difference in how you tum can handle the cherries (and other stuff, too).  

[Rbeth]

Hey Marc,

I sure hope this finds your gout attack eased up. I've had only twice once years ago & once in 10th week of Harvoni Tx. It was brutal for about 36-40 hrs(Big toe) & then surprisingly it just went away. The Only thing I did was drink drink drink water. I don't know if you're fluid restricted.

Anyway, cherries are wonderful. It's the anthocyanin concentration that is abundant in cherries that works on the break down of uric acid crystal formation.  You said you have to watch potassium intake so I google foods rich in anthocyanins(cyadanins). I haven't checked K levels in these foods, but I will. Perhaps some could be utilized for natural health. Of course, CHECK WITH DOCTOR, which I know you do! Here they are:

-all blackberries, grapes, blueberries
-eggplant & avocado
-oranges, elderberry, olives, red onion, figs, sweet potato, mango, purple corn
The article goes on to say 'purple' foods(even leafy purples) are rich in anthocyanins & antioxidants with anti inflammatory response.(as are cherries) great find Pat, wish I would've known that ~

SO , check w/ nephro & hepa re: Harvoni & kidneys & perhaps there may be a few here lower in K.

Again, I really just hope it's abating :( & again, can you intake fluids? Helpful!!
Think low grade fever must be w/ gout, but not a doc.
All best gout be gone blessings to you Marc,
Randy

[hepcandme]

Just wanted to let you know that my fever has not been above 99.8 today so I am still going to still wait to see someone about it

It's not so high and I like my primary doc but I am impatient at times trying to explain to him how the Hep C affects just about everything

Hope you get some relief from your pain

Be well

~ Linda

[virt111]

Always prefer a natural route, if possible. Your admonishment of starting easy with the cherries is a wise one. There's a fair amount of potassium in them as well, which I need to be careful with because my kidney disease, so all the more reason to ease into it.

Thank you so much for the well wishes and best wishes to you as well.

[patra_]

Hope it helps.  It did help me, but whether it was the colchicine (when Tom mentioned the meds I think I recognized that as the ingredient in cherries) or the placebo effect, I do not know.

Back to the col, I can understand why you would have problems with it in meds, not only would it be stronger, but there are other meds for it to interact with, but I am thinking, that in the 'natual' state, in cherries, it won't be such a problem.  

However, to be on the safe side, just eat a few to. begin with, not so much to see if it helps the gout, as to make sure it does not tear your stomach up.  

Good luck with your gout , pain, and your hepc tx!

Blessings,

Pat

[virt111]

Hi Pat,

I'm going to ask my wife to pick up some fresh, frozen, or canned cherries to give them a try. I need to get back to my life here.

Thank you for the info!

Marc

[patra_]

Just a comment.  You mentioned cherry juice.  The friend who introduced me to the concept specified cherries, themselve.  He even uses the cherries that are prepared for pie fillings, over s thin slice of pound cake, to cut the sweet.  I ocassionally find canned cherries packed in water or light syrup, like other canned fruits, but I buy the fresh, or occasionally the dried or frozen ones.

I don't know the difference, or even, for sure that there is one, just daying...

Pat

[hepcandme]

I don't have gout and still have the low grade fever

Despite my reservations, I think I will go and see a doc if tomorrow I still have a fever. Since it will have been a week and that is probably long enough to ignore it.

I will let you know what he says Virt

Do you think the fever making you feel bad?

[virt111]

Hi Tom,

Thanks for the information. My hep dr said no steroids during treatment. My experience with colchicine is not good. It upset my stomach and was coming out both ends. The Medrol Dose pack usually knocks the pain down in a day.

I'll check with my dr on the other med you have mentioned. I'm out of my mind in agony right now.

I think you may be right about the fever. Will post back when this torture is over to see if fever breaks.

Marc

[ChrisZou]

Hi Marc, It's been half a year, I really hope thing are better for you now.
It seems you were using Harvoni and Medrol together? My friend has both HCV and Systemic lupus Erythematosus. She wonders if Harvoni and Medrol could be used together. Can you tell me about your experience with them?

[virt111]

Hi ChrisZou,
Thank you. I'm doing very well! HCV is gone and I haven't had a gout attack since last April.

My doctor advised against going on the Medrol dose pack while on Harvoni as he didn't want to have my immune system compromised. He did not really elaborate further than that. As with any medication, your friend should seek out the advice of their physician. Also, they should contact Gilead's support staff, although I've had mixed results with them. In terms of contraindications, there are none for steroids:

https://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf

Best wishes to your friend on both ailments.