Aa
niacin, cholesterol and viral load
We were hearing that drugs that reduce certain cholestreol eas also effective for HCV in Vitro. Certain statins showed promise.
Niacin also reduces the cholestrerol, it is an essential vitamin. It can be purchased at any pharmacy. There has been some talk that high doses can have not such a good effect on the liver. Buy HCV was shown to require some sort of cholestreol mechanusm to reproduce didn't it?
Bottom line: will it reduce viral load and reduce it enough (when on peg/riba treatment) to wipe out the virus lets day in previous non-responders.
Any research been/being done here?
From "Fluvastatin Inhibits Hepatitis C Replication in Humans"
http://www.sovegastro.com/pdf/Fluvastatina%20inhibe%20replicacion%20HVC%20en%20humanos.pdf
From "Comprehensive Analysis of the Effects of Ordinary Nutrients on Hepatitis C Virus RNA Replication in Cell Culture."
"We found that three nutrients—ß-carotene, vitamin D2, and linoleic acid—inhibited HCV RNA replication and that their combination caused additive and/or synergistic effects on HCV RNA replication. In addition, combined treatment with each of the three nutrients and interferon alpha or beta or FLUVASTATIN inhibited HCV RNA replication in an additive manner"
http://aac.asm.org/cgi/content/full/51/6/2016?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&minscore=4000&resourcetype=HWCIT
From "Effects of promising antifibrotics in liver fibrosis reversal" (simvastatin and fluvastatin)......Page 146
http://www.actabp.pl/pdf/Supl4_07/session11.pdf
MerryBe: "Statins have so many contraindications they will probably never pass muster for liver patients. They happen to be needful for folks with high cholesterol, but most liver patients make too little not too much cholesterol, so they won't help most cases."
Co-Writer: It is scary to think that people may actually believe the stuff you come up with.
------------
I have to agree 100% with Co-Writer here. Statins are considered safe by every liver specialist I've spoken to and were recommended to me prior to treatment, during treatment and post treatment. Just check the current literature. You can't just make stuff up and scare people from a drug that if needed could save their life. You should also know that statins are now being shown to actually help kill the virus and if studies continue to be fruitful, statins may one day become apart of a Hep C treatment program. Do statins have risks? A downside? Of course, and I have concerns in that regard myself, but the risks have little to do with my liver and like Co-Writer says, you have to weigh the risks against the rewards with any drug you take. Just like with Peg and riba -- like those drugs don't have risks. LOL.
"Statins have so many contraindications they will probably never pass muster for liver patients. They happen to be needful for folks with high cholesterol, but most liver patients make too little not too much cholesterol, so they won't help most cases."
It is scary to think that people may actually believe the stuff you come up with.
As Mr Liver says, all the current literature says that statins are as well tolerated by people with liver disease as those in the general population without liver disease.
"never pass muster for liver patients"?
And as a matter of fact, a new study showed that Simvastatin decreased hepatic venous pressure and improved portal hypertension and liver perfusion on patients with CIRRHOSIS and side effects were minimal compared to beta blockers.
http://www.clinicaloptions.com/Hepatitis/Conference%20Coverage/Milan%202008/Tracks/Special%20Populations/Special%20Pop/Pages/Page%205.aspx
"the liver will convert any and all available tissue to assure a steady state of this substance."
"if there is no dietary source, then the liver will dissolve brain and muscle tissue to make it"
Yeah....and when it runs out of all your tissue, it will start using your dog's and then your cat's.....LOL
"As to LDL "MAYBE" being predictive of outcome, I wouldn't go anywhere on that kinds of a maybe. Let's be clear, that's a big maybe and without seeing the whole article, could just be a "publisher's fancy". "
Oh for Pete's sake....there are MANY studies showing the same thing......
"In a growing number of studies in hepatitis C virus monoinfected patients, better response to pegylated interferon and ribavirin treatment has been seen in patients with high baseline serum levels of low-density lipoprotein cholesterol (LDL-C). It has been suggested that the cellular receptor for LDL cholesterol also functions as a receptor for hepatitis C, so that there is competition for binding, with higher LDL levels resulting in less attachment of hepatitis C to cells.
While several previous studies had shown higher LDL to predict better treatment response in hepatitis C-monoinfected individuals, this retrospective study – reported in the May 11 issue of AIDS – is the first to show a similar effect in co-infected individuals."
http://www.hcvadvocate.org/news/newsRev/2008/NewsRev-257.html#_Higher_LDL_cholesterol
"For one thing, what should we do with this.... all rush out and start scarfing animal fat to get our LDL up? "
ROFL
"I'd like to see the whole abstract on this one before I'd buy any of it. They make no mention of ruling out other factors, such as NASH, diebetes, and other conditions known to influence lipid profiles and SVR outcomes. The better studies do rule these out in their predictive models, so this one becomes all the more suspect for not having done so. "
Hey...it's not our fault you missed reading all the studies on this topic....LOL
jogging the brain a little, I finally remembered what first alerted me to statin issues.
It was a little 70 year old with a pacemaker. He was on one of the first statins, and a patient of mine for about 3 years.
He suffered debilitating muscle pain and neuropathy, irritablility and mental issues. I don't know if he had impotence as well as I never asked him. He had been a well known attorney, but his care following his heart incident. had much to do with him never making a full recovery.
Of course, I tried to explain to him how essential cholesterol was to health, how in animal studies those deprived of it became crippled with many forms of we humans label autoimmune diseases. Because I farmed I had read dozens of agricultural studys dealing with nutritional deprivation of animals. These studies included thousands, not hundreds and ergo results were much more conclusive.
I tried numerous times while his physical therapist to convince him he did not need so much of the statin, and that it was responsible for his muscle pain, to no avail. He was also on diuretics and this compounded his issues. I thought his dosages of both were too high, he had lost half his weight and his skin was dehydrated.
He was certain his doctor knew best and had him on the proper dose. Unfortunately his doctor never saw the new "wonder drug" as a possible cause of what led to the mans pain and suffering, and eventual stroke. His cholesterol was below 100 due to the statins. So did this do harm?? Well, Maybe it did, maybe it didn't, but the best I can explain it is this:
Think of Cholesterol as the body's oil. It is essential for friction between muscle cells and in joints to not be destructive, to you being able to blink, to your heart beating without seizing and a whole host of other functions. It is so essential that if you don't eat enough, if there is no dietary source, then the liver will dissolve brain and muscle tissue to make it...the liver won't stop trying to correct the deficit, it's that important to life.
The same is true of electrolytes, your body cannot function without enough minerals and unfortunately diuretics...water pills...remove large amounts of minerals as well as water.
Ergo they are also a potential source of muscle pain, and eventual coma and death occur if the dosages are not monitored with this common "life saver".
the cautionary here is all these drugs have a good side and another evil twin. Be sure you know what these things really do before signing on the dotted line.
mb
http://www.****.***
It was a little 70 year old with a pacemaker. He was on one of the first statins, and a patient of mine for about 3 years.
He suffered debilitating muscle pain and neuropathy, irritablility and mental issues. I don't know if he had impotence as well as I never asked him. He had been a well known attorney, but his care following his heart incident. had much to do with him never making a full recovery.
Of course, I tried to explain to him how essential cholesterol was to health, how in animal studies those deprived of it became crippled with many forms of we humans label autoimmune diseases. Because I farmed I had read dozens of agricultural studys dealing with nutritional deprivation of animals. These studies included thousands, not hundreds and ergo results were much more conclusive.
I tried numerous times while his physical therapist to convince him he did not need so much of the statin, and that it was responsible for his muscle pain, to no avail. He was also on diuretics and this compounded his issues. I thought his dosages of both were too high, he had lost half his weight and his skin was dehydrated.
He was certain his doctor knew best and had him on the proper dose. Unfortunately his doctor never saw the new "wonder drug" as a possible cause of what led to the mans pain and suffering, and eventual stroke. His cholesterol was below 100 due to the statins. So did this do harm?? Well, Maybe it did, maybe it didn't, but the best I can explain it is this:
Think of Cholesterol as the body's oil. It is essential for friction between muscle cells and in joints to not be destructive, to you being able to blink, to your heart beating without seizing and a whole host of other functions. It is so essential that if you don't eat enough, if there is no dietary source, then the liver will dissolve brain and muscle tissue to make it...the liver won't stop trying to correct the deficit, it's that important to life.
The same is true of electrolytes, your body cannot function without enough minerals and unfortunately diuretics...water pills...remove large amounts of minerals as well as water.
Ergo they are also a potential source of muscle pain, and eventual coma and death occur if the dosages are not monitored with this common "life saver".
the cautionary here is all these drugs have a good side and another evil twin. Be sure you know what these things really do before signing on the dotted line.
mb
http://www.****.***
yeah what little I recall was all forms raise enzymes, raised enzymes means cell death.
it occured in regular and time released forms, with niacin, and with niacinamide you have the added issue of vasodialation. Since diseased livers can already have double normal blood pressure in them, vasodialation could lead to bleeds, especially with weakened vessels,
Vit C has a whole host of issues because of it's acidity.
Like with most mega dosing of vitamin propoents tell you how much good it may do one condition without mentioning the damage to vital organs that high dosing has long been know for. (like yeah, we cured your polio with C but you'll need 2 kidneys)...right!!
I think if someone is up in the 300's or above the statin benefit far outweighs it's risks.
However, people should make sure their thyroid is working, as that effect cholesterol, and that they are on a balanced diet.
After that, look to your liver not producing enough as a general rule, unless you have kidney disease also, in which case it could still be quite high.
My total Ch. is 111 now, with LDL at 70. That is going to be something many liver patients will face is cholesterol being too low due to loss of healthy liver cells, so for the
lions share of us without heart problems, statins aren't a safe bet.
I can see why with your heart problems statins would be a risk worth taking perhaps,
but based on the literature, would you still think that way without a heart problem would be my question?
mb
it occured in regular and time released forms, with niacin, and with niacinamide you have the added issue of vasodialation. Since diseased livers can already have double normal blood pressure in them, vasodialation could lead to bleeds, especially with weakened vessels,
Vit C has a whole host of issues because of it's acidity.
Like with most mega dosing of vitamin propoents tell you how much good it may do one condition without mentioning the damage to vital organs that high dosing has long been know for. (like yeah, we cured your polio with C but you'll need 2 kidneys)...right!!
I think if someone is up in the 300's or above the statin benefit far outweighs it's risks.
However, people should make sure their thyroid is working, as that effect cholesterol, and that they are on a balanced diet.
After that, look to your liver not producing enough as a general rule, unless you have kidney disease also, in which case it could still be quite high.
My total Ch. is 111 now, with LDL at 70. That is going to be something many liver patients will face is cholesterol being too low due to loss of healthy liver cells, so for the
lions share of us without heart problems, statins aren't a safe bet.
I can see why with your heart problems statins would be a risk worth taking perhaps,
but based on the literature, would you still think that way without a heart problem would be my question?
mb
I don't recall the science right now but I agree with you on the niacin which is rarely brought up. Vitamin C abuse I bring up all the time but the history of mega-dosed Vitamin C's placebo effect is too long and entrenched to change anyone's mind using only scientific truth and fact.
High LDL levels at the start of tx have been shown to be a predictor of response which is well-detailed in the medical literature. The underlying reason is still being debated and studied, with most researchers focusing on the ability of HCV to dock on lipids, and its use of lipids to attach to lipoprotein receptors on hepatocytes in order to gain cell entry. This subject was discussed recently here. I agree that until more is known about the cause and effect, pigging out on fats before tx may not be helpful. It may turn out to be of benefit, too.
Whether someone with liver disease produces less LDL is not so clear cut. Many have high levels of LDL as well. You correctly pointed out that the liver produces LDL. But it also has the job of clearing LDL from our bodies. So a compromised liver could, in one situation, actually produce lower amounts of LDL and yet have high test readings because of the inability of the liver to remove it. Also, the liver produces HDL and if it diminishes it can have the same effect as a rise in LDL. In fact, low HDL is a recognized predictor of heart disease.
They have found that statins can be tolerated at the same rate as those in the general population without liver disease. The rx of any statin for anyone should include a followup liver panel blood test. High ALT/AST on repeated exams and any patient with or without liver disease should discontinue.
My hepatologist and cardiologist both attended a seminar on the topic of statins and liver disease last year in D.C. I wasn't aware that they knew each other up to this point. My cardio doc deferred the rx for my cholesterol drug to my hepatologist, with whom I later discussed the studies which detailed the anti-viral effect of some statins on HCV. I've been taking statins since '06 and my labs have all been in normal range for ALT/AST. At the time, as is the case still, I was decompensated and awaiting transplant.
So, I would encourage anyone with high LDL and HCV to discuss with their doctor about the possibility of using a statin in an attempt to improve levels and reduce the odds of a heart problem, or the reoccurence of one.
Mr Liver
High LDL levels at the start of tx have been shown to be a predictor of response which is well-detailed in the medical literature. The underlying reason is still being debated and studied, with most researchers focusing on the ability of HCV to dock on lipids, and its use of lipids to attach to lipoprotein receptors on hepatocytes in order to gain cell entry. This subject was discussed recently here. I agree that until more is known about the cause and effect, pigging out on fats before tx may not be helpful. It may turn out to be of benefit, too.
Whether someone with liver disease produces less LDL is not so clear cut. Many have high levels of LDL as well. You correctly pointed out that the liver produces LDL. But it also has the job of clearing LDL from our bodies. So a compromised liver could, in one situation, actually produce lower amounts of LDL and yet have high test readings because of the inability of the liver to remove it. Also, the liver produces HDL and if it diminishes it can have the same effect as a rise in LDL. In fact, low HDL is a recognized predictor of heart disease.
They have found that statins can be tolerated at the same rate as those in the general population without liver disease. The rx of any statin for anyone should include a followup liver panel blood test. High ALT/AST on repeated exams and any patient with or without liver disease should discontinue.
My hepatologist and cardiologist both attended a seminar on the topic of statins and liver disease last year in D.C. I wasn't aware that they knew each other up to this point. My cardio doc deferred the rx for my cholesterol drug to my hepatologist, with whom I later discussed the studies which detailed the anti-viral effect of some statins on HCV. I've been taking statins since '06 and my labs have all been in normal range for ALT/AST. At the time, as is the case still, I was decompensated and awaiting transplant.
So, I would encourage anyone with high LDL and HCV to discuss with their doctor about the possibility of using a statin in an attempt to improve levels and reduce the odds of a heart problem, or the reoccurence of one.
Mr Liver
I was told to avoid niacin, excess vitamin C, along with marijuana and alcohol by my liver clinic. Risk and the way liver handles excess niacin outweighed benefit though certainly getting adequate amounts by use of a NO iron multiple vitamin would be fine.
Statins have so many contraindications they will probably never pass muster for liver patients. They happen to be needful for folks with high cholesterol, but most liver patients make too little not too much cholesterol, so they won't help most cases.
Also your liver has to work harder to make more cholesterol if your levels get too low...again taxing the organ. Cholesterol is so essential to health the liver will convert any and all available tissue to assure a steady state of this substance. So removing too much just works the organ extra hard.
As to LDL "MAYBE" being predictive of outcome, I wouldn't go anywhere on that kinds of a maybe. Let's be clear, that's a big maybe and without seeing the whole article, could just be a "publisher's fancy".
For one thing, what should we do with this.... all rush out and start scarfing animal fat to get our LDL up? Some cautionairies there for sure. High LDL is also indicative and a precursor to diebetes, not to mention influential in plaque formation and heart disease, etc.
the research I thought was interesting was that on PPC and the antifibrotic benefits.
It really hasn't changed my lipid profile enough to matter there though.
The trouble with all the fats and oils, good bad or indifferent is that the HCV Virion protects itself with the same darn lipids on it's outshell that we need to have in there for life itself.
Bottom line is to maintain a healthy lipid profile and hope for the best. I'd add some Omega's if you like but avoid the saturated animal fat, even if one researcher thinks a hundred people proved LARD is the key to SVR, I'd be tempted to say balderdash and remember for every misdiagnosis there's also a flawed study somewhere. Studies are only as good and thourough as the people doing them. (let us use Vertex as our prime example here).
I'd like to see the whole abstract on this one before I'd buy any of it. They make no mention of ruling out other factors, such as NASH, diebetes, and other conditions known to influence lipid profiles and SVR outcomes. The better studies do rule these out in their predictive models, so this one becomes all the more suspect for not having done so. (and remember drug companies pay for studies showing how statins could benefit us all, so just some points to ponder is all.)
mb
Statins have so many contraindications they will probably never pass muster for liver patients. They happen to be needful for folks with high cholesterol, but most liver patients make too little not too much cholesterol, so they won't help most cases.
Also your liver has to work harder to make more cholesterol if your levels get too low...again taxing the organ. Cholesterol is so essential to health the liver will convert any and all available tissue to assure a steady state of this substance. So removing too much just works the organ extra hard.
As to LDL "MAYBE" being predictive of outcome, I wouldn't go anywhere on that kinds of a maybe. Let's be clear, that's a big maybe and without seeing the whole article, could just be a "publisher's fancy".
For one thing, what should we do with this.... all rush out and start scarfing animal fat to get our LDL up? Some cautionairies there for sure. High LDL is also indicative and a precursor to diebetes, not to mention influential in plaque formation and heart disease, etc.
the research I thought was interesting was that on PPC and the antifibrotic benefits.
It really hasn't changed my lipid profile enough to matter there though.
The trouble with all the fats and oils, good bad or indifferent is that the HCV Virion protects itself with the same darn lipids on it's outshell that we need to have in there for life itself.
Bottom line is to maintain a healthy lipid profile and hope for the best. I'd add some Omega's if you like but avoid the saturated animal fat, even if one researcher thinks a hundred people proved LARD is the key to SVR, I'd be tempted to say balderdash and remember for every misdiagnosis there's also a flawed study somewhere. Studies are only as good and thourough as the people doing them. (let us use Vertex as our prime example here).
I'd like to see the whole abstract on this one before I'd buy any of it. They make no mention of ruling out other factors, such as NASH, diebetes, and other conditions known to influence lipid profiles and SVR outcomes. The better studies do rule these out in their predictive models, so this one becomes all the more suspect for not having done so. (and remember drug companies pay for studies showing how statins could benefit us all, so just some points to ponder is all.)
mb
Some cholesterol medications showed an anti-fibrotic effect.
"Buy HCV was shown to require some sort of cholestreol mechanusm to reproduce didn't it? "
HCV uses LDL's receptor sites and damages trhem in the process. So a high LDL predicts SVR.
"Bottom line: will it reduce viral load and reduce it enough (when on peg/riba treatment) to wipe out the virus lets day in previous non-responders. "
No.
"Higher pretreatment levels of low-density lipoprotein (LDL) and cholesterol may predict successful treatment of patients infected with hepatitis C virus (HCV) according to a study presented at the 2005 Digestive Disease Week (DDW) conference. A total of 107 participants were selected from charts of patients e18 years of age who underwent interferon-based therapy between 1998 and 2004 at Beth Israel Medical Center. Forty-five patients (42%) had HCV genotype-1 (mean LDL 100 mg/dL), 50 patients (47%) had genotype 2 or 3 (mean LDL 111mg/dL), and for 12 patients (11%) genotype was unknown (mean LDL 78 mg/dL). Early viral response (EVR) was achieved in 70 patients, end of treatment response (ETR) in 58 patients, and sustained virologic response (SVR) in 50 patients. Statistically significantly higher pretreatment LDL and total cholesterol levels were found in patients who attained EVR, ETR, and SVR compared with those who did not reach these endpoints. These findings suggest that higher pretreatment LDL and cholesterol levels may be used to predict response in HCV-infected patients undergoing interferon-based antiviral therapy."
"Buy HCV was shown to require some sort of cholestreol mechanusm to reproduce didn't it? "
HCV uses LDL's receptor sites and damages trhem in the process. So a high LDL predicts SVR.
"Bottom line: will it reduce viral load and reduce it enough (when on peg/riba treatment) to wipe out the virus lets day in previous non-responders. "
No.
"Higher pretreatment levels of low-density lipoprotein (LDL) and cholesterol may predict successful treatment of patients infected with hepatitis C virus (HCV) according to a study presented at the 2005 Digestive Disease Week (DDW) conference. A total of 107 participants were selected from charts of patients e18 years of age who underwent interferon-based therapy between 1998 and 2004 at Beth Israel Medical Center. Forty-five patients (42%) had HCV genotype-1 (mean LDL 100 mg/dL), 50 patients (47%) had genotype 2 or 3 (mean LDL 111mg/dL), and for 12 patients (11%) genotype was unknown (mean LDL 78 mg/dL). Early viral response (EVR) was achieved in 70 patients, end of treatment response (ETR) in 58 patients, and sustained virologic response (SVR) in 50 patients. Statistically significantly higher pretreatment LDL and total cholesterol levels were found in patients who attained EVR, ETR, and SVR compared with those who did not reach these endpoints. These findings suggest that higher pretreatment LDL and cholesterol levels may be used to predict response in HCV-infected patients undergoing interferon-based antiviral therapy."
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
