Aa
post treatment ??'s
UDT @ 6 month post.Now with the addition of simvastaitin @ 8 months post my blood work came back with elevated AST enzymes and my platelets are @ 70,000 ( lower when I started treatment in November 08) .I have a scarey feeling something is wrong!! Dr's said we'll do a viral load in March and continue with the simvastatin for 1 more month till the draw and consult. They never mentioned a relapse but do the numbers? Any suggestions or ideas? I'm already thinking the worst.
Mr. Liver said "the point here being that if anything a statin may help someone on the tipping point of relapse more than hurt."
That's very reassuring and something I didn't know. The fact that you were a Genotype Two, cleared on target at four weeks and SVR'd at six months post-tx puts you in a dream position. I'd keep closer tabs on your LFT's, though, as Mr. Liver suggested.
Fresh off the SOC victory boat myself, I guess I've been plain stubborn in fighting off statins. My doc joked (in her menacing way) that there'd be no point in having toughed out tx only to get clobbered by cardiovascular disease.
The confusing thing is if the virus somehow kept a lid on our LDL all those years, was our risk of heart disease just as great all along but undiagnosed? My doc used to regularly congratulate me on my terrific cholesterol numbers pre-SVR but now shakes her head. I've cleared the virus :) and my liver is now churning out cholesterol galore, so my Framingham score puts me in an entirely new heart risk classification. :(
Best wishes on those platelets and hope you can get them normalized soon. Do you take any other meds, other than the statin? Maybe they're affecting your AST.
That's very reassuring and something I didn't know. The fact that you were a Genotype Two, cleared on target at four weeks and SVR'd at six months post-tx puts you in a dream position. I'd keep closer tabs on your LFT's, though, as Mr. Liver suggested.
Fresh off the SOC victory boat myself, I guess I've been plain stubborn in fighting off statins. My doc joked (in her menacing way) that there'd be no point in having toughed out tx only to get clobbered by cardiovascular disease.
The confusing thing is if the virus somehow kept a lid on our LDL all those years, was our risk of heart disease just as great all along but undiagnosed? My doc used to regularly congratulate me on my terrific cholesterol numbers pre-SVR but now shakes her head. I've cleared the virus :) and my liver is now churning out cholesterol galore, so my Framingham score puts me in an entirely new heart risk classification. :(
Best wishes on those platelets and hope you can get them normalized soon. Do you take any other meds, other than the statin? Maybe they're affecting your AST.
I don't think I would be too concerned with relapse because of elevated AST or drop in platelets without an accompanying elevated ALT on repeated tests.
Statins do not affect the livers of those with or without disease at different rates. Those who take statins all have the same basic risk for negative effects on the liver (about 1%) .You need to monitor LFT's whenever starting or changing statins. My doctor usually recommends labs at 6 weeks but tested me at 4 because of my advanced disease. If infected with HCV I think all of the statins have shown some degree of anti-viral effect towards the virus. I used to have the order of 5 statins according to their anti-viral effects around somewhere and if I find it I will post it for those who might care to know. The point here being that if anything a statin may help someone on the tipping point of relapse more than hurt.
I have been on statin drugs for 4 years and all of my LFT labs have remained unchanged, while LDL decreased and HDL increased. Combined with diet and excercise positive changes in cholesterol levels can be dramatic. High LDL has been linked to stroke and heart attack for years, and it has been shown more recently that low HDL is connected to a rise in risk for heart attack also.
Statins are turning out to be a class of wonder drugs. They keep finding more positive effects of statins on other conditions as well. To the degree that the FDA is considering the use of statins in the absence of elevated LDL for everyone.
Keep in mind that there are other statins that your doctor can prescribe if necessary and I wouldn't be overly concerned about relapse as the risk is very low at this point and it is extremely unlikely that taking any statin would bring one about. Keep us posted on your labs. I would ask if it is not already planned to have labs for LFT again in as short as time from now as practical to watch for elevated ALT/AST, etc.
Regards, ML
http://www.medicalnewstoday.com/sections/statins/
Statins do not affect the livers of those with or without disease at different rates. Those who take statins all have the same basic risk for negative effects on the liver (about 1%) .You need to monitor LFT's whenever starting or changing statins. My doctor usually recommends labs at 6 weeks but tested me at 4 because of my advanced disease. If infected with HCV I think all of the statins have shown some degree of anti-viral effect towards the virus. I used to have the order of 5 statins according to their anti-viral effects around somewhere and if I find it I will post it for those who might care to know. The point here being that if anything a statin may help someone on the tipping point of relapse more than hurt.
I have been on statin drugs for 4 years and all of my LFT labs have remained unchanged, while LDL decreased and HDL increased. Combined with diet and excercise positive changes in cholesterol levels can be dramatic. High LDL has been linked to stroke and heart attack for years, and it has been shown more recently that low HDL is connected to a rise in risk for heart attack also.
Statins are turning out to be a class of wonder drugs. They keep finding more positive effects of statins on other conditions as well. To the degree that the FDA is considering the use of statins in the absence of elevated LDL for everyone.
Keep in mind that there are other statins that your doctor can prescribe if necessary and I wouldn't be overly concerned about relapse as the risk is very low at this point and it is extremely unlikely that taking any statin would bring one about. Keep us posted on your labs. I would ask if it is not already planned to have labs for LFT again in as short as time from now as practical to watch for elevated ALT/AST, etc.
Regards, ML
http://www.medicalnewstoday.com/sections/statins/
Interesting that my doc started to talk statins to me because my cholesterol levels are elevated since ending tx. My LDL was always low before this.
I brought her a recent and very interesting study that links SVR to post-tx elevated LDL. (I posted it here a while back.)
I told her I'd like to give myself a year post-tx to see if I can reduce LDL through lifestyle changes. She's not entirely pleased with this because she's a statin fan.
Stories of elevated cholesterol post-tx in cases of SVR have come up numerous times here on the forum. I wonder if it's better to 'watch and wait', make 'serious' lifestyle changes and see if LDL can be improved in a year or two post-tx.
Here's a link to other potential side effects of your statin:
http://www.rxlist.com/zocor-drug.htm
I brought her a recent and very interesting study that links SVR to post-tx elevated LDL. (I posted it here a while back.)
I told her I'd like to give myself a year post-tx to see if I can reduce LDL through lifestyle changes. She's not entirely pleased with this because she's a statin fan.
Stories of elevated cholesterol post-tx in cases of SVR have come up numerous times here on the forum. I wonder if it's better to 'watch and wait', make 'serious' lifestyle changes and see if LDL can be improved in a year or two post-tx.
Here's a link to other potential side effects of your statin:
http://www.rxlist.com/zocor-drug.htm
Sorry about that last part of the article concerning thre recommended supplements - I actually had missed reading that.
Personally, I don't know what to make of supplements, so I don't take them myself and would never recommend any, due to my lack of knowledge about them.
My doc did mention LFT concerns to me connected to statins, although I don't take them.
Personally, I don't know what to make of supplements, so I don't take them myself and would never recommend any, due to my lack of knowledge about them.
My doc did mention LFT concerns to me connected to statins, although I don't take them.
Elevated liver enzymes is one of the potential side effects of Zocor (simvastatin). I started TX in Nov. 08, too, finished early and still have bone marrow suppression (low platelets) from the interferon. If it was me, I'd look for a different statin or a different way to control cholesterol and really exercise some patience about the platelets. I know it's hard and way too easy to get anxious for people like us, but some of us need additional time to get over the effects of interferon and all the changes it causes to the body. Hang in there and try not to worry about a relapse. It's very unlikely after a UD 6 mo. PCR.
Sometimes elevated LFT's are transient when starting statins. Here's something to discuss with your doc:
http://www.free-press-release.com/news/200905/1241234554.html
"If your physician decides to start you on a statin drug, the main side effect s/he should discuss with you is liver dysfunction and advises periodic monitoring of your liver enzymes. Liver function is adversely affected in direct proportion to the dose of statin used. The degree, to which cholesterol is lowered, however, has not been shown to correlate with liver dysfunction. Statin dose therefore is the primary determinant of liver toxicity, not degree of cholesterol lowering. (Alawi A, Alsheikh-Ali, et al. Effect of the Magnitude of Lipid Lowerinf in Risk of Elevated Liver Enzymes, Rhabdomyolysis, and Cancer Insights from Large Randomized Statin Trials. J Am Coll Cardiology. 2007; 50(5):409-418.) Your doctor may tell you that as long as liver enzymes are three times the level of normal, that is, a three hundred percent elevation; it is alright to continue stain use. Most patients find this to be a rather scary approach to a medication. Is a slight decrease in the risk of heart disease worth a 300 percent increase in liver enzyme production, marking a considerable decline in liver function? "
"There are ways to protect the liver if you actually are on statins. First, you must discuss with your doctor the appropriate schedule to check the liver so that you are cognizant of what those numbers are. Ask for copies of all your blood work and make a chart for yourself monitoring their ups and downs. Second, one important piece of information to keep in mind is that your muscles may release the exact same enzyme that is elevated in the setting of liver dysfunction. It is referred to as AST. Being that statins can adversely affect our muscle tissue, these two side effects must be differentiated. So, if you are told that you have a liver dysfunction due to statin use, be certain to ask whether or not the elevated enzymes are those released by muscle injury, rather than the liver. In order to differentiate between the two, your doctor should check a creatine phosphokinase level, or CPK, which would be elevated in muscle injury."
"In addition to monitoring your blood for liver enzyme elevation, you must monitor yourself for physical signs of liver dysfunction. They include a yellowish hue to your skin and to the whites of your eyes, pain in the upper right part of the abdomen, yellowish or tan colored stool, tea-colored urine, profound fatigue, and generalized itching."
"Lastly, you should take supplements that can protect the liver from being adversely affected by statin use. The ones I recommend routinely with great success are N-acetyl-cysteine (600 mg twice a day) and alpha-lipoic acid (200 mg twice a day), among many others. I find that these work well in both protecting and helping to reverse a damaged liver secondary to medication. I would also maintain adequate hydration. I would stay away form a commonly used herb for liver dysfunction called milk thistle. It changes the rate at which medications are metabolized by the liver."
http://www.free-press-release.com/news/200905/1241234554.html
"If your physician decides to start you on a statin drug, the main side effect s/he should discuss with you is liver dysfunction and advises periodic monitoring of your liver enzymes. Liver function is adversely affected in direct proportion to the dose of statin used. The degree, to which cholesterol is lowered, however, has not been shown to correlate with liver dysfunction. Statin dose therefore is the primary determinant of liver toxicity, not degree of cholesterol lowering. (Alawi A, Alsheikh-Ali, et al. Effect of the Magnitude of Lipid Lowerinf in Risk of Elevated Liver Enzymes, Rhabdomyolysis, and Cancer Insights from Large Randomized Statin Trials. J Am Coll Cardiology. 2007; 50(5):409-418.) Your doctor may tell you that as long as liver enzymes are three times the level of normal, that is, a three hundred percent elevation; it is alright to continue stain use. Most patients find this to be a rather scary approach to a medication. Is a slight decrease in the risk of heart disease worth a 300 percent increase in liver enzyme production, marking a considerable decline in liver function? "
"There are ways to protect the liver if you actually are on statins. First, you must discuss with your doctor the appropriate schedule to check the liver so that you are cognizant of what those numbers are. Ask for copies of all your blood work and make a chart for yourself monitoring their ups and downs. Second, one important piece of information to keep in mind is that your muscles may release the exact same enzyme that is elevated in the setting of liver dysfunction. It is referred to as AST. Being that statins can adversely affect our muscle tissue, these two side effects must be differentiated. So, if you are told that you have a liver dysfunction due to statin use, be certain to ask whether or not the elevated enzymes are those released by muscle injury, rather than the liver. In order to differentiate between the two, your doctor should check a creatine phosphokinase level, or CPK, which would be elevated in muscle injury."
"In addition to monitoring your blood for liver enzyme elevation, you must monitor yourself for physical signs of liver dysfunction. They include a yellowish hue to your skin and to the whites of your eyes, pain in the upper right part of the abdomen, yellowish or tan colored stool, tea-colored urine, profound fatigue, and generalized itching."
"Lastly, you should take supplements that can protect the liver from being adversely affected by statin use. The ones I recommend routinely with great success are N-acetyl-cysteine (600 mg twice a day) and alpha-lipoic acid (200 mg twice a day), among many others. I find that these work well in both protecting and helping to reverse a damaged liver secondary to medication. I would also maintain adequate hydration. I would stay away form a commonly used herb for liver dysfunction called milk thistle. It changes the rate at which medications are metabolized by the liver."
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