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Post Info TOPIC: Be careful using Crestor post DAA treatment


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RE: Be careful using Crestor post DAA treatment
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Hi Canuck,

Thanks for your advice as always. I have a follow up visit with my gastroenterologist next week to go over the colonoscopy/endoscopy. I'll ask him to give me lab orders for viral load, LFTs, and a lipid panel. I'll discuss an additional FibroScan with him as well, but I suspect he will tell me to wait until my one year anniversary of EOT. It is a bit of a chore to get a FibroScan as the closest hospital that has one of the units is a good hour and a half drive.



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Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.



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Hey thanks for reminding me about your kPa's, as well as laying out what your chol.panel was (both of these being "pre-treatment" stats).

I think your chol panel is not too bad, not horribly out of wack, if i interpret these things correctly. You, I am sure, have probably already sussed all this out with your doc, but (just speaking for myself) I am personally relieved to see that these chol levels are not higher/more out of wack.

The books say we should strive for a normal (or low risk "ratio") of about 4 to 1, yours, at 5.2 to 1, isn't that bad.

The formula (to figure "ratio" out) is to take your "total chol." and divide by your "HDL". In your case (just for comparison purposes) ... say your "total chol." had been 200 (instead of 223) and your HDL had been 50 (instead of 43), then your ratio would have worked out to 4 to 1 - a good ratio, so your ratio of 5.2 to 1 is not that bad.

You have to go by what your docs think of course, they know best, they know what is risky for you, and what all your other contributing parameters are that can increase cardiovascular risk for you. But me, as a know-nothing novice just looking at your lab values alone, in isolation, i don't think your chols are crazy out of wack, and, they might just be better than a lot of other North Americans! smile

You and your doc have done really well, to have attempted two trials of statins. I wonder what your lipids are doing now (compared to your pre-Epclusa lipids) - it will not be long now before you are arriving at SVR24 - 6 months from your EOT in May, SVR 24 would be at the end of Nov? So, if you are going to have LFT's and VL done for SVR24 anyway, then ... why not do a lipid panel again as well, AND maybe have another fibroscan done then too - maybe things are looking better than you think, or, at least you will know things are similar or stable. Just a thought. I am assuming you have not had another chol panel done since the pre-treatment one in Jan 2018? It would be a bonus if you already got a lower kPa in your fibroscan in Nov! Good you have had multiple CT sessions, they can see lots from those. I wonder ... if it is a truth that a fatty liver can bump up the kPa's a bit, then i wonder if a big ole hard rock in your GB could also influence the kPa's of a fibroscan! Not likely - you'd think the angle of fibroscan through the liver misses completely being anywhere near the GB. Oh dear my mind is wandering off ...!

You can check out chol hx in my bio if you want.

It's really good you and your cardiologist are tracking everything that needs to be dealt with on you, given your hx and health circumstances. C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Hi Canuck,

Back in January 2018 (before Epclusa) my fasting lipid panel results were Cholesterol, Total: 223 H, Triglycerides: 257 H, HDL 43, LDL 140 H, Non HDL Cholesterol 180 H with CHOL/HDLC ratio of 5.2 H.



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Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.



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lamassu,

Of course your F3 was determined by fibroscan - it's right in your sig line for heavens sake! I'm asleep at the wheel, and I was just too tired and lazy to be bothered to look for the info further into your threads, as i did recall us discussing fibroscans before, but just not every detail - but hey, it would help a lot if i would just read your sig line eh?!

So ya, you and me were not that far apart on pre-treatment Fscores yours being 12.4 (F3) and mine 12.6 (F4), my doc never wished to scope me for varices before, during or after my Vosevi trial. Even in the second subsequent "follow-up trial" I got into (after cure) that was deemed/designed to follow cirrhotic-type people - even there they warned I might have to have an initial scope, but then ... they elected not to do one - they just depending on all other labs and imagings and signs and symptoms. I have to admit i was relieved not to have to be subjected to a scoping, just one less thing - funny i was more just concerned regarding my basic liver damage/function/steatosis//liver stiffness (and subsequent imaging of pancreatic calcifications and other calcifications and funny transient bits here and there, lymph nodes, granulomas, those things I dwelled on and followed way more than I was ever worried about having varices for some reason. I laboured over everything why not varices eh? Dunno why.

Me too, I am so glad how that profound fatigue broke up for you toward EOT, and how you have gleaned some good feeling tangible gains since then - really good!

Good for you that you had 2 goes at 2 rounds of statins too, never say never, where there is a will there is a way to improve those lipids eventually, somehow, one way or another ... how radical are your lipids anywho?

Everyone is dif, but look how quick my kPa's and liver stiffness reversed after cure! It could be reversing just as quick for you too, as we speak! C.



-- Edited by Canuck on Thursday 25th of October 2018 03:38:59 AM

__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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No kidding. I feel loads better, too, and I'm very lucky that I didn't harm my liver much. I know it's not the case for everybody but I hope anybody who is considering treatment or on treatment will read this and look forward to improvements and a better overall immune system.

Good work, lamassu. Really good recovery.



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GT2a, VL 681,500, Less than F1, Treatment Naive

12 wks Sovaldi/Ribavirin,SOT 2/25/16, EOT 5/17/16

UND at 2,4,8 and 12 wks during treatment but ribavirin crazy.

ALT/AST normal EOT

SVR12 8/13/2016!!!!!!!!! I WON!!

EOT 6 Months 11/12/2016 CURED



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Thanks Cheddy, I'll update after I see my cardiologist. I continue to marvel at how good I feel now that the HCV is cured. It is a new lease on life for me. Sure I am living with an F3 liver but I will get another FibroScan next June and see if there has been any improvement in my kPa score.



__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.



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I hear you. Enough is enough with fatigue. Still, I hope you can sort out what you need in the way of statins.

I'm glad you are feeling better!



__________________

GT2a, VL 681,500, Less than F1, Treatment Naive

12 wks Sovaldi/Ribavirin,SOT 2/25/16, EOT 5/17/16

UND at 2,4,8 and 12 wks during treatment but ribavirin crazy.

ALT/AST normal EOT

SVR12 8/13/2016!!!!!!!!! I WON!!

EOT 6 Months 11/12/2016 CURED



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Canuck:

F3 was by FibroScan. My twofer procedure was originally scheduled for end of August because my liver doc did think it important to check for varices due to my 12.4 kPa. Rescheduled due to conflicts on my end. My BP is normal and CT scan of liver was unremarkable except for the gallstone. I was surprised how wiped out I felt from the propofol having had it previously for cardioversions (paroxysmal atrial fibrillation.) Took me a good day to sleep it off.

Hoodietree:

Per my cardiologist I have now tried both Crestor and Lipitor and both induced fatigue after one week of use. I went back to normal in about a week after discontinuing both. I'll have another chat with my cardiologist when I see him next month but we are running out of statins to try. After living with HCV induced fatigue for many years I sure as shootin' will not take any med that makes me feel tired again no way no how.



-- Edited by lamassu on Monday 22nd of October 2018 01:21:01 PM

__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.



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Lamassu, I have heard similar things about the side effects of statins. I follow a nutritionist online (Chris Kresser) who is into Functional Medicine (FM = treating the root cause of any disease, not just the symptoms). He is strongly against statins except when absolutely positively nothing else has worked. Nutrition and exercise can be so effective and beneficial holistically. Proper nutrition and exercise in the treatment of disease can then paradoxically lead you to better health even when youve been diagnosed with something if you treat your root cause rather than just taking a pill to manage symptoms. Because then you don't have to manage the side effects of the pills!

But there are some cases when medicinal intervention truly is life-saving. It's just that we have looked to the medical community to provide us with a "cure" for so long rather than trying to do the hard work of treating the root cause instead of just the symptoms. The responsibility for that falls on OUR shoulders, and when we shift our mindset to be becoming a team with our doctor to figure stuff out and manage the process of sustaining excellent health together.

It's quite complex as each person is different. Some people do well on a high carbohydrate diet for example while other people do well with few if any carbs and lots of healthy fat. Nutrition is not one size fits all -- it really depends on our genetics what type of diet is optimal for excellent health. And of course exercise is highly individual as well depending on pre-existing conditions and so forth.



-- Edited by Hoodietree on Monday 22nd of October 2018 10:00:25 AM

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F, 51, GT3, HCV since 1989, no alcohol since 1999, Fibrosis score F0-1 (.36), VL 216,000, ALT 23, AST 26, Epclusa SOT 7/26/18 EOT 10/18/18. Thank you God.



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Hey lamassu,

Further to your post to 5 tonight about GB's and GB stones, what's this about you being surprised that you DON'T have esophageal varices? Why did you think you might have varices? Was it a question your doc was real big on and suspicious of prior to treatment? Something you two discussed prior? If he had a high level of suspicion, they usually do check these things out right away (pre-treatment or most likely quite soon after their suspicion) if they feel strongly that you were "looking" that way. Remind me again about blood pressure issues with you, and/or what methods they used to come up with your F3 scoring, and if your CAT imaging showed things of note aside from sporting a 2.2 karot GB pearl.

I am happy your doc felt he could and should do both ends of you. And, me too, I think it's lovely, NO varices! I'm glad you got the 2 fer 1 - that IS a good and thrifty idea - we did the same for my partner (both ends, one drug, one table, one date). Glad they nipped a couple polyps for ya, kinda at least makes the prep trouble all worth it, aside from them just having wandering looki-loos. I am so glad people know how to take good care of themselves and know how to get good care for themselves - half the battle! I can relax knowing you will make sure to get good following.

I am so happy and relieved for you lamassu that you are feeling so much better (than you were!), that was a long hard haul for you there for a while! I hope to see you continuing to feel better and better, day by day. : ) C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Me too lamassu, I experienced profound fatigue that was exponentially increasing (for a long time) before I even got diagnosed and then it just increased/continued in this direction as i neared treatment, it was even thicker when I got on treatment, the fatigue stayed after treatment too. On treatment the sof/vel/vox certainly did nothing to improve this situ (understatement), rather, the fatigue was never so thick as when i was on treatment. It existed for a long time before treatment and for quite some time after treatment - it was a very inconvenient/restricting, if not a downright debilitating situ (to say the least)! It was actually boggling and unbelievable how one can be so fatigued without finding any relief for it! I think it was Iris who recently spoke of waking up feeling exhausted - lots of us have known the feeling! Poor Obs humourously (not!) describes how she used to accomplish getting her house vacuumed between naps (took weeks apparently!). On treatment my mind and body were affected by fog and fatigue. But, thank goodness, after treatment, slowly, things started to turn around. I too lost ground, physically, with fatigue/energy affecting my exercise time/ability, in all ways. Things, such as you mention ... stamina, loss of physical abilites, inability to exercise due to restrictions - we manage to work ourselves around them as best we can. I was weak after treatment. I slowly rebuilt - and that came in fits and starts as well, but always in a corrective direction. I am certainly waaaybetter now than I was, it took a while, and I am still improving!

No wonder you found that trial of statin especially unwanted, due to the similar feeling of fatigue you experienced during your HCV tretament.

You have a lot of things to juggle, and to work around with your joint things, but you are a smart diligent guy and i know you will figure out ways to gain/regain your exercise/stamina while managing the joint pain control. Did you ever get any more opinions on the use of kratom versus other things for pain control?

It is early days yet, since your HCV cure - be patient, take some time, keep working slowly, steadily and carefully at the rebuilding/re-couping of your health/stamina. : ) C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Hi Canuck,

I am feeling fine now thanks after stopping the Crestor. Due to the side effects I had from Epclusa I got very little exercise during the three months of treatment so stamina is low but improving as I walk as much daily as my osteoarthritis can handle. I have been told to expect a right knee replacement sometime in the next few years. When is up to me but I am going to postpone as long as possible.

Right now I can manage the osteo discomfort with a low dose of tramadol daily. The three months on Epclusa was not easy for me (heavy fatigue) so I have zero interest in any invasive procedures this year and certainly not until I see SVR at EOT plus 6 months.

I don't have the labs you asked for. I was finally fatigue free at EOT so was alarmed that after only less than two weeks on Crestor fatigue was returning which prompted a literature search that showed me significant side effects from statins are more common than I expected. I'll discuss with my cardiologist next visit.



__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.



Guru

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Oh dear, it's really too bad you didn't like the way crestor made you feel, as statins can be such a good thing (and a fairly easy way) for people to reduce their lipid-related problems! Some people find it difficult to reduce their LDL/lipid-related problems (lipid related risks) on their own, without a statin, people can derive a lot of good from statin therapy.

So, you had fatigue and then fatigue+, after being on statins for only about a week?, but, you also said your "liver" didn't like the statins? ... what were your LFT's before and after the statin use? - it could be you were simply of the group who have experienced feelings of fatigue as a side of taking a statin drug new to you, versus the drug actually doing any harm to your liver?

Did your LFT's show any evidence of a protesting change/any increase as an effect of this short course of statins, or was it more a case of you didn't feel well while you were on it? Too bad you could not tolerate the fatigue or see if the fatigue dissipated in a while, over time, as some people have difficulty reducing their lipid problems on their own. Some people are just built funny, it seems, like they have an unfortunate set of built-in circumstances which makes it hard for them to get a handle on reducing lipid related problems/risks.

How out of wack have your lipids been in the past and for how long?, you never did elaborate.

Been wondering how you have been doing and feeling. I am glad you did at least give the statins a try. How are your sore joints feeling, are you still back on the same pain control things now, as you were before your HCV cure?

I recall you were due to see a rhumy guy soon? Let us know how everything else has been going. :) C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

Tig


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Im sorry you experienced issues with a statin, but I know many, many people that do without difficulty. I would hesitate giving the warning about statins and all DAAs however. There are several medications that are hard on our livers and caution is advised when using any of them. Better to discuss the addition of any drug regimen during or after significant liver disease with the prescribing physician. Im glad youre feeling better.



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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My cardiologist had wanted me on Crestor but it was contraindicated during treatment with Epclusa. After completing treatment and enough time had passed for the sofosbuvir and velpatasvir to be metabolized completely I asked my hepatologist if taking Crestor was OK to which he said yes.

Within a few days of starting only 5 mg/day of Crestor I noticed symptoms of mild fatigue which got worse after a week. I researched Crestor on line and read many reports of significant side effects which prompted me to stop the Crestor immediately. After about a week I was feeling fine again. I was surprised that my hepatologist actually approved use of Crestor; I won't take a statin again. I'll manage my cholesterol with diet. One thing I know is my damaged liver does not like Crestor. Even physicians have reported significant side effects from taking statins.



-- Edited by lamassu on Thursday 5th of July 2018 03:27:35 PM

__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24.

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