Friday, April 10, 2015

Harvoni and Low Dose Naltrexone




Somehow, I was approved for Harvoni last month and things happened quickly afterwards.  The pharmacy called to tell me that my monthly co-pay would be $3.60.  I am to treat for 2 months.

Initially, I was prepared to wait until next year to do this - but as everything seemed to fall into place, I decided to do it now.

So I took my first pill two nights ago at around 9:30.  The pharmacy had suggested that I take it before bedtime to offset any side effects.  Unfortunately, for me, insomnia was one of the sides, so I pretty much tossed and turned all night.  I did not feel bad; it was not unlike starting LDN in the early days.   The next morning I felt wired up but ok once I got up and had some coffee.

Yesterday, I took the Harvoni at around 5:30 in the afternoon.  I felt slightly wired a few hours later but not much else.  It was easier to fall asleep later but I did not sleep well.

This morning, I decided to go ahead and take the LDN (about 2 1/2 mls)  - and when that kicked in, I really felt pretty wired.  

Overall, after two doses, I don't feel bad - every now and then, I get a twinge of a headache that quickly goes away.  Same with a rumbling in my stomach and an overall unwell feeling - but these feelings do not last long.  I have been drinking a lot of water!  I have always drank a lot of water  but now I can't seem to get enough - and it does seem to help the brief "unwell" feelings.   Of course, all of this water drinking leads to many, many bathroom visits - particularly on the first night that I took the Harvoni - seemed that I had to get up a dozen times during the night.

Been taking my usual supplements of Alpha-Lipoic-Acid with a B Complex 100 and a Methyl-Folate capsule.  Lysine and Vitamin D3. IP6.  I did not take the magnesium and initially held off on the Milk Thistle, per the pharmacy instructions.  However, I took the Milk Thistle against all advice.   I think that it is very important to support the methylation system and milk thistle is part of the process.

And of course, I am completely wheat free as I have been for the past 7 years.  I am wondering if some of the stomach upset and bloating reported by some folks could be caused by the Harvoni triggering an immune response to the gluten in the wheat - as interferon does.

Hepatitis C is a virus and I am treating a virus.  Seems that most folks say that HCV is a liver disease - sure it resides in and affects the liver, but it is also found in every cell in the body as viruses do.

Am sure hoping that more of the reported side effects don't show up as time goes on.  I can definitely tell that I am taking a powerful medication -  feels almost like rocket fuel. I do get slightly metallic taste in my mouth at times, but again, the water makes it go away.  The zinc lozenges help as well.

I wonder why some folks do ok on Harvoni with few sides and others suffer terribly?  Viral load and physical shape and liver condition going into treatment?

Prior to starting the Harvoni, I read many online forums and pharmaceutical sites to learn more about possible side effects.  Most sites and patients mentioned headache, fatigue and insomnia as being the most common.  However, I had read about a few folks having vision problems and changes after being on Harvoni and even after stopping it.  Interestingly, Gilead Canada had a list of the more "uncommon side effects:"

Gilead Canada Less Common Side Effects pdf

Less Common Clinical Trial Adverse Drug Reactions (< 2%)
Adverse reactions (Grades 2 to 4) occurring in less than 2% of patients
receiving 8, 12 or 24 weeks treatment with HARVONI in clinical trials
are listed below by body system:

HARVONI (Ledipasvir/Sofosbuvir) Tablets
Product Monograph
Page 8 of 61

Table 2. Adverse Reactions (Grades 2 – 4) Reported in < 2% of Patients
Receiving 8, 12 or 24 Weeks of HARVONIa from the Pooled Phase 3 Studies
(ION-1, ION-2, ION-3)


Blood And Lymphatic System Disorders - Factor VIII inhibition

Cardiac Disorders - Palpitations

Eye Disorders - Visual impairment

Gastrointestinal Disorders - Abdominal discomfort, abdominal
distension, abdominal pain, abdominal pain upper, constipation,
diarrhoea, dyspepsia, gastrooesophageal reflux disease, mesenteric vein
thrombosis, nausea, oral discomfort, vomiting

General Disorders And Administration Site Conditions - Asthenia,
feeling abnormal, irritability, edema

Hepatobiliary Disorders - Hepatitis acute

Infections And Infestations - Conjunctivitis infective, salpingitis,
sinusitis

Injury, Poisoning And Procedural Complications - Contusion, ligament
sprain, meniscus injury, muscle strain

Metabolism and Nutrition Disorders - Abnormal loss of weight, decreased
appetite, gout

Musculoskeletal and Connective Tissue Disorders - Arthralgia, joint
effusion, muscle spasms, muscular weakness

Nervous System Disorders - Disturbance in attention, dizziness, memory
impairment, migraine, migraine with aura, parosmia, somnolence

Psychiatric Disorders - Affect lability, aggression, anxiety, depressed
mood, depression, emotional disorder, insomnia, libido decreased, sleep
disorder

Renal And Urinary Disorders - Urinary retention

Reproductive System and Breast Disorders - Erectile dysfunction,
metrorrhagia

Respiratory, Thoracic and Mediastinal Disorders - Oropharyngeal pain,
sinus congestion

Skin And Subcutaneous Tissue Disorders - Acne, alopecia, hyperhidrosis,
prurigo, pruritus, rash

Vascular Disorders - Hemorrhage, hypertension

Prior to looking at the Gilead Canada site, I did not find most of the above listed in any adverse conditions lists - save for the folks on forums who did mention some of the above.  Granted,  the list was compiled from the Trials and supposedly involved less than 2% of the patients.  But who knows in the real world how many more sides will  come to light.

I started walking regularly again after becoming extremely lazy over the last couple of years.  I even jogged a bit though my 62 year old bones didn't care for that.  But this rocket fuel makes me feel like going outside and running around the block.  Wonder if I should report that as a side, lol.

I'll be updating every now and then as this goes on.  Seems that I've been a guinea pig with the Low Dose Naltrexone for over 6 years (lab work in previous post)  and now I am joining thousands of others in being a guinea pig for Harvoni.  And taking it a step further by continuing the Low Dose Naltexone.

Update after 4 days - doesn't feel so much like rocket fuel.  Don't feel bad - sometimes achy - sleeping better but probably because I am taking it now around 5:45 PM instead of at bedtime.  Do seem to have a somewhat short fuse at times....but as I have been under so much unending financial stress, it is not surprising. I had hoped to be in a better financial shape before doing the Harvoni in case I felt too bad to leave the house.  Neither has happened but it would be nice to just be able to stay home and not deal with the daily chore of finding food for me and the critters, paying bills and caring for the remaining 6 rescue cats....


Tuesday, March 10, 2015

6 Years Lab Tests Results and Low Dose Naltrexone

I am posting some lab test results - going back to 2002, when I was first diagnosed with HCV.  I began taking 3 mg. Low Dose Naltrexone in February 2009.


HCV PCR:

12/12/2002 -   >500,000  LOG - 5.7
01/03/2007 -   853,254
01/15/2009 - 1,280,000 
05/01/2009 - 49,400 after being on 3 months
09/15/2009 - 18,729
04/29/2010 - 11,300
02/28/2011 - 16,500
11/12/2012 - 16,288
06/19/2013 - 13,973
02/07/2014 - 34,284
02/01/2015 - 37,934  -  Retest 02/19/2015 - 81,398? (had taken 2 ml LDN mixture 4 hours before)


ALT/AST:  (ALT (6-29) - AST(10-35)

10/18/2002 - 117/63
12/12/2002 - 76/49
05/20/2003 - 74/51
09/23/2003 - 65/49
03/18/2004 - 58/42
10/24/2005 - 58/39 - post Katrina
10/27/2007 - 140/72 
09/11/2008 - 82/51
01/15/2009 - 174/99
05/01/2009 - 23/30  after LDN
09/15/2009 - 36/37
12/22-2009 - 34/31
04/29/2010 - 25/30
09/16/2010 - 24/31
02/28/2011 - 33/30
09/07/2011 - 27/28
06/19/2013 - 31/30 
02/08/2014 - 47/39 - after Girls Night Out party the day before (wine)
02/01/2015 - 32/23


BILIRUBIN TOTAL:( 0.2-1.2)

12/12/2002 - 0.8
05/20/2003 - 1.3
10/04/2005 - 0.7
10/27/2007 - 1.1
09/11/2008 - 0.7
01/15/2009 - 1.3
05/01/2009 - .09
09/15/2009 - 1.1
12/22-2009 - 0.7
04/29/2010 - 1.1
09/16/2010 - 0.8
02/28/2011 - 0.7
09/07/2011 - 0.8
06/19/2013 - 0.6
02/08/2014 - 0.7
02/01/2015 - .06

ALKALINE PHOSPHATASE: (33-130)

12/12/2002 - 64
05/20/2003 - 46
10/27/2007 - 60
09/11/2008 - 74
01/15/2009 - 55
05/01/2009 - 58 after LDN
09/15/2009 - 57
12/22/2009 - 66
04/29/2010 - 54
09/16/2010 - 59
02/28/2011 - 67
09/07/2011 - 64
11/28/2012 - 65
06/19/2013 - 54
02/08/2014 - 62
02/01/2015 - 56

ALBUMIN - (3.6-5.1)

12/12/2002 - 4.3
05/20/2003 - 4.6
10/24/2005 - 4.3
10/27/2007 - 4.9
09/11/2008 - 4.8
01/15/2009 - 5.2
05/11/2009 - 5.0
09/15/2009 - 4.9
12/22/2009 - 4.8
04/29/2010 - 4.9
09/16/2010 - 4.9
02/28/2011 - 5.0
09/07/2011 - 5.1
06/19/2013 - 4.9
02/08/2014 - 5.1
02/01/2015 - 4.8

GLOBULIN - (2.3-3.5) now (1.9-3.7)

12/12/2002 - 3.7
10/27/2007 - 3.3
09/11/2008 - 2.6
01/20/2009 - 3.7
50/11/2009 - 3.0
02/08/2014 - 2.5
02/01/2015 - 2.5


TOTAL PROTEIN (6.1-8.3)

12/12/2002 - 8.0
10/27/2007 - 8.2
09/11/2008 - 7.4
01/20/2009 - 8.9
05/11/2009 - 8.0
02/07/2014 - 7.6
02/01/2015 - 7.2



Blood Urea Nitrogen (7-25)

05/20/2003 - 4
10/27/2007 - 9
09/15/2009 - 9
12/22/2009 - 8
04/29/2010 -10
09/16/2010 -10
02/28/2011 - 11
09/07/2011  - 8


02/01/2015 - 12


Prothrombin Time -(10.0-13.0)

12/12/2002 - 10.1
INR: 0.9

05/20/2003 - 10.3
 INR - 0.9

02/01/2015 -   10.1
INR - 1.0


FERRITIN (10-232)

12/12/2002 - 95.4 (10.0-150)
10/22/2007 - 176
02/04/2008 - 93
05/06/2008 - 92
09/11/2008 - 60
01/20/2009 - 115
05/11/2009 - 83
09/15/2009 - 80
11/12/2012 - 89
02/01/2015 - 73

IRON TOTAL: (40-160) (45-160)

12/12/2002 - 83

02/01/2015 - 141

IRON BINDING CAPACITY (250-450)

12/12/2002 - 346

02/01/2015 - 377


ALPHA-FETOPROTEIN - TUMOR MARKER  <6 strong="">

12/12/2002 - 3.40
10/27/2007 - 4.0
09/11/2008 - 4.9
01/20/2009 - 5.2
05/11/2009 - 6.1
09/07/2011 - 5.2
11/12/2012 - 5.1




Platelet Count (140-400)

12/12/2002 - 252
05/23/2003 - 215
10/24/2005 - 204
10/27/2007 - 250
09/11/2008 - 209
01/20/2009 - 186
05/11/2009 - 187
02/07/2014 - 198
02/01/2015 - 168


WHITE BLOOD CELL COUNT (3.8-10.8)

12/12/2002 - 7.2
10/24/2005 - 6.0
10/24/2007 - 5.8
09/11/2008 - 5.8
01/20/2009 - 6.0
05/11/2009- 5.0
02/07/2014 - 6.7
02/01/2015 - 5.1


RED BLOOD CELL COUNT (3.80-5.10)

12/12/2002 - 3.99
05/23/2003 - 4.10
10/24/2005 - 4.25
10/27/2007 - 4.07
09/11/2008 - 4.03
01/20/2009 - 4.21
05/11/2009 - 3.96
02/07/2014 - 4.14
02/01/2015 - 3.77

Absolute Neutrophils (1500-7800)

10/27/2007 - 3509
09/11/2008 - 3300
01/20/2009 - 3750
05/11/2009 - 2410

Absolute Lymphocytes (850-3900)

10/27/2007 - 1630
09/11/2008 - 1966
01/20/2009 - 1686
05/11/2009 - 1950


Hemoglobin AIC - <6 strong="">

10/27/2007 - 5.4 
10/25/2011 - 5.2 



Misc. tests - only done once or twice by Integrative doctor:


Fibrinogen (175-425)

10/27/2007 - 239


Insulin  <17 strong="">

10/27/2007 - 6


 I will be adding more along the way - I have folders filled with lab results going back to 2002 -  some Katrina water logged -  I am still digging through all of them.



Sunday, February 15, 2015

Changes 2015 - Harvoni?

Hi all, sorry for not updating in so long!  As mentioned previously,  my great Integrative doctor who ran all of those comprehensive lab tests ( including the many HCV viral load tests) quit taking Medicare in 2013. So I could not find the cash to go back to her.

And I lost two of my long time companions recently; 13 year old Rosemary left me right before Thanksgiving. ..the vet found a tumor in her bladder..I had to let her go soon afterwards. And my 17 year old heart, Cayenne passed over on January 16, the day after my 62nd birthday. I miss them so.

Now, moving forward, I recently saw a new Gastrointestinal do over at LSU. He was very excited about Harvoni and pretty determined to get as many of his clients on it as possible. So I had a lot of blood drawn and many, many tests done, including a Fibrosure test.

Now I had not had any new labs done since about a year ago and those were pretty good. Liver panel ok (tho ALT/AST slightly elevated due to a Project Runway girl's night party the night before where wine was served) Viral load was @35,000 and all other regular stuff was fine.  Basically the same results as I've had since early 2009 when I started using 3 mg.  LDN (Low Dose Naltrexone)   My 2003 liver biopsy had shown "minimal inflammation. )

But despite knowing I have had HCV since 2002 (and probably been infected since the early 1970's) I was nervous.  Having a low viral load and pretty much normal liver function tests was good, but having another liver biopsy or a Fibrosure test would reveal the true shape that my liver was in.

Also, as I was unable to get a prescription for the compounded LDN that I had been using for most of the last 5-6 years (from Skips Pharmacy) I switched to the 50 mg Naltrexone tablets (from India) and began mixing my own LDN.  I also switched from taking it at night and started taking it in the morning. I have had terrible sleep issues these last couple of years due to the seemingly unending financial stress.

At any rate , the partial labs that were mailed to me (part of Fibrosure equation)

HCV RNA: 37,934
ALT: 35 (0-40)
Bilirubin Total: 0.4. (0.0-1.2)
GGT: 26. (0-60)
Haptoglobin:  64 (34-200)
Apolipoprotein A 1:  187 (110-205)
Alpha 2 Macroglobulins QN: 299 (110-276) H

Fibrosis Score: 0.32  (0.00-0.21) H
Fibrosis Stage: F1-F2  (0.00-0.31)

Necroinflammat ACT. Score: 0.19 (0.00-0.17) H
Necroinflammat ACT. Grade: A0-A1

So really not bad. Note that my fibrosis stage is only one point over F1.

But in the Harvoni scheme of things, these results will disqualify me from initially being approved to get it. My doctor told me about appealing and all this other stuff. My next appointment with him is in a couple of weeks and I will find out more. Along with getting the rest of my test results. ..CBC, LFT's, etc.

I did get the iron/ferritin tests back. All in range with Ferritin at 73, which is cool. (20-288)

My doc is at LSU Health and he is an Attending there so he's pretty familiar with the red tape involved. But it's like pulling teeth to get your labs from them. The nurse did call the other day to tell me that the doc wanted me to retake the HCV RNA test. I guess despite me telling him that it had been low since starting LDN back in February 2009 (Valentines Day) he wasn't really listening. Maybe he will at the next visit. I would also imagine that the low VL might raise some eyebrows among others along the way.

Overall,  I'm pretty pleased.  The stress of being in constant poverty, the illnesses of my companion cats, being out of many supplements,  not eating as well as I should (except for gluten free!) and probably indulging in a bit too much Chardonnay,  has not been very conducive for overall health.  But having the Low Dose Naltrexone on board, whether compounded or mixed from 50 mg Naltrexone tablets,  has been a blessing for me. And one that I plan on using for the rest of my life, virus or no virus!

At this point, I still am not in that big of a rush to treat. There are even more HCV drugs in the pipeline with even more promise. ..shorter treatments and supposedly 100% cure rate.  Hopefully in the next few years there will be 100% cure rates for all genotypes. ..and that Hepatitis C will be eradicated!

Saturday, July 26, 2014

World Hepatitis C Day New Orleans



July 26, 2014
  • Location: Audubon Park
  • Address: 6500 Magazine St, New Orleans, LA 70118
  • Times: 10:00 am - 1:00 pm
  • Admission: Free
  • Visit Website
World Hepatitis Day is part of Avita's campaign to raise awareness about Hepatitis in Louisiana and worldwide.

Come join us on The Prowl For A Cure for a fun-filled pet friendly day at the park featuring local food, education, games, door prizes and entertainment. Including Free Hep C & HIV testing provided by NO/AIDS Task Force. 
Special guests include the 610 Stompers & Gina Brown! 

Did you know that 3 out of 4 people infected with Hepatitis are unaware that they have it?

In 2008, the World Hepatitis Alliance founded World Hepatitis Day as an answer to the lack of awareness centered on Hepatitis. Since then the event has grown to be celebrated in 136 countries and has even broken Guinness World Book records!
Last year, Avita hosted the first World Hepatitis Day event in Louisiana, accounting for 34% of participation in the US.

To learn more about Hepatitis and World Hepatitis Day, check out our Hepatitis Infographic.


See ya'll there! 

Monday, June 30, 2014

So now, there is pretty much a cure out there for Hep C - and others on the horizon that probably work even better!  However, as of now, no one can afford it.  Medicare and Medicaid, as well as private insurers, were not quite prepared for a 90-95% success rate Hepatitis C drug to hit the market.  And the tens of thousands of folks wanting to do one of the newer treatments - ones that actually work, have much less side effects, and a much shorter treatment time, are all lining up.

Meanwhile, there is LDN - Low Dose Naltrexone -

Since my integrative doctor no longer takes Medicare,  I have been unable to have the regular Hepatitis C labs and viral load tests done as regularly as I had since early 2009 when I began taking 3 mg of Low Dose Naltrexone.   However, my rheumatologist over at LSU ran basic labs, a liver panel and a viral load test back in February 2014.  As I had posted last, everything was pretty much the same as they have been - normal liver enzymes and still low viral load - thankfully.

I plan on going back to my CAM doc but I need a few hundred bucks to do so.   But I am seeing a new gastro next month and am hopeful that she will be as supportive as my integrative doctor is/was.  Or at least more supportive than my last gastro who refused to run any viral load tests as "LDN is not used to treat Hepatitis C and will not affect viral load", he said.   And he was less than supportive when I showed him the results of my first labs done after being on LDN for 3 months.  Viral load dropped from 1,600,000 to 48,000.  And has remained below that in the five years since.  Usually 11,000-36,000 range.

At any rate, until next month and new labs, here is:


Treating Hepatitis C With Low Dose Naltrexone


Updated it slightly and removed any reference of increasing LDN dosage past 3 mg.

In the rescue cat side,  Cayenne, my 16 year old white Siamese mix, went into liver failure last December.  His ALT was something like 1375 and all of his other numbers were astounding.  I put him on Denosyl (SAMe) and Marin (Milk Thistle) and he improved and put weight back on.  Then, a few months ago, he was not doing well.  The vet said that he was dehydrated and had an enlarged kidney.  I was sent home with a bag of fluids "to keep him comfortable" as none of us believed he would live much longer.   And he was so dehydrated that he needed sub-q fluids two times a day!  At any rate, surprisingly,  Cayenne is now getting fluids every other day.  He has gained weight again, is grooming himself and begs to go out for a supervised walk every day.  The vet thinks that as his liver heals, his kidney function has also improved.   I am thrilled - I have had him since he was 6 weeks old and been through everything with him.

 

Tuesday, February 11, 2014

Still here

Just letting you all know that I am still here - and celebrating 5 years Low Dose Naltrexone for Hep C! And will be posting again soon - am waiting for a replacement computer. My other one's hard drive crashed during the summer and I have been struggling to use my 2003 Katrina soaked one. It takes 20 minutes to go from page to page on it and is extremely frustrating. Will be adding some new posts soon! Got new viral load test - 34,284 - which is great. Since 2009, it has never been above 48,000 - and either seems to be in the teens or @ 30-35,000. And has never made the jump back to the million+ that it was pre-LDN. Anyway, much more to come - still waiting on a computer!

Monday, September 30, 2013

Mr Magoo - Rest in Peace

My boy Mr. Magoo, was put to rest last Thursday at my vet's office. He fought a hard, cruel battle against Oral Squamous Cell Carcinoma - but finally lost it last week. Magoo was my friend, companion and child for the last 12 years and I miss him terribly. One day I will return to posting on this blog - back in June, I was so excited to write about my latest LDN labs until I noticed Mr Magoo drooling as he watched me type. That is when I found the awful tumor underneath his tongue. Nothing has been the same since then.