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Strange fat under chin

As some here know I was treated with S&O last summer and reached SVR24 cured a few weeks ago. Even though I am nearly 60 I have always had a very chiseled chin/jaw line. My lovely sister mention a few weeks before my last IDS appointment that I now have a slight double chin. Indeed I do have an area of fat that has developed between my chin & neck. If I drop my head it is really visible.
I asked my IDS if she had seen this occur or read about it happening in people who had been treated with S&O. My concern was the fact that Olysio is a PI and that type of drug caused a lot of facial fat problem in people using them to control HIV. My IDS no longer prescribes PIs anymore for her HIV patients because of this reason.
She did show me a graft of my vitals and I have gained 20 lbs since starting treatment and cure and she suggested that the fat area could just be a natural fact of aging and the weight gain from being in better health since my body is not fighting a chronic infection that burns up calories fighting the virus.  
But in all honestly she did say that it was too soon to know what long term effect the DAAs could have on people but she did note my concerns and said that she would forward them to the makers of Olysio.
Bucky
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747988 tn?1396536878
have you had your thyroid checked? Most hiv folk I know with lipidostrophy have sunken faces and fat tends to be redistributed to the buttocks or back of the shoulders.I know thyroid dysfunction can make the neck look swollen and that hcv treatment often affects the thyroid.
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Avatar universal
Otterwatcher, Thanks for posting back. Two of my friends who took PIs now have chipmunk cheeks because of fat redistribution. I had my thyroid checked at my SVR24 appointment because of the treatment effects on the thyroid gland and it was OK. The fat pad is between my chin and where my head attaches to my neck. My neck is fine although I have had to go up to a 18" neck from a 17" in my shirts because of my overall weight gain.  
Bucky  
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747988 tn?1396536878
my 12 year old niece had exactly that double chin look from thyroid issues that's why I thought it might be related but it could well be the Olysio. It could also be diabetes related brought on by hcv or treatment-have you been checked for that recently?
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Avatar universal
Yes, My fasting glucose is 82.  I will have my thyroid rechecked because labs can make mistakes.
I guess that I should be happy enough that I am cured and not be dwelling so much about a little extra facial fat. My IDS did say that because I had been on Olysio for such a short time that the fat pad might disappear in a few months. She also said that I might try dropping 10 lbs and see how I look then.
Bucky
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747988 tn?1396536878
haha! maybe try to lose the weight you put on through treatment and then see what you think.
If you're feeling good then that's what counts!
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Avatar universal
Yes, I feel great now and I am really happy about that. I am sure that I will drop the weight since the weather has improved and I can get out of my house and into the yard.
Bucky
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Avatar universal
My thyroid sort of has been 'wacky' just in the past 2 mon. and really was never a problem prior to this past treatment. Since I've done Interferon and Riba numerous times and this past treatment only had the Interferon/Riba/ and Sovaldi  No Olysio, my only assumption would be:

1. Natural occurrance with aging.., but my weight hasn't changed but about 3 lbs., up one day, 4 lbs. down the next.., etc., etc. nothing significant.

2.  Thyroid  My TSH was really, really, high when I had labs for post treatment followup in Feb.  It was rechecked by my internal meds Dr. and it was still high.  He started me on 50mcg of Synthroid but it was way too much for me to tolerate and I was sort of mad because he didn't check the T3.., finally checked the T4..., I had to get the T3 done on my own.  So, I went to an endocrinologist and he said, I could start taking 25mcg and cut the pills in 1/2, then, he gave me a script and sent me on my way.  I was still feeling weird-not right at all and worse than before I ever started the meds for the Thyroid.  So, I went again to the walk-in/self-pay lab and got everything rechecked.  Everything had dropped back into normal range and the good news is I don't have autoimmune Hashimoto's!  The only thing out of range was the T3(which the other 2 doctor's didn't check-idiots.., I told them to.)   So, I decided, I am going to now, break the 25mcg pills in 1/2 again and see if I can get by with only taking 12.5mcg a day and recheck it again in a week.  I had once freak episode of a T3 problem about 15 yrs ago, and only had to be on T3 replacement for 1 mon and everything reset itself.  I told these doctors that and they didn't even seem to register it or listen.  This was like after one of my TX's and don't remember which one.  Anyhow, my neck, too, seems a little puffier and not quite as firm, but don't know yet if it's the thyroid or just body trying to readjust to all the h*ll I've put it through.  My intention is to slowly wean off of the thyroid med and if my TSH remains in normal range, then, totally not take it.  I hate the way it makes me feel, but on the other hand, you need a working thyroid, too.

3.  A post treatment lag of body metabolism trying to readjust and in 6 mon., maybe you'll not even notice it anymore?  I hope this is the case for me, too.
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Avatar universal
Susan,  I think that I will go with #1 & #3. On other thing that has occurred is that I don't sweat like I used to. I used to have it dripping off my forehead with only a minimal amount of work/exercise. My body temp used to run around 98.5 but it has now dropped to 97.4. I still have an old mercury thermometer that I have had for years so I know it is accurate. My IDS said that she is not surprised since my body is no longer under siege from HepC.  
Bucky  
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Avatar universal
Interesting..  It takes alot for me to sweat, too.., however, remember, I relapsed so, I can't claim it's from not having the Hep.  When I do the 1 spin class a week, I will sweat in that, but with the rest of my workout, no matter how hard I push myself, can't really work up a sweat.. Hmmm, strange.  

What is an IDS?  Is that some abbreviation for a doctor that I'm not familiar with?  I know, MD... Osteopaths, Nurse Practioner=NP, Physician's Assistant = PA, Certified Medical Assistant = CMA,  Registered nurse=RN   But, can't say that I can figure out IDS??  

Susan400
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747988 tn?1396536878
yes my face used to sweat profusely pre treatment but now I'm always cold.
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Avatar universal
Susan:  I use that for my Infectious Disease Specialist.  I believe others do too.

Pat
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Avatar universal
Sorry your having this issue.  As we age fat tends to gravitate to our face predominantly if we are genetically predisposed.  The fact that you have gained 20 lbs would seem to correlate with fat deposits in your chin.  Not much you can do unfortunately other then losing weight.
If you've checked your Thyroid and are not on Steroids it's likely weight gain.
Hope this helps
.....Kim
Helpful - 0
568322 tn?1370165440
Lipodystrophy, fat atrophy and redistribution, causes you to loose subcutaneous fat and move it to the deep tissues.  It happens from immune reconstitution (caused by your quick recovery) and is considered an inflammatory reaction.  It is also associated with having metabolic changes like high cholesterol, low HDL, high triglycerides, and elevated levels of insulin.

I hope I'm wrong.

Co
Helpful - 0
Avatar universal
I do have low HDL but all my other blood and chem levels are perfect although I still have low platelets.
I have lost 10 lbs but the fat pad is still there. I contacted my new Gastro doctor about this since he is now seeing many people on the other side of successful HepC treatment. Weight gain has been noted, but he said it was mostly from the body not being under attack and not needing extra nutrition.

He has arranged a consult with an HIV IDS to look at my face to see if indeed I have a lipo issue since they have dealt with it using  PIs in their practice.

One other puzzling event that I am pleased about is the fact that I am not having any spring allergies! I have had horrible springs for many many years but this year not a sneeze, itchy eyes or scratchy throat so far. Everything outside is heavily covered in yellow pollen but I haven't had to take any allergy meds. I really don't know what to make of this.  
Bucky  
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747988 tn?1396536878
That is strange but what a relief that you can at last enjoy the Spring flowers!
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Avatar universal
if it is related to the thyroid, so often the labs show you are "within range" but you actually do have thyroid problem
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Avatar universal
I had these test preformed :
•TSH, T4, T3, thyroid-stimulating immunoglobulin (TSI), antithyroid antibody.


Everything was normal. I have no enlargement of my neck.The area of fat is between my jaw bone and it goes no further back than that.
Bucky
Helpful - 0
Avatar universal
"TSH, T4, T3, thyroid-stimulating immunoglobulin (TSI), antithyroid antibody" will not always detect a thyroid problem. Believe me, I know, I had my thyroid labs done more than once by more than one doctor and they missed the diagnosis despite the symptoms. I'm glad I did not give up and demanded a referral to an endocrinologist; however, they too are not all created equal.You should head over to the "Thyroid" message board and post those labs. Was it just T3 and T4 or Free T3 and Free T4? There is a big difference.

Low temperature and weight gain are symptoms as well. Your prior temp of 98.5 was more normal than your new 97.4. I have never heard of a normal temp being considered a mild fever that would be associated with HCV.

I think the area of the fat accumulation you are describing (i.e.,"The fat pad is between my chin and where my head attaches to my neck) is what is called "jowls" and one article says, "Handing jowls: The jowls are the area of skin underneath your jaw bone.  This skin will start to sag and then apparently become fat-filled.  This is one of the surest signs of hypothyroidism..."

Thyroid dx is tricky, and it could be in the process of failing and labs won't show alarming numbers right away. If things don't improve with the weight, or if you start to have other symptoms, I'd suggest you revisit the thyroid with a good endocrinologist. Don't wait three years like I did. :)  And congrats on your SVR!
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Avatar universal
I had a consultation with a Plastics Specialist today who deals with lipo issues and corrective surgery. He has seen this fat pad before but not recently since PIs aren't used very often anymore. He believes that it came from the Olysio although I am the first that he has seen with this complaint.
I inquired as to if he thought it could have to do with my thyroid and he said "no" especially since I had an extensive screening for it.
Anyway, if the area doesn't improve by Fall then I am going to have Liposuction and have the area removed.    
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Avatar universal
I just wanted to post back with an update. The fat pad is now gone even though my weight is the same. I am glad that I waited and let nature take its course. It had to come from the PI (Olysio) but it was a small price to pay to be cured especially since it is no longer a problem.
Now if I could only get my waist under control!
Bucky
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317787 tn?1473358451
Hey there!  So glad to hear.  I have some odd things on my neck after tx.  It turned out it was a swollen lymph node (under chin) and a muscle in neck
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747988 tn?1396536878
great news! yes I had swollen lymph nodes in the back of my neck post tx  too.
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