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Keeping hemoglobin levels up
Hi everyone, have read lots of comments concerning hemoglobin levels an RIBA. Is there anything to boost these levels concerning diet, an if so, any suggestions apart from just eating a well balanced diet. Does anyone know if iron supplements would help?? Thanks in advance
Hi Mary,
Yes some drop is to be expected. It is a side effect of the Ribavirin. How much it drops depends on the individual and what their level was before starting treatment. Technically anemia is a decrease in amount of red blood cells (RBCs) or the amount of hemoglobin in the blood. Hgb of <10 g/dl. You are at 11 g/dl. A drop of amount 4 you will feel. People will find it harder to exert themselves. They might become more winded and less muscle strength walking up a flight of stairs for example. This is because the muscles don't get the amount of oxygen they are used to having because the red blood cells carry oxygen.
If you haven't treated before and G2 the chances of SVR are very high. SOVALDI + RBV 12 weeks in both the FISSION and VALENCE studies the SVR=97% if you don't have cirrhosis! Can't get much better than that!
In the studies/trials of Sovaldi + Ribavirin the rate of hemoglobin (g/dL) < 10 was 8% in people that took Sovaldi + Ribavirin. 1% experienced hemoglobin < 8.5.
But we are all different and "stuff" happens.
I hope your will hemoglobin will level off. If you go below 10 let your provider know as they may want to reduce the dose of Ribavirin or try Procrit. If you go to much below 10 you will probably feel pretty crummy unfortunately.
The most common side effects of this treatment in the trials were...
Fatigue 38%
Headache 24%
Best of luck with your treatment!
Hector
Yes some drop is to be expected. It is a side effect of the Ribavirin. How much it drops depends on the individual and what their level was before starting treatment. Technically anemia is a decrease in amount of red blood cells (RBCs) or the amount of hemoglobin in the blood. Hgb of <10 g/dl. You are at 11 g/dl. A drop of amount 4 you will feel. People will find it harder to exert themselves. They might become more winded and less muscle strength walking up a flight of stairs for example. This is because the muscles don't get the amount of oxygen they are used to having because the red blood cells carry oxygen.
If you haven't treated before and G2 the chances of SVR are very high. SOVALDI + RBV 12 weeks in both the FISSION and VALENCE studies the SVR=97% if you don't have cirrhosis! Can't get much better than that!
In the studies/trials of Sovaldi + Ribavirin the rate of hemoglobin (g/dL) < 10 was 8% in people that took Sovaldi + Ribavirin. 1% experienced hemoglobin < 8.5.
But we are all different and "stuff" happens.
I hope your will hemoglobin will level off. If you go below 10 let your provider know as they may want to reduce the dose of Ribavirin or try Procrit. If you go to much below 10 you will probably feel pretty crummy unfortunately.
The most common side effects of this treatment in the trials were...
Fatigue 38%
Headache 24%
Best of luck with your treatment!
Hector
I keep a journal of sorts an the last 5 days, I'm feeling soo much better an hoping it continues. It's extremely hot an humid here in L.A. (lower Alabama) so getting out in the heat is something I've been avoiding since I've started treatment. Headaches bother me when I do. Just having to adjust my life an routine alittle. It's doable since I'm no longer in the work force, can be flexible that way. Love the comment about not losing sleep. I'm gonna borrow that attitude from you. Kinda like "Don't worry, Be happy". I've just gotta stop being a" Doubting Thomas" an get with the idea of beating this virus. So I'm gonna stay positive an try to not to dwell on things I cannot change. Take care. Mary
Hi Hector, thanks for saving me $$ on useless iron supplements. From what I'm understanding, the drop is to be expected. GT2. Started solvaldi / ribasphere 4 wks ago. Starting labs before treatment...hemoglobin 14.6 and hematocrit 45.4. Four week labs are...hemoglobin 11. And hematocrit 35.5. Is this fairly normal to see a drop of 10 with the hematocrit in just 4 wks ?? Thanks so much in advance an hope your doing well. Mary
Hi Mary, My 6 month post is early October. Not worrying at all.....if it should come back, I'll just retreat. As long as there are drugs to eventually kill this beast, I'm not going to lose sleep. Sounds like your doing great. Yeah, I'm the peanut butter lover. It really is great protein, and perfect with those pills.
I eat the plain old Jiffy, and don't worry about the sugar as I'm so active that I need the added calories.
If you ever find that you have a side effect that's bothering you and no ones online to help, go back and read past posts starting in Feb, as that's kinda when we all started, and every Q and A is on there. We had really nothing to compare to as no one had done Sovaldi or Oyslio before except people in clinical trials, and they rarely went online. Honestly, have not seen anything from these new meds that have been dangerous or life threatening. You just try and get thru it, and not worry as everyone is so unique.
Again, your doing great
...Kim
I eat the plain old Jiffy, and don't worry about the sugar as I'm so active that I need the added calories.
If you ever find that you have a side effect that's bothering you and no ones online to help, go back and read past posts starting in Feb, as that's kinda when we all started, and every Q and A is on there. We had really nothing to compare to as no one had done Sovaldi or Oyslio before except people in clinical trials, and they rarely went online. Honestly, have not seen anything from these new meds that have been dangerous or life threatening. You just try and get thru it, and not worry as everyone is so unique.
Again, your doing great
...Kim
Ooh, reading your comments on your diet made my mouth water..LOL. So just basically, eat as healthy as you can, good advice. I don't eat meat except for fish. My breakfast is usually half a peanut butter an banana sandwich an glass of milk. ( Elvis's favorite snack ) before RIBA. Seems to working for me. It was either you, Jo, or Nan that suggested peanut butter earlier when I was having so much trouble keeping food down in the morning. I'm beginning to think that my nausea was not related to the meds, just that I had never ate breakfast in my adult life an maybe my body was rebelling the change. Some healthy changes are happening to me now. I know how important breakfast is to your metabolism, an believe me, even after treatment, I will be eating breakfast from now on. Thanks. Mary. P.S. When is your 6 mth. Labs due?? Praying for all
How low is your hemoglobin?
What week of treatment are you on?
"Is there anything to boost these levels concerning diet, an if so, any suggestions apart from just eating a well balanced diet."
No. The only thing that will raise your hemoglobin level is either reducing the ribavirin level (which depending upon the treatment could increase the chance of treatment failure) or receive Procrit injections that will stimulate your bone marrow and temporarily raise the hemoglobin level.
This is what was done when people commonly developed anemia with older peg-interferon based treatments.
NOTE: Procit is usually only given for hemoglobin levels <10 g/dL. It is a very expensive drug and has its own set of side effects that you should be aware of.
"Does anyone know if iron supplements would help?"
Iron supplements don't help. The ribavirin is suppressing the bone marrow so it can't produce red bell bloods. Hemoglobin reduction is dose-dependent hemolytic anemia and is not related to low iron levels. In some people with liver disease additional iron can cause further damage the liver.
Contact your provider and let them know you are concerned about your hemoglobin levels.
Good luck.
Hector
What week of treatment are you on?
"Is there anything to boost these levels concerning diet, an if so, any suggestions apart from just eating a well balanced diet."
No. The only thing that will raise your hemoglobin level is either reducing the ribavirin level (which depending upon the treatment could increase the chance of treatment failure) or receive Procrit injections that will stimulate your bone marrow and temporarily raise the hemoglobin level.
This is what was done when people commonly developed anemia with older peg-interferon based treatments.
NOTE: Procit is usually only given for hemoglobin levels <10 g/dL. It is a very expensive drug and has its own set of side effects that you should be aware of.
"Does anyone know if iron supplements would help?"
Iron supplements don't help. The ribavirin is suppressing the bone marrow so it can't produce red bell bloods. Hemoglobin reduction is dose-dependent hemolytic anemia and is not related to low iron levels. In some people with liver disease additional iron can cause further damage the liver.
Contact your provider and let them know you are concerned about your hemoglobin levels.
Good luck.
Hector
The only way to increase Hmg is thru eating foods rich in iron. Those would include, meat, seafood, nuts, leafy green veggies, and I'm sure you remember good old Popeye "Eat your Spinach". If you have cirrhosis or late stage fibrosis, you must be careful consuming to much iron. You can take supplements in the B family, but during treatment I think you should only go the natural route, or ask your Doc.
Sometimes if your Hmg goes extremely low, then cam give you a blood transfusion, or a rescue drug to raise your #s. What I've noticed lately when the #s go low, they reduce your Ribavirin. Alot of people sail thru, and with a 12 week protocol it typically doesn't happen until your near the end of treating, and then they do the watch and see approach.
Keep in mind that men have a higher Hmg by nature, so you can't really compare your levels as a female to theirs.
I'm in the health field, and always eat a great diet. Am very aware of what I put into my body as far as fruits, veggies, fish, low sugar, you name it. I also work out on a daily basis with cardio and weights. During treatment I still had a pretty big drop in my Hmg, so there must be other factors causing the decline, perhaps my own body chemistry.
Your best bet is to stay active, and not worry to much about things that you can't change, or changes that will never happen. Embrace the fact that this virus is going to be history in the near future, and how lucky we are to be a part of that. With the older treatments, they would have to grin and bear it for sometimes a year and still not reach SVR.
Keep doing what your doing, and keep that water flowing. Happy that you are doing well, and it will be over in no time
Take care
...Kim
Sometimes if your Hmg goes extremely low, then cam give you a blood transfusion, or a rescue drug to raise your #s. What I've noticed lately when the #s go low, they reduce your Ribavirin. Alot of people sail thru, and with a 12 week protocol it typically doesn't happen until your near the end of treating, and then they do the watch and see approach.
Keep in mind that men have a higher Hmg by nature, so you can't really compare your levels as a female to theirs.
I'm in the health field, and always eat a great diet. Am very aware of what I put into my body as far as fruits, veggies, fish, low sugar, you name it. I also work out on a daily basis with cardio and weights. During treatment I still had a pretty big drop in my Hmg, so there must be other factors causing the decline, perhaps my own body chemistry.
Your best bet is to stay active, and not worry to much about things that you can't change, or changes that will never happen. Embrace the fact that this virus is going to be history in the near future, and how lucky we are to be a part of that. With the older treatments, they would have to grin and bear it for sometimes a year and still not reach SVR.
Keep doing what your doing, and keep that water flowing. Happy that you are doing well, and it will be over in no time
Take care
...Kim
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