Lowering viral load

[maggiepie471]

Am I understanding that I am capable of lowering my viral load. I am assuming a good HCV diet (I'll call it) with no alcohol consumption (whatsoever),exercise, lots of water and good rest can do it. Is this true? I know my viral load from a couple of weeks ago was 2,850,000. I have not had the biopsy done yet. Ultrasound, yes, and nothing showed up at all. I was the so called social drinker so this part was easy--and yes the food is easy too. I am 129 lbs and 5'6" so don't have the weight problem. Drawback may be 70 yrs old. I am asymptomatic so far. Will not go  for the current treatment offered.  Some of this is repeated information. But, this is the best forum of all.

[willbb]

Your lifestyle sounds fine  and may help with your overall health ,however once you have contracted HCV the only modality that will eradicate the virus is the current medical treatment available.(approx 70 80 %succesful)
.
If you choose not to go that route I would strongly advise to have a biopsy to ascertain the amount of liver damage (fibrosis) you may have.

I f at your age you have  no or mild damage then not treating is certainly an option ,however if the damage is severe(and it often is with no symptoms ) you may want to discuss treating with your doctor

Good luck and welcome to the group..
Will

[orphanedhawk]

"Am I understanding that I am capable of lowering my viral load. "
You have no control over your viral load.
You can do things to help keep your liver as healthy as possible, but that is all you can do.

Viral loads fluctuate by themselves as the virons die and replicate.
Viral load count does not equal liver damage. The viral load is not really important other than during treatment.
What is important is the condition of your liver.

I was asymptomatic until my liver was severely damaged. This is the sneaky thing about hep c, it isn't called the silent epidemic just because of it's image.

The health of your liver is paramount.

There are claims of certain herbs and supplements helping to reduce fibrosis though none will rid you of the virus and none are proven in trials, as yet.

If a healthy life style was all it took to keep hep C at bay, I wouldn't have needed a liver transplant.

[Idyllic]

I read your other post ("Do I have my head in the sand?") and it sounds as if you have a fairly decent understanding of the limitations of the ultrasound as well as most aspects of treatment in general. I agree with willbb when it comes to a biopsy though.  It helps to know what condition your liver is in so you realise exactly what you are dealing with. I don't think being 70 years old today is the same as it was in back in our grandparents day.

To answer your question, I am not sure how you would lower your viral load without treatment or if it even matters. I guess keep an eye on your liver enzymes:
http://surgery.about.com/od/beforesurgery/qt/LiverLabTests.htm

[maggiepie471]

Thanks to all of you again. I am just trying to get educated as best I can to what I am dealing with.  I have read until I can hardly think of questions any more. I did read a gals comments, my age who claims she did lower her viral load with her diet. Significant from 14 mil to 6.7mil. That is why I asked since she is very similar to my situation even her age is the same. And thanks to Idyllic, you are correct-I am more like a 50 year old with my life and what I thought was excellent health. Was this a punch in the stomach!

[willbb]

read a gals comments, my age who claims
she did lower her viral load with her diet. Significant from 14 mil to 6.7mil

-----------------------------------------------
These two viral loads are not at all different and has no bearing whatsover on damage being done or not done to the liver from the bodys own immune system..

Best  to you....

Will

[maggiepie471]

Thanks for that information.  I truly did not understand that at all. I have just returned from a walk in my tiny town finding out there is a lot of people already here who know they have this. I did not know that at all.

Wow-this is becoming more and more shocking to know. I am involved with my hospital here and am going to suggest that at our health fairs, there be a hepatitis C test offered. Education and change of life style just to hold it back a little while longer.

[James10500]

"Am I understanding that I am capable of lowering my viral load"

Where did you read that.  One thing about HCV is there are a lot of snake oil salesman out there claiming crazy things.  Be careful when coming to conclusions,

[frijole]

I don't think I can add anything here.  I have recommended you get a biopsy on another thread.  There is virtually no difference in 6 million and 10 million when it comes to IU/mL as will said.  Those little buggers are constantly dying off and replicating and the numbers change daily - hourly.  The only thing that matters is how damaged your liver is.  Take heed of what orphanhawk said so consisely -- if diet and lifestyle were the key, she would not have had a liver transplant in the first place.

I told you on the other thread - and I am just a few months short of 65 - that my liver condition went to cirrhosis in the last 3 years.  And never have I had a symptom and my liver enzymes have always been in range.  

So do yourself a favor and at least get the biopsy.
frijole

[Dawn703]

I did not know I had HCV for 37 years, just recently found out this Jan. I have lived a healthy lifestyle for my adult life. I always ate right Lots of fruit and veggies, very little red meat, worked out, no street drugs, little alcohol, green tea, and some supplements. My viral load at treatment time was only 14,000. I have heard of others keeping their viral load low for a long time through healthy lifestyle. Not sure about lowering the vl, I heard that viral loads go up and down anyway.

That said, as others have said, viral load is no indication of liver damage and yes a healthy lifestyle can help your liver, but not prevent damage. This is why I started treatment even though my viral load was so low. All natural treatments will not cure you of the virus and as long as there is virus, your immune system will continue to fight it, causing damage. The only thing that will cure it is treatment. I am not pushing treatment mind you but as others have said, you need to have a biopsy done and go from there.

[willbb]

   Good post Dawn...
Will

[James10500]

". I have heard of others keeping their viral load low for a long time through healthy lifestyle.

But they don't know what their VL would have been otherwise.  Drawing conclusions in regard to HCV is difficult.

[Idyllic]

This is the reason most of us encourage you to have a biopsy. It truly is the only way to assess the stage of fibrosis you have. Plus, I understand the older we get the more rapidly fibrosis can progress:
http://gut.bmj.com/content/53/3/451.abstract

[Dawn703]

for my particular situation, I agree with your statement.

However, some people I know of knew they had HCV decided to go the healthy natural route, did keep track of their viral load  (stayed low, very low), as well as their liver disease progression.  

I respect your opinion and I agree that drawing conclusions is difficult, at times.

[Dawn703]

Thanks Will

[mikesimon]

You can know a whole lot about the liver histology without undergoing a liver biopsy. Although there seems to be a consensus here that everyone should get a biopsy I am not in agreement. I never had a biopsy before my transplant and yet I received a liver. And yes, my liver was shot.

There is Fibroscan and blood test results that can often diagnose pretty accurately the shape of the liver.

Now, that's not to say I have anything against against liver biopsies. I've had more than I can remember but it's been at least 8 and some of them were performed in my hospital room and obviously there was not ultrasound guidance with those. I found them to be no big thing although I do prefer the ultrasound guided ones.

[nan535]

My husband never had a biopsy either before his liver transplant. He had cat scans and ultrasounds. He was diagnosed with cirrhosis,  ESLD, hepatic encephalopathy and esophageal varices (which were banded). As I recall, they felt doing a biopsy was an unnecessary risk in his case..

[Advocate1955]

I agree with most of the posters above.  The VL is irrelevant.  It can fluctuate daily, and a high VL does not mean more or faster rate of damage.  A low VL does not mean less damage.  It is the presence of the virus in the blood that leads to the liver damage.  If the virus is present, it is damaging the liver.  As frijole said, the progress of liver damage can be slow, but sometimes it can be faster.  My husband's VL has always been in the middle range (except when undergoing treatment of course), and yet he progressed from f1/f2 in 2007 to f4/Cirrhosis in 2010.  As others have said, your next step is to learn as much as you can about your specific stage of liver damage so that you and your doctor can determine the best course of action.  At your age, your risk for progressing to Cirrhosis is higher, and if you progress to Cirrhosis, treating your Hep C becomes more difficult.  Here is some information about viral load from my journals that another forum member, hrsepwrguy, shared awhile back:  http://www.medhelp.org/user_journals/show/332522/Viral-Load-HCV-Equivalents-per-Milliliter--Viral-Load-Chart
Feel free to ask any questions.
Advocate1955

[maggiepie471]

Thanks so much for the info. My doc will not be around to give the recommendation for a couple of weeks of who I am going to see for the next step--biopsy or the fibroscan. I understand all that you all have said clearly. I think the age thing is bothering me quite a bit now-I have seen that a few times about the progress speeding up. I now have friends who are telling me about friends or relatives of theirs who have already died from this. They were actuallly afraid to tell me. Most did not change their habits at all involving smoking, alcohol use or diet. I am still absolutely scared of the current treatments and those side affects. I don't have someone living with me and staying with my kids and my young grandchildren just seems to much to put on them. I want to hold out for something without the interferon--but that may be asking for a miracle.

[Advocate1955]

There is no way to predict how quickly or slowly your liver damage may progress.  Until you know how much damage you have right now, it will be difficult to speculate about whether you should treat now or wait until the new polymerase inhibitors are available, hopefully in a couple of years.  Generally speaking, liver damage progresses more quickly as people with Hep C get older.  Generally speaking treating is more difficult as people with Hep C get older.  A doctor who specializes in Hep C treatment will be able to guide you much better after you know the results of a biopsy or fibroscan.
In the meantime, there is no need to worry while you're waiting to get those things scheduled as soon as possible.  Liver damage doesn't progress in a day or two or even in weeks or months.  As long as you make the appointments and do the follow up testing as soon as possible, in the next month or two, so that you have more information on which to base your decision is fine.
Treatment with current medications is tough, no doubt.  The good news is it sounds as though you are generally healthy and not overweight.  The difficult news is your age, which will make treatment more difficult for you.  If you are otherwise healthy and active, you can probably manage treatment living on your own, if you plan ahead and have some strategies for having things at home that you might need to make treatment a bit easier.  However, it is a tough treatment, and would certainly be easier if you had some support (someone to help with grocery shopping, someone to drive you if you're not feeling well, someone to help with heavier work around the house, etc.).
Back to your original question:  liver healthy diet, no alcohol are both a big yes.  Ask your doctor before taking any supplements, pain relief medications, or herbs.
First things first, get your appointments made as soon as you can, wait for the results, and then discuss treatment options with your doctor.  
Best wishes.
Advocate1955

[maggiepie471]

Advocate1955--A special thanks for the latest info. All very helpful. I knew most of it but each piece of info does help.  I am extremely healthy and have always been. I don't even get a cold. I think my friends think that I am invisible. Of course, I am educating them. Because of my involvement with my hospital, I am going to request that we provide a blood test at our health fair for HCV every year. Also, provide information about it. As I have said before to my friends, "who knew that this was going on". I am not keeping it a secret at all.I think it is a responsibility now to educate.

Yes, and I will be proceeding as soon as my Doc returns.  She assured me that this is what we do next. Once again, this is the best forum and what a great group of people to have to help all of us new ones start the journey.  

[frijole]

maggie
you have a great attitude  and your desire to educate others is wonderful to see.  I wish you the best.  We all know the hard decisions that lay before you.

As for the age thing, I don't know what to say.  Do you have long genes or short genes ????  How long did your parents live?  And does that matter? What is your life expectancy?    You will give up 6 months or a year of your life if you treat, and you may or may not clear the virus.  Does that outweigh the risk of having more liver damage.  Only you can make the decision.  

frijole

[maggiepie471]

I have terrific genes behind me with a mom still alive at 96 yrs old. All of my fathers side made it to 90 yrs of age. Great grandmother made it to 90 on my mothers side. I thinkof that all the time and basically know if this blood transfusion had not have happened, I would live to be at least as long as my mom or longer.  I have always said she would mke 100 yrs old. There is really no history of cancer in my family. My dad's only time in a all hospital for a bypass and home in three days.  He was 79 yrs old.  By the way, all my relatives were always slender and thought about what they were eating meaning quite healthy. No alcohol was every around either. So that is why I am so upset and having a hard time adjusting to this insidious disease. But, yes I will do what I can to get the word out.  By the way there is a petition started at change.org to get the Feds involved with Gilead and get people aware of this.  

[orphanedhawk]

I don't want to scare you but I always thought I'd live to be an old lady as my family lives well into their 90s. I ate well, was active and  shocked beyond belief when, I was diagnosed with hep C and decompensated cirrhosis.
My point being, the only thing that is important is the condition of your liver.

Of course, life style fits into all of this and I like to think I've done as well as I have partially because of those things.

If your liver is not damaged, do indeed wait for the new orals or look into getting into a trial. Forget about what your viral load is or isn't. It's your liver that is important.

[Dee1956]

I just wanted to tell you how sorry I am.  I know how shocking it can be to be diagnosed with HCV, evidently I had it for 30 years before being diagnosed with cirrhosis.  I was in shock for several months.  You are doing the right thing in looking for more information.  Everyone above has given you excellent advice, some had to have liver transplants before treating.  The most important thing to do is find out how much liver damage you have.  I wish you the very best