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Author Topic: Is gallon of water daily really the way to go?  (Read 10179 times)

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Offline elias

  • Member
  • Posts: 285
Is gallon of water daily really the way to go?
« on: December 13, 2016, 10:54:27 pm »
I keep reading here that its suggested to drink as much as a gallon of water daily while on these meds.

Is that to mitigate side effects?

Or is it actually to make the meds more effective?

I've read nothing like this apart from the Forum. What is this based on?

Personally, I havent found it helps me with sides. Some here say it does. So of course, that's a good idea in that case

But I also wonder how good an idea it is to dilute the level of the meds in the blood, and if hydrating to such a large degree might be diluting it some? This is  bit worrisome..

« Last Edit: December 14, 2016, 12:01:12 am by elias »
Contracted HCV ~age 12
Diagnosed: September 2016 GT2b
F3 by Fibrosure: 0.66
Necroinflammat activity: A3 0.76
================
VL Sep. 12, 2016: 1.44 million/ Log: 6.157
AST:71/ ALT:114   Sept. 1, 2016 Before treatment
==================
4 week after beginning  Epclusa:
Viral Load: UNDETECTED
AST 17/ALT 11
===============
Began Epclusa:  October 22, 2016
End of Treatment [EOT]: January 13. 2017
====================
EOT+4 Weeks: UNDETECTED
====================
SVR 12 April14-HCV Not Detected

Offline FutureThinker

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  • Posts: 711
  • Onward and upward!
Re: Is gallon of water daily really the way to go?
« Reply #1 on: December 14, 2016, 12:21:04 am »
Hi Elias, I completed my Harvoni treatment in May.  There isn't a certain volume for one to drink, i.e., 8 cups or a gallon / day, but you want your urine to be pale yellow.  You are right that drinking too much water can be detrimental, so it's difficult to say just how much one should drink. Go by the color.

Since you're taking Epclusa, perhaps this medication won't make you as thirsty as the Harvoni.  But I did find the increased water intake to help avoid headaches and constipation, and I was more thirsty than usual.

Take care, FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline Lynn K

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Re: Is gallon of water daily really the way to go?
« Reply #2 on: December 14, 2016, 03:01:18 am »
My doctors office advised just to be properly hydrated as it can help with the mild headaches some experienced.

Properly hydrated is as was said your urine should be pale yellow. This is what everyone should be doing. Any excess fluid is urinated out it does not dilute your blood.

That being said it is possibke to drink too much fluid there was an incident a couple of years ago involving a contest on a radio station the winner was the one who could drink the largest amount of water in the shortest time. One person died as a result of water intoxication.

http://articles.latimes.com/2007/jan/14/local/me-water14

So there is such a thing as way too much water.

This is the recommendation from the Mayo Clinic

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256

"How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

So how much fluid does the average, healthy adult living in a temperate climate need? The Institute of Medicine determined that an adequate intake (AI) for men is roughly about 13 cups (3 liters) of total beverages a day. The AI for women is about 9 cups (2.2 liters) of total beverages a day.

What about the advice to drink 8 glasses a day?

Everyone has heard the advice, "Drink eight 8-ounce glasses of water a day." That's about 1.9 liters, which isn't that different from the Institute of Medicine recommendations. Although the "8 by 8" rule isn't supported by hard evidence, it remains popular because it's easy to remember. Just keep in mind that the rule should be reframed as: "Drink eight 8-ounce glasses of fluid a day," because all fluids count toward the daily total."

Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline elias

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  • Posts: 285
Re: Is gallon of water daily really the way to go?
« Reply #3 on: December 14, 2016, 07:08:50 am »
Thank you Lynn and Future Thinker for detailed replies.

If all fluid intake including juices and soups are counted, I'm getting enough without adding much "pure water"

It does make me wake up often to go to the bathroom if I try to add a few  pints of water. For some odd reason I don't comprehend, other fluids don't  keep waking me as much. I have little in the way of headaches with Epclusa unless there's sleep loss.That's been a way out-of-control side effect of Epclusa for me. Trying to adhere to the 4 litres a day I've seen advised here does seem to make that worse. I'll try to use more juices and soups then

And my urine has been pale colored throughout this..regardless

Contracted HCV ~age 12
Diagnosed: September 2016 GT2b
F3 by Fibrosure: 0.66
Necroinflammat activity: A3 0.76
================
VL Sep. 12, 2016: 1.44 million/ Log: 6.157
AST:71/ ALT:114   Sept. 1, 2016 Before treatment
==================
4 week after beginning  Epclusa:
Viral Load: UNDETECTED
AST 17/ALT 11
===============
Began Epclusa:  October 22, 2016
End of Treatment [EOT]: January 13. 2017
====================
EOT+4 Weeks: UNDETECTED
====================
SVR 12 April14-HCV Not Detected

Offline Lynn K

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  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Is gallon of water daily really the way to go?
« Reply #4 on: December 14, 2016, 10:33:09 am »
And the article from the Mayo Clinic did say an adult male only needs 3 liters of fluid while a female only needs 2.2 liters. So you really don't need a gallon aka 4 liters you only need 3 liters
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Mw2324

  • Member
  • Posts: 138
Re: Is gallon of water daily really the way to go?
« Reply #5 on: December 14, 2016, 04:58:03 pm »
Elias,
  I am just curious in asking you, does the medication make you thirsty or do you consume water just because it's recommended? For me, I was so thirsty all the time I had no choice. I didn't drink because it was suggested, I had to. Just wondering. Thanks.
30 yr. old female
Infected in 2006
Genotype 2b
Pretreatment:
F0
Alt 28
Ast 30
Viral load 49,000
Started Epclusa on 9/9/16 -12 week treatment
4 week viral load undetected... ALT 19 AST 19
12 week eot viral load undetected...ALT16 AST 11

Offline elias

  • Member
  • Posts: 285
Re: Is gallon of water daily really the way to go?
« Reply #6 on: December 14, 2016, 05:11:11 pm »
Hi Mw:

No, the Epclusa doesn't make me thirsty at all.

  Some have said Harvoni had that effect. and I  know youve written that Epclusa does make u thirsty, so clearly increasing drinking is a good idea for you

What i needed clarification on here was if the recommendation I keep reading about to increase water is for side effects or to make the meds more effective. Seems from what I read here is that it has  little or nothing to do with medication effectiveness --positive or negative--and everything to do with side effects
Contracted HCV ~age 12
Diagnosed: September 2016 GT2b
F3 by Fibrosure: 0.66
Necroinflammat activity: A3 0.76
================
VL Sep. 12, 2016: 1.44 million/ Log: 6.157
AST:71/ ALT:114   Sept. 1, 2016 Before treatment
==================
4 week after beginning  Epclusa:
Viral Load: UNDETECTED
AST 17/ALT 11
===============
Began Epclusa:  October 22, 2016
End of Treatment [EOT]: January 13. 2017
====================
EOT+4 Weeks: UNDETECTED
====================
SVR 12 April14-HCV Not Detected

Offline Mw2324

  • Member
  • Posts: 138
Re: Is gallon of water daily really the way to go?
« Reply #7 on: December 14, 2016, 05:15:41 pm »
Thank you for answering, I guess this just goes to show how everyone is affected differently. I don't think the amount of water intake really changes the efficacy of the meds. Everything I've read is like you've mentioned, to keep side effects at bay. Whether that works or not, I can't say but I definitely never drank a gallon of water in one day. 4 to 5 bottles a day was my normal. Hope you are feeling well.
30 yr. old female
Infected in 2006
Genotype 2b
Pretreatment:
F0
Alt 28
Ast 30
Viral load 49,000
Started Epclusa on 9/9/16 -12 week treatment
4 week viral load undetected... ALT 19 AST 19
12 week eot viral load undetected...ALT16 AST 11

Offline elias

  • Member
  • Posts: 285
Re: Is gallon of water daily really the way to go?
« Reply #8 on: December 14, 2016, 05:23:49 pm »
It's common thing about side effects that some dont show up in the clinical trial but only later when the meds are "in the wild" people report new SE's. Somehow that's supposed to be reported so that future product descriptions should include those new ones

I'm a bit disappointed in Gilead's Onward program  which I'm subscribed to, that they don't ask about this. Seems would be a good venue for them to learn more from us about those
Contracted HCV ~age 12
Diagnosed: September 2016 GT2b
F3 by Fibrosure: 0.66
Necroinflammat activity: A3 0.76
================
VL Sep. 12, 2016: 1.44 million/ Log: 6.157
AST:71/ ALT:114   Sept. 1, 2016 Before treatment
==================
4 week after beginning  Epclusa:
Viral Load: UNDETECTED
AST 17/ALT 11
===============
Began Epclusa:  October 22, 2016
End of Treatment [EOT]: January 13. 2017
====================
EOT+4 Weeks: UNDETECTED
====================
SVR 12 April14-HCV Not Detected

Offline Mw2324

  • Member
  • Posts: 138
Re: Is gallon of water daily really the way to go?
« Reply #9 on: December 14, 2016, 05:28:40 pm »
I agree. I'm also subscribed. Not even my Dr asked about my side effects but I don't think he really cared either.
30 yr. old female
Infected in 2006
Genotype 2b
Pretreatment:
F0
Alt 28
Ast 30
Viral load 49,000
Started Epclusa on 9/9/16 -12 week treatment
4 week viral load undetected... ALT 19 AST 19
12 week eot viral load undetected...ALT16 AST 11

Offline andrew j

  • Member
  • Posts: 477
Re: Is gallon of water daily really the way to go?
« Reply #10 on: December 14, 2016, 09:01:09 pm »
I just drank however-much I felt like drinking.
That turned out to be quite a lot, because Harvoni has such a dehydrating effect (as FT said somewhere, recently).
I had got used to drinking quite a lot anyway, because I found it helped with managing the side-effects of Hep C.

I think our bodies are really good at self-regulating.





« Last Edit: December 14, 2016, 09:09:46 pm by andrew j »

Offline FutureThinker

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  • Posts: 711
  • Onward and upward!
Re: Is gallon of water daily really the way to go?
« Reply #11 on: December 15, 2016, 11:43:55 am »
Good morning, all -- I should have included in my post above that I had never been good about hydration, all my life.  I've never drank the "recommended" # cups of water, so when I knew I was finally going to get treatment w/ Harvoni and read the recommendations, that was my cue that I was going to need to step up on the water.  And, I felt the dehydrating effects very quickly, so between my poor history w/ adequate hydration and the medication, I increased my intake religiously to (3) 16.9 oz bottles/day, and have continued close to that even after treatment -- I feel better with it! So it turned out to be a good habit for me post treatment.  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline andrew j

  • Member
  • Posts: 477
Re: Is gallon of water daily really the way to go?
« Reply #12 on: December 15, 2016, 03:01:37 pm »
Yes.

Offline elias

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Re: Is gallon of water daily really the way to go?
« Reply #13 on: December 15, 2016, 03:17:52 pm »
Might be good habit to cultivate in terms of liver health in general, especially for those with significant fibrosis. Just speculating here.
Contracted HCV ~age 12
Diagnosed: September 2016 GT2b
F3 by Fibrosure: 0.66
Necroinflammat activity: A3 0.76
================
VL Sep. 12, 2016: 1.44 million/ Log: 6.157
AST:71/ ALT:114   Sept. 1, 2016 Before treatment
==================
4 week after beginning  Epclusa:
Viral Load: UNDETECTED
AST 17/ALT 11
===============
Began Epclusa:  October 22, 2016
End of Treatment [EOT]: January 13. 2017
====================
EOT+4 Weeks: UNDETECTED
====================
SVR 12 April14-HCV Not Detected

Offline andrew j

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  • Posts: 477
Re: Is gallon of water daily really the way to go?
« Reply #14 on: December 15, 2016, 04:18:47 pm »
I think it lowers toxicity.
That's a bit of a no-brainer, isn't it?!

I've found that drinking plenty of water really helps if I'm feeling wound-up or frazzled.
It can, quite literally, return me to sanity!

I generally don't eat breakfast; I sort-of drink water instead.
(But I drink plenty throughout the day, anyway).

Offline Gaj

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  • Posts: 172
  • Optimist
Re: Is gallon of water daily really the way to go?
« Reply #15 on: December 17, 2016, 08:34:30 pm »
Might be good habit to cultivate in terms of liver health in general, especially for those with significant fibrosis. Just speculating here.

Like FT I was never very good about hydration, I only drank when I was noticeably thirsty and water was that stuff fish swam in.  ;)

When I was diagnosed 5 years ago my specialist recommmended that to assist my liver I keep myself well hydrated at all times including the advice about urine being pale yellow. I followed his advice and regular glasses of water (or other suitable fluids) through the day have become a habit that I can feel helping my health now and no doubt into the future. I did find that increasing my water intake a bit more than usual during treatment helped compensate for the meds and any sides I felt.
Male - 61 years
Genotype 3a (since 1978?)
Diagnosed 2012
Treated 2013 PEG/Riba/Dac (Relapsed)
F4 - HCC#1 Resected 06/15 - #2 RFAblated 11/15
11/18/15 Commenced Generic Tx - Sof/Dac/Riba (24wks)
Pre Tx = ALT: 270  AST: 209  ALB: 31
05/05/16 = ALT: 34  AST: 32  ALB: 40  VL: Undetected (EOT)
06/16/16 = Relapsed
06/23/16 = ALT: 92  AST: 59  ALB: 40  VL: 290,770
01/12/17 3rd Tx - Zepatier + Sofosbuvir (16wks)
05/03/17 EOT und
06/22/17 SVR7 und
07/27/17 SVR12 UND!
10/26/17 SVR24 UND & Cured!!!

Offline KimInTheForest

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Re: Is gallon of water daily really the way to go?
« Reply #16 on: December 20, 2016, 04:42:27 pm »
I drank 1/2 gallon of water daily while on treatment (8 x 8-oz glasses). I drank that much water in addition to the milk, juice, tea I was drinking. My pee was pale yellow but did not turn clear on that amount of fluids. (If your pee is clear, you are drinking too much.)

I found treatment quite dehydrating, but then I had ribavirin along with the Harvoni, and I think ribavirin is especially dehydrating. I weigh 120 lbs. A bigger person may need more water. I agree with (and followed) the advice about drinking half your body weight in pounds... converted to ounces of water... So 1/2 x 120 lbs = 60 oz of water daily. I was drinking 64 oz.

I found that staying well hydrated on treatment made me feel a lot better.

kim :)
Kim Goldberg (Nanaimo, BC)
1970s: Contracted HCV (genotype 3a)
2015: Cured with Harvoni + ribavirin (12 weeks)
MY STORY: https://pigsquash.wordpress.com/2016/01/28/undetectable-my-hep-c-story/

Offline Lynn K

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  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Is gallon of water daily really the way to go?
« Reply #17 on: December 20, 2016, 05:55:35 pm »
 I read somewhere that as we age we are less aware of thirst and tend not to drink enough water so the drink if you are thirsty may not work that well for older adults
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

 


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