Lifestyle changes, nutrition, and supplements for hep b

Hi @leonk
Follow your doctors instructions. I’m not a doctor but I’ve had hepatitis B for 40 years.
If your results are good there’s no reason to see your doctor sooner, having tests every six months would be fine and the lifestyle that you are living is very healthy you’re doing all the things.
Well done

Hi @leonk,

As mentioned by @Caraline, this should be a question for your doctor, as the frequency of monitoring can depend on many aspects of your clinical history.

Hope this helps,

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I would just say exercising 20 hours a week is better than sitting around doing nothing for 20 hours a week.

Eat right, keep exercising, since you’re taking supplements, take quality.

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Hello everyone,

I hope you’re all doing well. I’m reaching out to this knowledgeable community with a specific question regarding medication interactions. I am currently taking Vemlidy for Hepatitis B management. Due to a rise in my cholesterol levels related to Vemlidy, I am considering starting a supplement – Jarrow Formulas Red Yeast Rice 1200 mg & Co-Q10 100 mg per serving.

However, before proceeding, I am concerned about a potential interaction between Vemlidy and the Red Yeast Rice supplement. My understanding is that both Vemlidy and components of Red Yeast Rice are metabolized via P-glycoprotein (P-gp). The warning label on Vemlidy indicates that drugs which strongly affect P-glycoprotein activity may alter the absorption of Vemlidy.

Given this, I am seeking insights or experiences from anyone who might have faced a similar situation or has knowledge about this. Specifically, I’m looking for information on whether there is a known contraindication or interaction between Vemlidy and Red Yeast Rice supplements.

I am planning to discuss this with my healthcare provider, but I thought it would be beneficial to hear from this community as well. Any shared experiences, information, or guidance on this matter would be greatly appreciated.

Some insights about my results: 33 years old, male, 70Kg, 178cm [I have tried diet but it does not help to reduce the numbers]

Hi @learnandshare,

Thanks for sharing this information.

You should probably be cautious about taking this supplement regardless of its cross reactions with
vemlidy (which may be more suitably answered by @PharmacyExperts on this forum). There have been cases of liver toxicity from Red Yeast Rice supplement:

Due to the uncontrolled nature of supplements, it may be more worthwhile considering statins with very highly controlled concentrations of active agent so that you can get the cholesterol lowering effects with lower risks of the hepatotoxic side-effects.


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Hi Thomas,

Thank you for the thoughtful response and for raising those concerns about potential liver toxicity with the Red Yeast Rice supplement. I appreciate you providing those specific references demonstrating cases of toxicity. That is definitely something WARNS that the risk is too high.

Going with a highly regulated statin may allow me to achieve the cholesterol lowering effect more safely as you said.

Thanks again,

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Hello learnand share,
My doctor is also suggesting to start using Velmidy. Could you pls let me know for how many months it years usage of Velmidy high cholesterol issue start coming up? Have you had any high cholesterol issues prior stating Velmidy?

Me personally - I didn’t have high cholesterol before taking vemlidy and don’t have it now on vemlidy. Been taking vemlidy for around 3.5 years.

I’m vegetarian/pescatarian for around 25 years, BMI well in norm, doing moderate amount of exercise.

Hello, I have taken Vemlidy from 2019. The cholesterol I have started to see it rising after 2 years of treatment.

Can you please detail a bit your lifestyle?

Hi kindly help to understand this kind of test. I even doubt if we have it here in uganda

I’ve taken Vemlidy/tenofovir for many years and have not seen increases in my cholesterol levels. I am a meat eater and don’t really limit what I eat. I’m moderately active, with regards to exercise.



Hello @learnandshare

I’ve been on statins for years. tried to control my cholesterol by changing my diet and exercising more. Unfortunately it did not work. And I went on the statins.

I hope that encourages you.

@Caraline Hello, Thank you for your insights. Can you please let me know what statins are you using? What is the active substance? I’m curious because most of the statins are labeled with harsh side effects.

There’s a few different ones around I personally haven’t suffered any side-effects that affect me. What side-effects would you be referring to, the ones that are listed on the health sheet they give you when you get your prescription?
If they are the ones, then they highly exaggerate., List every possible side effects that you could have, not necessarily get. Pharmacist need to be cautious possibly overcautious so just because side-effects are listed does not mean that you will get them.
Hoping that is helpful.

Hello, I was also curios if is one this active substances:

  1. Atorvastatin
  2. Simvastatin
  3. Rosuvastatin
  4. Pravastatin
  5. Lovastatin
  6. Fluvastatin
  7. Pitavastatin

No 3 is the active ingredient of the one that I’m taking.
But you really should talk to your doctor. There’s also I think, if my memory is working, there’s a non-statin one …I switch between statin and non-statin. There are many around that can lower your cholesterol.
I am not a medical expert, just lived experience, willing to share.

Thank you, @Caraline, for sharing your experience with both statin and non-statin cholesterol medications. Your insights are appreciated, and I’ll definitely discuss these options with my doctor

Hello everyone! I have a general question about lifestyle changes.

I am an HBV carrier for 10 years now. I am not on any medication. In my last exam my viral load was 130IU/mL (was 3000 in the test before the last one) and my Alt was slightly above level (59, with 46 being the limit).

I know that we should not drink alcohol. My doctor told me (and think I’ve read the same here too) that a beer/week which is fine.

My question is about cigarettes. I am not a smoker in the strict sense. But I smoke around 3-4 cigarettes per week. Is that too much?Are cigarretes big no-no? Or is it fine given the small number?


Hi @Drew_rous ,

Technically, you are not an HBV carrier. These individuals have HBV DNA < 2000 IU/mL and normal ALT (we also call this partial cure). In your case, you have very mildly active HBV infection (although your HBV DNA appears to be declining - this can wobble overtime).

A beer a week is no problem. It would be even better if you took at 15 min walk outside each week for each beer you drink :wink:.

Smoking is a different issue: although your cigarette use is low, persistent smoking can reduce immune function, even at the minimal exposure you have. Although your HBV DNA is quite low, your ALT is very mildly elevated. If you really only have one beer / alcoholic drink each week, than this elevated ALT not from alcohol consumption but is a sign that there is some small amount of liver inflammation present. It could be from fat in the liver or from your HBV infection. I recommend to stop the cigarette use (if you can). Your chance of reactivating your HBV infection is low but still present and doing anything to inhibit your immune function should be avoided.