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A person with red spots on their hands, feet, arms and legs crouches on the ground against a night sky.

Dealing with Cryoglobulinemia and Hepatitis C

Hepatitis C patients can sometimes experience joint and muscle pain, which can be a sign of a blood disorder called cryoglobulinemia.

Cryoglobulinemia: What’s That?

Cryoglobulinemia is a blood disorder where abnormal proteins in the blood clump together, causing the blood to become thicker in low temperatures. These protein clumps can interfere with normal blood circulation and damage the skin, joints, nerves, and organs, especially the liver and kidneys.

Cryoglobulinemia is considered a type of vasculitis (enlargement of the blood vessels).

Cryoglobulinemia is commonly associated with hepatitis C and its co-infections. Cryoglobulinemia is also associated with other conditions such as blood cancers like lymphoma, multiple myeloma, and connective tissue diseases like lupus.

Types of cryoglobulinemia

There are three types of cryoglobulinemia:

  • Type 1: Monoclonal
  • Type 2: Mixed
  • Type 3: Mixed, Polyclonal

Type 2 and 3 involve rheumatoid factor activity, which results in joint and muscle pain.

Type 2 and 3 are most commonly seen in patients with hepatitis C. Approximately 50% of patients with chronic hep C have mixed cryoglobulinemia; However, only 3% experience symptoms.

It is recommended for all hepatitis C patients to be tested for cryoglobulinemia (as well as patients who have kidney disease).


Symptoms of cryoglobulinemia may include:

  • Joint and muscle pain
  • Purple spots or blotchy areas on the legs
  • Tingly and numbness in the toes and fingers

Other possible symptoms:

  • Raynaud’s Phenomenon (color change in hands or feet from normal/white to purple/bluish color in cold temperatures)
  • Weight loss
  • High blood pressure
  • Swelling of ankles and legs
  • Enlarged liver or spleen
  • Skin ulcers and gangrene
  • Weakness in strength
  • Numbness and tingling
  • Kidney damage


There is a special blood test to detect cryoglobulins in the blood. Other blood tests need to be run to determine if other body functions or organs have been affected.


For patients with hepatitis C and cryoglobulinemia, treatment with direct-acting anti-viral medications for hepatitis C is typically the recommended course of treatment and usually prevents recurrence of cryoglobulinemia.

Symptoms normally resolve after treatment, as long as there is no permanent damage to the internal organs or nerves. After treatment, the long-term prognosis is typically excellent.

If other organs have been affected, your doctor may recommend other treatments or medications (such as corticosteroid) to help relieve symptoms. Before starting treatment for cryoglobulinemia, your doctor will consider all your medical conditions as well as the condition of your liver.

If you have hepatitis C – or have symptoms such as joint and muscle – talk to your physician about testing for cryoglobulinemia.

Have you experienced symptoms of joint and muscle pain with hepatitis C? Tell us below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Floridasheller
    1 month ago

    I am new to this group. Me and my identical twin brother had hepatitis C . For well over a decade , until we both used the new “cure” meds about 5 years ago now.
    We both had genotype 3 which required 6 month treatment .
    That was the begining of both of our nightmare health issues.
    It’s as if the chemo treatment caused a whole bunch of new issues. Or the virus itself caused these new issues. Or both the virus and treatment caused them.
    It has been 5 yrs and we both have major fatigue , joint and muscle pain , skin issues , etc.
    We both had cervical fusion surgery years before we even knew we had hepatitis C . And staying true to the twin thing , the same 3 disc’s were affected and we have thr same hardware too
    ( plate & screws ).
    Since the 6 month chemo treatment, we have the same issues now . Our rheumatoid factor was extremely elevated. We see the same rheumatologist , who diagnosed us with fibromyalgia , and
    “rheumatoid–like arthritis” , shorjens disease . I have peripheral neuropathy. And a very strange symptom where I get full body itchy stabbing prickly pin’s & needles when exposed to heat , feels more like I am being attacked by a swarm of angry bee’s. I cannot even drink or eat anything hot. This has been happening for years now . And the peripheral neuropathy is at the point where my fingers , hands, arms are numb , feels like I am wearing tight latex gloves.
    While the disc’s above and below my cervical fusion are all herniated and I have needed another fusion surgery. It is difficult to know if the neuropathy or numbness in my upper extremities is due to my cervical issues or from the chemo treatment , chemo induced .??
    And the fatigue is brutal , my rheumatologist has given me a stack of lab orders to get done. But it is difficult when you are unable to afford to get them done.

    Well , that is my story. There’s a lot more going on , other symptoms , etc. But essentially that’s it in short.
    Unfortunately here in America , if you don’t have the $$$. You are screwed .

  • MatthewFerry moderator
    1 month ago

    Hi Floridasheller, thank you for posting and sharing you and your brother’s story. What an incredibly difficult journey you’ve had–we’re here for you and your family. What has your doctor said about chemo therapy and the symptoms you’re describing? An advocate, Kimberly, has written about her experience with peripheral neuropathy. I wanted to link two for you here: one highlighting treatment options and one discussing relief she found through exercise. Given your herniated discs, we’d definitely recommend checking in with a doctor about low- or no-impact exercises if you haven’t already and if it’s of interest. The community is thinking of you and hoping that your health improves. Best, Matt  (, Team Member)

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