If your current treatment plan isn’t working, find one that will

There are many treatments available to those who suffer from hepatitis, but some are more effective while some have more side effects than others.

The standard therapies include interferon (which boosts the immune system) and ribavirin (an antiviral drug). Adding ribavirin to interferon increases the chances of suppressing the hepatitis. The new, longer lasting pegylated interferons have a greater effect, while thymosin and glucocorticoids (steroids) have no benefit. 

The standard therapies come with a promise of benefit for up to 60 percent of patients, but they also have significant side effects.  Depression, autoimmune reactions, blood changes and infectious disorders may prevent up to 25 percent of patients from continuing therapy. 

More importantly, patients may not be good candidates for interferon therapy. In a German study of hepatitis C patients, 73 percent of patients did not meet the criteria for treatment. The reality of multiple medical diagnoses makes it necessary to find alternatives for these patients. 

For many patients there are no standard medical options, and patients are left to wait for the next medical breakthrough or to look for alternatives on their own. Most doctors are able to provide little guidance beyond the standard treatments.

3 simple rules

Once beyond the confines of the hospital, a patient is likely to be bombarded by supplements and plans that claim everything under the sun. Consumers, therefore, should follow three basic rules when considering alternative treatments. The first rule is that if an individual is receiving money from selling something, he or she is unlikely to be a good source of objective information. The second rule is that if something is supposed to cure everything, it doesn’t. The third rule is that natural does not mean harmless, and if side effects occur, a person should discontinue use immediately. 

Too often alternative medicine is surrounded by magical thinking, where normal body processes are ignored. Simply because something was prayed over or came from a shamanic recipe, patients will continue to take it long after it has proven to be ineffective and/or is causing significant side effects. 

A physician needs to be informed of any experimentation. Patients who are embarrassed to tell their doctors about experimentation need to realize that their reluctance may be life threatening. The safest choices are either to stop experimenting or to find a doctor with whom they feel comfortable speaking freely.

Doctors familiar with and open to alternative therapies are far more available now than they were even 10 years ago. The American Association of Naturopathic Physicians and the American Holistic Medical Association are two sources of licensed doctors.

Got milk thistle?

Any alternative treatment for hepatitis should include milk thistle (Silymarin marianum). Long-term studies of alcohol cirrhosis found that taking 420mg of milk thistle daily decreased death rates by 7 percent. Milk thistle halves the death rate from acute mushroom poisoning and prevents lead poisoning destruction of the liver.  Animal studies show that milk thistle prevents destruction and preserves liver function. Milk thistle has no antiviral effect and has a side effect picture equivalent to placebo. It is nontoxic and can prevent death at a cost far lower than standard drug regimens. 

While milk thistle blocks fibrotic damage, bile salts (UDCA) cut the elevation of liver enzymes in half. In combination therapy with interferon, UDCA halved the relapse rate of those responding. The bile salts provide raw materials to the liver, lowering inflammatory buildup. The addition of licorice to bile salts also significantly lowered GGT inflammatory levels, but licorice can have significant side effects. 

In 22 randomized trials, the plants from the phyllanthus plant family were found to be equivalent to interferon in removal of hepatitis B markers in the blood, although no large trials of the plants have been done. 

A huge number of other plants have been shown effective against the hepatitis viruses. In Sudanese medicinal plants, 34 of 71 plants had antiviral effects against hepatitis C. Of these, eight had a greater than 90 percent inhibition. No human or animal trials have been done, despite the fact that in the , standard treatment is unavailable. 

A variety of Chinese formulations also are effective in lowering hepatitis C markers, and both rosemary and tomatoes have been shown to be protective of the liver. Gingko biloba has antioxidant properties and was liver protective in a short-term trial. It is also a vasodilator that may affect bleeding, so it should be used under supervision.

Diet’s important

Within the diet, specific changes should be instituted immediately.  Several studies have shown that low-iron-intake diets have been effective in lowering inflammatory markers for patients with hepatitis.  Patients in had significant inflammatory drops without anemia. In , inflammation was halved when iron intake was halved. None of these patients had been diagnosed with hemochromatosis (massive liver iron overload).

Looking at the liver function provides a context for the results of medical studies. The destruction of the liver from hepatitis results from chronic, long-term inflammation. Standard medical treatment increases the immune response with interferon while providing support (with ribavirin). If successful, the virus is destroyed. If unsuccessful, standard treatment tries the same thing, expecting different results.  Liver function is not optimized beyond restricting alcohol. 

Complementary medicine increases day-to-day liver functioning. Milk thistle provides antioxidant support while blocking toxin uptake by liver cells. Bile salts speed the processing of the liver and decrease its need to create bile salts. Rosemary and a host of other herbs provide antiviral support. But adding supplements without removing other impacts on the liver is like putting fingers in a dike. 

Maximizing liver function involves the idea of a liver load. At a given time, the liver can process only so much material. Within standard medicine we see the overload of the liver as drug side effects and the occasional drug or alcohol overdose. But like an overworked office worker, the liver experiences various levels of load long before it quits. Daily living places a tremendous strain on the liver, which processes everything we eat. It must take care of last weekend’s buffet in addition to the constant sleep deprivation and stress hormones. Add a chronic virus and the necessity for rest and repair in a frantic world, and you have a recipe for fibrosis. A constant routine, eating a very healthy diet and minimizing unnecessary drug and supplement intake (including vitamin megadoses) will go a long way in preserving liver function. 

One of the effects of decreased liver function is called hepatic encephalopathy. The backup of unprocessed body toxins, including ammonia, affects brain function. Increasing bowel clearance (which removes processed toxins excreted by the liver and gall bladder from the body) has been shown to be effective in decreasing symptoms. Another therapy is decreased protein intake, done under a doctor’s supervision. The use of probiotics (good intestinal bacteria) may also be helpful in minimizing liver load. 

Prior to experiencing brain symptoms, it would be wise to treat the body like it has a chronic viral infection. Patients are familiar with viral infections in the shape of colds or flus, and may forget that the viral response of the body to a liver virus is similar. Rather than waiting for interferon to boost the immune system, simple treatments (hot packs over the liver, avoidance of sweets, plenty of fluids, etc.) will certainly not harm and will help prevent other illness. While there are no studies on garlic and hepatitis, garlic is twice as effective as drug antivirals against the flu and also acts as a broad-spectrum antibiotic.  Patients taking garlic capsules had half as many flus and the flu symptoms lasted half as long. In treating viral load, one should look at the body as a whole, rather than fixating on the liver load alone. 

Money matters

Chronic disease is a great drain on financial resources. Individuals too ill to work may be unable to support themselves, adding that tremendous stress to the viral illness. After exhausting standard treatments, an individual might partner with a doctor to treat themselves for a chronic viral illness. A possible treatment plan requiring no extra money would include eating brown grains, very good quality oils, nuts and seeds, and a rainbow of fruits and vegetables. A patient could learn to do lymphatic drainage massage and stretching exercises, including tai chi or yoga. Liver processing could be maximized by regular small meals, more bitter tasting food (which stimulates bile excretion) and by gentle massage of the liver and abdomen or hot and cold packs over the area. Strong smelling household spices, including rosemary, would be used freely. 

An individual without a lot of money would be wise to research any supplement prior to purchase. Products with independent laboratory testing are available to all naturopathic physicians. Any product purchased should be put through an individual objective trial for symptom resolution and lowering of liver inflammatory levels. Three months would be the maximum trial, with improvement often seen within days. Milk thistle and bile salts would be high on my list of possible choices, which also would include the phyllanthus plant family from reputable Eastern importers. The bottom line: If your current treatment plan is not working for you, find one that will.