Liver disease is serious and requires treatment and regular monitoring by a liver specialist. A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner. Over nearly 40 years of practicing medicine I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.
I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.
If you have any questions you may contact my naturopaths on 623 3343232 or email us at firstname.lastname@example.org
How can you catch the Hepatitis C virus?
Hepatitis C is transmitted mainly by blood. This occurs through the sharing of equipment to inject drugs, needle stick injuries in health care workers, and unsafe techniques of body piercing and tattooing. Cocaine snorting is recognized increasingly as a potential mode of transmission through the sharing of contaminated straws.
Only a tiny quantity of virus is necessary for the virus to become established in the case of hepatitis C, and transmission usually occurs when the skin becomes contaminated by injecting paraphernalia, such as spoons, mixing tools, tourniquets, cotton buds or by hands. Razor blades and toothbrushes can become contaminated with blood, so it is important not to share these things. Always wear gloves when wiping up blood spills, using paper towels and good quality bleach. While bleach is an effective surface antiseptic, there is no absolute evidence that it can kill the HCV. In about 10 to 15 percent of cases no definite risk factor is detected and the mode of transmission remains unclear.
The incidence of sexual transmission from a patient with chronic hepatitis C infection seems to be quite low, in comparison with hepatitis B and HIV (AIDS). However, those with an acute hepatitis C infection are possibly more likely to spread the virus sexually. It is important to practice safe sexual techniques to avoid blood to blood contact. The risk of sexual transmission is estimated to be around 4%
Transmission of the disease from mother to baby also occurs but much less frequently than with hepatitis B. This occurs in only around 6% of such cases. Infection of the baby through breast-feeding from an infected mother is very uncommon, however great care should be taken to avoid nipple trauma.
Nowadays the risk of catching hepatitis C from a blood transfusion is extremely low, because blood banks now screen all donated blood. As with hepatitis B it is possible to be a symptom-free carrier of the virus. Hepatitis B sufferers in the acute stage of infection and all hepatitis C patients should consider themselves infectious.
HCV is NOT spread by:
- food or water
- sharing eating utensils or drinking glasses
- casual contact
- shaking hands
The following precautions must be taken by Hepatitis C patients:
- Do not donate blood or organs
- Do not share needles, toothbrushes, razors or other intimate articles
- Blood spills should be wiped up with bleach and all cuts and wounds covered with adhesive dressings.
- Blood stained tissues, sanitary napkins and so on must be disposed of safely.
- “Safer sex” should be practised, with the use of condoms recommended, especially for anal intercourse. However, in the case of hepatitis C, the need for condom use in heterosexual intercourse with a stable partner is not entirely clear. The risk of oral sex is also not fully known, though oral-anal contact should be avoided. Intercourse during menstruation should also be avoided.
Do you need a test for Hepatitis C?
If you received a blood transfusion or blood products before routine screening of donor blood was introduced (before February 1990), or if you have ever shared equipment (needles, spoons, swabs, tourniquets, etc) for injecting any drugs, it is important that you ask your doctor for a blood test to check for hepatitis C. If you have been tattooed, had body piercing or needle-stick injuries, you should also consider being tested for hepatitis C.
Testing and diagnosis
1. Antibody detection
The initial screening test for Hepatitis C, tests for the antibodies to the virus, so it does not look directly for the virus itself. Sometimes the antibody test comes back indeterminate and then a repeat test is required. Antibodies are produced in the body after exposure to the virus. Therefore this test indicates if the body has been exposed to the virus and has produced antibodies to fight it. It does not determine whether or not someone still has the virus or how long he or she has been infected. It takes up to 6 months for antibodies to HCV to form in the blood (this is called sero-conversion) It is therefore important to get retested 6 months after initial antibody test.
The main tests used are:
- ELISA III (Enzyme Linked Immuno-sorbent Assay)
- RIBA (Recombinent Immunoblot Assay) This test is more expensive than ELISA and is generally used as a confirmatory test.
2. Virus Detection and analysis
The PCR (Polymerase Chain Reaction) is a test that looks for the virus in the blood. The PCR test amplifies the virus genetic material to a level that can be detected so it is useful when the antibody tests are unclear. The PCR test is the viral load. It is often required to have these tests done to confirm a diagnosis.
Initial Effects of Infection with the Hepatitis C Virus
People are generally completely unaware that they have contracted this virus because it does not produce any symptoms in the early or acute stages of the infection. During the first 3 to 6 months after infection, the virus replicates itself rapidly and the immune system tries to fight it by producing antibodies against it.
Unfortunately in around 80 percent of infected people, the virus is not eliminated and becomes a long-term inhabitant of the body. In other words, the infection becomes chronic. In a significant percentage of people with chronic infection, there are no signs or symptoms of disease and many are unaware that they are carrying an infection that can be transmitted to others through contact with their blood.
Long Term Effects of Infection with the Hepatitis C Virus
The amount of long term liver damage caused by the hepatitis C virus varies from person to person, and those with a strong immune system and a healthy diet and lifestyle will have a much better outcome.
In those who become infected with this virus we find the following approximate outcomes:
- Around 20 percent of people will completely eliminate the virus from their bodies within 3 to 6 months (much like we overcome the flu virus).
- Around 60 percent of people will develop a long-term (chronic) infection that may not cause any problems or may go on to varying degrees of liver damage.
- Around 20 percent of people will suffer serious liver damage, although this takes around 20 to 30 years to develop. In this group, 10 to 15 percent will remain stable and be able to survive with their disease, while 10 percent will go on to develop liver failure and/or liver cancer. Chronic infection may also cause severe loss of liver cells and extensive scarring of the liver which is called cirrhosis.
The death rate from chronic hepatitis C infection is around 5 to 10% and is due to end stage cirrhosis and liver failure or the development of liver cancer.
Why do we need nutritional medicine to fight HCV?
- The HCV can hide in various parts of the body, such as the liver, even when you cannot detect the virus in the blood stream; thus a blood test will show the viral load is zero, which may give you a sense of a false cure. If the HCV reappears in the blood stream after “anti-viral drug cure” then nutritional medicine is essential for a good outcome. According to two recent Spanish studies the HCV can remain in the liver even when a patient has an undetectable viral level in their blood stream. In one of these studies reported in The Journal of Infectious Diseases July 2006, liver biopsies and blood specimens were taken from 12 patients who had HCV antibodies but had been negative for the HCV RNA (viral load) for 12 months. Despite their negative blood tests the HCV was found to be present in the liver in 10 of these patients. The other study reported in Clinical Infectious Diseases in November 2006, looked at 20 patients who tested negative for the HCV in their blood after interferon/ribavirin treatment. In 19 of these 20 patients, the HCV was still present in the liver tissue, as determined from a liver biopsy in these 20 patients. Thus you can see that even in the vast majority of successfully drug treated patients the HCV survives and waits for another time to attack you, especially when you let your immune system become weak and run down.
- The HCV can become resistant to the anti-viral drugs which then become useless.
- Research into vaccines against the HCV (mainly synthetic prophylactic and therapeutic vaccines) is still in its early stages and more funding is needed. According to the experts an effective vaccine against the HCV is 10 years away.
- Fatigue is a common symptom of infection with the HCV. The liver provides the body with energy and if it is damaged, the liver cannot store glucose or make proteins – thus the muscles become weak. Treatment with anti-viral drugs causes worsening of the fatigue, depression and insomnia. This is where nutritional medicine can really make a huge difference.
- Thyroid problems often co-exist with HCV infection and nutritional medicine can support thyroid function.
- HCV infection is a chronic disease that must be managed for life, otherwise it can lead to cirrhosis, liver failure and liver cancer. There is a shortage of liver donors for liver transplants.
- Excess weight often results in fatty liver which greatly reduces liver function and health. Fatty liver can co-exist with HCV infection and will worsen the liver damage caused by the HCV.
To overcome all of these problems, drugs can only play a limited role. To treat the underlying causes we need to turn to the power of nutritional medicine. Over the past two decades there have been enormous advances in information in the scientific and medical literature linking incorrect nutrition to disease states. Research gives great insight into the nutritional factors in illness. Dietary changes and the appropriate use of nutrients, juices and herbs will reduce the risk of chronic liver disease.
In many cases it is impossible to eradicate the hepatitis C virus from the body and patients find it difficult to tolerate drug side effects. It is therefore not surprising that sufferers are turning towards nutritional and herbal therapies to fight the virus. Natural therapies will not usually be able to eradicate the virus from the body; however they will definitely help to prevent the virus from damaging the liver. This approach is very successful and can keep the virus in a dormant or harmless state so that it does not damage liver cells.
Although nutritional medicine cannot ‘cure’ HCV infection, by using Liver Doctor’s program for Hepatitis C, many people have experienced a great improvement in the function of their liver and have reduced the risk of associated conditions such as cancer, cirrhosis and liver failure. This program needs to be adhered to basically as a way of life.
While we cannot guarantee to completely eradicate the virus by nutritional medicine alone, the following approximate results have been seen in Dr Cabot’s patients:
- 70% have improved liver function
- 25% have normalized function
- 40% have significantly reduced viral load
Excellent results have been achieved by using nutritional programs in many patients with chronic viral infections of the liver. This can also reduce damage caused by any long-term systemic viral infection, including the AIDS virus. The most important strategy is to begin such a program as early as possible and to stay on it long-term.
It is possible to restore normal liver function in many chronic viral hepatitis sufferers provided they also stick to a drug free life-style. Nutritional medicine may prevent the virus from damaging the liver and can induce repair and regeneration in the liver. The good news is that of all the organs in the body the liver is most able to repair and regenerate itself. At the very least a significant improvement in liver function and well being will always be achieved, provided you do not wait until end-stage liver disease has set in. Download Dr Sandra Cabot’s Free e-Book titled “Hepatitis – How to treat it naturally”
Nutritional medicine for Hepatitis C
It is not surprising that sufferers are turning towards nutritional and herbal therapies to fight the virus. Natural therapies will not usually be able to eradicate the virus from the body; however they will help to prevent the virus from damaging the liver. This approach is very successful and can keep the virus in a dormant or harmless state so that it does not damage liver cells.
In summary a basic protocol to support liver function in those with HCV includes –
An increased intake of antioxidants, which will reduce damage to liver cells caused by the viruses.
The most important antioxidants include –
- Vitamin C in a dose of 1000 mg twice daily
- Selenium in the form of selenomethionine in a dose of 150 – 300 mcg daily
- Natural vitamin E in a dose of 500 to 1000 IU daily
Vitamin E is able to reduce the ability of the stellate cells to manufacture collagen and so reduces scar tissue production. Vitamin E can also soften existing scar tissue and therefore improve blood flow to the liver, which is essential for regeneration of the liver cells. Vitamin E assists in the maintenance of high levels of glutathione, which is the most powerful liver antioxidant to prevent cirrhosis. A clinical study of hepatitis C sufferers not responding to interferon therapy, showed that nearly 50% improved dramatically with 800 IU daily of vitamin E. These are the reasons why a high dose of vitamin E is required. Use only natural vitamin E which is known as d-alpha tocopherol.
It is vital to obtain plenty of beta-carotene and its related carotenoids from eating a wide variety of brightly colored fruits and vegetables. Beta-carotene is converted in the body to vitamin A. Beta-carotene, other carotenoids and vitamin A, have a powerful anti-cancer effect in those with liver damage. This will reduce the risk of cirrhotic livers developing cancer. Those with liver disease need to be careful not to take excessive amounts of vitamin A and should not take more than 10,000 IU daily.
Selenium has been shown in clinical studies to reduce the incidence of liver cancer and should be taken daily by those with chronic hepatitis C and B.
An observation study of the liver cancer preventive effect of selenium supplementation was done in China. The 8-year follow-up data showed reduced primary liver cancer incidence of 35.1% in selenized table salt supplemented people versus the non-supplemented population. On withdrawal of selenium from the treated group, primary liver cancer incidence rates began to increase. However, the inhibitory response to the HBV was sustained during the 3-year cessation of treatment.
It takes quite a few months for the selenium to build up to protective levels in the important areas of your body, such as the liver and the immune system and thus a long term commitment to taking these supplements is needed.
Reference: Selenium as a chemo preventative agent in human primary hepatocellular carcinoma Yu SY, Zhu YJ, Li WG. Cancer Institute, Chinese Academy of Medical Sciences, Beijing 100021 and Qidong Liver Cancer Institute, Jiangsu, PR China.
For more information see the website www.seleniumresearch.com
Take a liver tonic that contains the essential nutrients to support the liver’s ability to detoxify and repair damaged liver cells. For hepatitis, I would recommend a daily liver tonic that contains milk thistle, B vitamins, sulfur containing amino acids and selenium.
Supplements of N – Acetyl Cysteine (NAC) are very beneficial and can be taken in a dose of 600mg three times daily. NAC enables damaged liver cells to make more glutathione which reduces ongoing liver damage.
General Measures in those with hepatitis C
Minimize the use of all medications, especially liver toxins such as alcohol, analgesic drugs (especially acetaminophen, paracetamol and narcotics) and anti- inflammatory drugs. Avoid using household and workplace chemicals such as insecticides, pesticides, chlorine, bleach, paints, glues and solvents.
Fifty percent of your diet should consist of raw and cooked vegetables and fruits. Dressings can be made with organic vinegars (balsamic, apple cider vinegar etc) and cold pressed olive oil. Drink one or two glasses of raw vegetable juices daily. Eat cruciferous vegetables including broccoli, cauliflower, Brussels sprouts, kale, cabbage, bok choy and watercress as well as garlic and onions to help the detoxification ability of the liver.
Ask your doctor to check that your body’s total iron content is within normal limits. This can be confirmed with a simple blood test known as serum iron studies. Excess iron can increase liver damage and hepatitis viruses thrive in high-iron environments.
If your iron levels are abnormally high, avoid iron-enriched cereals, vitamin pills containing iron and liver.
Weight Loss and Hepatitis C
Weight loss in overweight people with chronic HCV infection will improve liver function. This was found by researchers in Queensland Australia who followed a group of people with chronic Hepatitis C and fatty liver. These patients were put on a 3 month weight reduction program and it was found that the weight loss led to a reduction in fatty liver, improved liver enzymes and improvement in fibrosis despite persistence of the virus. Reference: GUT 2002; 51:89-94
Excerpt from The Liver Cleansing Diet by Dr Cabot
“The Liver Cleansing Diet will help to repair liver damage in those who drink too much alcohol or those who have taken recreational drugs, especially intravenously. Those who test positive for Hepatitis B and/or Hepatitis C and are chronic carriers of these viruses will have less chance of developing chronic liver disease if they follow the Liver- Cleansing Diet.
Supplements to support liver function
Choose a powerful liver tonic, one which contains enough Milk Thistle to provide 420mg of pure Silymarin per day. Ideally, this liver tonic should also contain the additional supporting nutrients- sulfur bearing amino acids, the antioxidant vitamins E and C, the minerals zinc and selenium and all the B group vitamins.
Extra selenium may be needed. The maximum total daily dose of selenium is 400mcg. A dose of 200mcg of selenium is ideal and very safe. See www.seleniumresearch.com
Vitamin E assists in protecting liver cell membranes from free radical damage. Natural vitamin E (d-alpha-tocopherol) is superior to synthetic vitamin E (dl-alpha-tocopherol). Livatone Plus contains natural vitamin E
Raw juices are an incredible powerful healing tool for the liver and strengthen the immune system. Raw juicing can improve the function of the liver, bowels and kidneys.
Time saving and sanity saving juicing tip
Some folks would love to juice but they hate cleaning the juicer – I can understand that! It is also time consuming. Well you can juice 4 to 6 pints of juice at one time and freeze it in daily-serving-sized containers. Freeze immediately after making the juice and drink it straight after it thaws out. If you do this, it will retain all its goodness and power.
Dr Cabot’s excellent book contains carefully designed juices to help with common health problems. Appropriate juice recipes found in Dr Cabot’s Raw Juices Can Save Your Life book.
Drug Treatment for Hepatitis C
Previously the mainstay of treatment was a combination of the drugs Interferon and Ribavirin and this is still the treatment for HCV genotypes 2 and 3.
The aim of this treatment is to eradicate the hepatitis C virus and prevent liver damage and liver cancer. Treatment with Interferon alone eliminates the virus in only 20% of patients. Another 30% respond but subsequently relapse. Genotype 2 and 3 patients achieve better results with Interferon/Ribavirin combination therapy and cure rates approximate 80%. For patients with genotype 1 HCV, treatment with Interferon and Ribavirin does not have high success rates. Two new drugs called telaprevir (marketed under the brand names Incivek and Incivo) and boceprevir (brand name Victrelis) have been made available at liver clinics for patients with HCV genotype 1. These drugs are known as protease inhibitors and they work by inhibiting the ability of viruses to replicate.
These drugs must be used with Interferon and Ribavirin to prevent the virus becoming resistant to the drugs. If this triple therapy is used in cases of genotype 1 HCV, the success rates of cure approximate 70%. Protease inhibitors have the potential to interact negatively with a large number of prescription medications, therefore they are not suitable for every patient. Another disadvantage of these drugs is they need to be taken for between six and 12 months, usually several times per day.
In many cases it is impossible to eradicate the hepatitis C virus from the body and patients find it difficult to tolerate the severe drug side effects. Patients with cirrhosis have a greater risk of severe drug side effects. Treatment with these anti-viral drugs cannot be used in patients with autoimmune diseases or depression.
New drug therapies for hepatitis C
In 2013 and 2014, a new class of antiviral medications were approved in the United States. These drugs have dramatically improved success rates of viral clearance, with much shorter treatment regimes, spanning from between six weeks and three months. Most of these drugs are taken just once daily and so far seem to be well tolerated, with few side effects.
These new drugs include:
simeprevir (brand names Olysio and Sovriad)
sofosbuvir (brand names Sovaldi, Hepcinat, Resof, Hepcvir and SoviHep)
ledipasvir/sofosbuvir (brand name Harvoni)
ombitasvir, paritaprevir and ritonavir (A combination of three drugs, sold under the brand name Viekira Pak)
Unfortunately these new drugs are extremely expensive, and they are not available to every patient. At this stage they are only available to patients with the HCV genotype 1 who have not responded to conventional interferon/ribavirin treatment, or patients in whom the traditional therapy is contraindicated.
In patients using these new drugs, at least 90 percent are able to eradicate the hepatitis C virus from their body.
These statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any diseases.