| | | | Other Names | | | Viral Hepatitis, Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis
D, Hepatitis E, Hepatitis F, Hepatitis G, Alcoholic Hepatitis, Drug
Induced Hepatitis, Drug-Induced Hepatitis.
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| | | Also known as: Inflammation (Liver).
Hepatitis is a liver disease
that can result from long-term alcohol abuse, infection, or exposure to
various chemicals and drugs. Because hepatitis is potentially very
dangerous, a healthcare professional should be involved in its
treatment.
What are the symptoms of hepatitis? Acute viral
hepatitis varies from a minor flu-like illness to an overwhelming
infection resulting in liver failure and death. The early phase is
characterized by loss of appetite, malaise, nausea and vomiting,
and fever. Signs include a darkening of the urine and jaundice
(yellowing of the skin and whites of the eyes). Chronic hepatitis
may be asymptomatic, or may manifest as malaise, fatigue, loss of
appetite and a low-grade fever.
Conventional treatment options:
Acute hepatitis generally resolves without treatment. Treatment of chronic
hepatitis includes cessation of causative drugs (e.g., alcohol).
Autoimmune hepatitis is usually treated with corticosteroids. Therapy for
chronic hepatitis B and C is evolving and may include interferon, and
antiviral and immune-modulating drugs. In the late stages of certain types
of hepatitis (not hepatitis B, generally), liver transplantation may be
required to preserve life.
Lifestyle changes that may be helpful:
Avoiding alcohol is the most obvious way to avoid the liver damage it
causes.
A variety of prescription drugs can, on rare occasions,
cause hepatitis, as can large amounts of niacin or niacinamide (forms of
vitamin B3). Excessive intake of acetaminophen or other painkillers can
damage the liver, so excessive intake of these drugs should be avoided.
People with hepatitis C who failed to respond to interferon therapy have
been found to have a higher amount of iron within the liver.1 People with
hepatitis C should, therefore, avoid iron supplements. People with any
type of hepatitis should ask their physician whether any medication they
are taking poses a risk to the liver.
For infectious (viral)
hepatitis, good hygiene is necessary to avoid spreading the infection. The
hepatitis A virus can be spread very easily through food that is handled
by infected individuals; therefore, people with hepatitis A should wash
their hands very carefully after using the restroom and should not handle
food at work. The hepatitis viruses B and C are both transmitted by blood
and sexual contact.
Nutritional supplements that may be helpful:
Catechin, a flavonoid, has helped people with acute viral hepatitis,2 as
well as individuals with chronic hepatitis,3 though not all trials have
found a benefit.4 A typical amount used in successful trials is 500-750 mg
three times per day. Although catechin is found in several plants, none
contain sufficient amounts to reach the level used in the trials; thus,
catechin supplements are needed. However, because of its potential to
cause side effects on rare occasions,5 catechin should be used only under
medical supervision.
Proteins from the thymus gland, an important
part of the immune system, may have a beneficial effect in people with
chronic hepatitis B. Initial trials done in Poland used injected thymus
proteins with good results.6 Further trials using a variety of thymus
extracts by mouth have found that they can improve blood tests that
measure liver damage as well as improve immune cell numbers.7 8
Preliminary evidence also suggests these extracts may help patients with
hepatitis C.9 The standard recommendation for supplementation is 200 mg
three times per day of crude extracts or 40 mg three times per day of
purified proteins.
S-adenosylmethionine (SAMe) (1,600 mg/day orally
or 800 mg/day intravenously) has been shown to aid in the resolution of
blocked bile flow (cholestasis), a common complication of chronic
hepatitis.10 11
Taking 3 grams per day of phosphatidylcholine
(found in lecithin) was found to be beneficial in one investigation of
people with chronic hepatitis B.12 Signs of liver damage on biopsy were
significantly reduced in this trial.
Vitamin E levels have been
shown to be low in people with hepatitis,13 as well as in those who later
develop liver cancer from long-standing hepatitis.14 Vitamin E levels in
the liver may also be decreased in some people with hepatitis.15 In a
controlled trial of individuals with hepatitis B, 600 IU of vitamin E per
day for nine months resulted in all signs of hepatitis disappearing in
five of twelve people.16 In a preliminary trial of adults with hepatitis
C, administering 1,200 IU per day of vitamin E for eight weeks appeared to
reduce liver damage to some extent.17 In a preliminary trial of people
with hepatitis C, 544 IU of vitamin E per day for 24 weeks improved the
response to interferon/antioxidant therapy, although the results did not
reach statistical significance.18 However, in children with viral
hepatitis, daily injections of vitamin E (300 IU) for seven days did not
produce any benefit.19
Vitamin C in the amount of 2 grams per day
was reported in a preliminary trial to prevent hepatitis infection in
individuals receiving blood transfusions.20 This report was followed up by
a double-blind trial, in which 3.2 grams per day of vitamin C was reported
to have no protective effect against post-transfusion hepatitis.21
(However, in the latter trial, vitamin C actually reduced the incidence of
hepatitis by 29%, although this reduction was not statistically
significant.) An older trial suggested that injections of vitamin C may be
helpful in treating viral hepatitis.22
A potent antioxidant
combination may protect the liver from damage in people with hepatitis C,
possibly decreasing the necessity for a liver transplant. In a preliminary
trial,23 three people with liver cirrhosis and esophageal varices (dilated
veins in the esophagus that can rupture and cause fatal bleeding) caused
by hepatitis C received a combination of alpha-lipoic acid (300 mg twice
daily), silymarin (from milk thistle; 300 mg three times daily), and
selenium (selenomethionine; 200 mcg twice daily). After five to eight
months of therapy that included other "supportive supplements," such as
vitamin C and B vitamins, all three people had significant improvements in
their liver function and overall health. Larger clinical trials are needed
to confirm these promising preliminary results.
Vitamin B12 (with
or without folic acid) has been reported in trials from the 1950s to help
some people with hepatitis.24 25 Vitamin B12 injections are likely to be
more beneficial than oral administration, though 1,000 mcg (taken orally)
each day can also be supplemented.
Are there any side effects or
interactions? Refer to the individual supplement for information about any
side effects or interactions.
Herbs that may be helpful: Silymarin,
the flavonoid extracted from milk thistle, has been studied for treating
all types of liver disease. The standard amount used in most trials has
delivered 420 mg of silymarin per day. For acute hepatitis, double-blind
trials have shown mixed results.26 27 A preparation of silymarin and
phosphatidylcholine was reported to help sufferers of chronic viral
hepatitis. One small preliminary trial found that at least 420 mg of
silymarin was necessary each day.28 A controlled trial found that
silymarin decreased liver damage.29 One trial has suggested that silymarin
may be more effective for hepatitis B as opposed to hepatitis
C.30
Recent findings have shown that silymarin has the ability to
block fibrosis, a process that contributes to the eventual development of
cirrhosis in persons with inflammatory liver conditions secondary to
alcohol abuse or hepatitis.31 While there are no published clinical trials
in people with hepatitis C to date, this action makes milk thistle extract
potentially attractive as a supportive treatment for the
condition-particularly for those that have not responded to standard drug
therapy. The effectiveness of silymarin (particularly its antifibrotic
actions) needs to be studied in larger numbers of persons with hepatitis C
to determine whether it is an effective treatment for this
condition.
Phyllanthus (Phyllanthus amarus), an Ayurvedic herb, has
been studied primarily in carriers of the hepatitis B virus, as opposed to
those with chronic active hepatitis. In one trial, administering this herb
for 30 days appeared to eliminate the hepatitis B virus in 22 of 37 cases
(59%).32 However, other trials have failed to confirm a beneficial effect
of Phyllanthus amarus against hepatitis B.33 34 A West Indian species,
Phyllanthus urinaria (not widely available in the United States or
Europe), has achieved much better results than Indian Phyllanthus
amarus.35 Thus, the specific plant species used may have a significant
impact on the results. The amount of phyllanthus used in clinical trials
has ranged from 900-2,700 mg per day.
A crude extract of red peony
root was shown in a small, preliminary trial to reduce cirrhosis in some
people with chronic viral hepatitis.36 Other preliminary trials published
in Chinese demonstrated that red peony root was helpful (by reducing liver
enzyme levels or symptoms or both) for people with viral
hepatitis.37
Preliminary trials have shown that the
bupleurum-containing formula sho-saiko-to can help reduce symptoms and
blood liver enzyme levels in children and adults with chronic active viral
hepatitis.38 39 40 41 Most of theses trials were in people with hepatitis
B infection, though one preliminary trial has also shown a benefit in
people with hepatitis C.42 Sho-saiko-to was also found, in a large
preliminary trial to decrease the risk of people with chronic viral
hepatitis developing liver cancer. However, people who had a sign of
recent hepatitis B infection were not as strongly protected in this
trial.43 The usual amount of sho-saiko-to used is 2.5 grams three times
daily. Sho-saiko-to should not be used together with interferon drug
therapy as it may increase risk of pneumonitis - a potentially dangerous
inflammation in the lungs.44
One of the active constituents in
licorice, glycyrrhizin, is sometimes used in Japan as an injected therapy
for hepatitis B and C.45 46 Glycyrrhizin also blocks hepatitis A virus
from replicating in test tubes.47 One preliminary trial found that use of
2.5 grams licorice three times per day providing 750 mg glycyrrhizin was
superior to the drug inosine polyIC in helping people with acute and
chronic viral hepatitis.48 Because glycyrrhizin can cause high blood
pressure and other problems, it should only be taken on the advice of a
healthcare practitioner.
A series of cases of acute viral hepatitis
were reported by one group in India, showing picrorhiza, combined with a
variety of minerals, to be helpful in hastening recovery.49 A variety of
similar reports have appeared in the Indian literature over the years,
although no double-blind clinical trials have yet been published. Between
400 and 1,500 mg of powdered, encapsulated picrorhiza per day has been
used in a variety of trials. Andrographis, another traditional Indian
herb, has shown preliminary benefit for people with chronic viral
hepatitis.50
Preliminary human research demonstrates some efficacy
for the mushroom reishi in treating chronic hepatitis B; however,
additional clinical trials are needed.51
An uncontrolled trial
found that shiitake formulations containing Lentinus edodes mycelium (LEM-
the powdered mycelium of the mushroom before the cap and stem grow) may
help decrease blood markers of liver inflammation.52 One marker of
hepatitis B infection in the blood (HBeAg) disappeared in 14% of the
patients in this trial. Given the preliminary nature of the research, more
information is needed to determine if LEM is effective for
hepatitis.
Modern Chinese research suggests that compounds called
lignans in schisandra promote regeneration of liver tissue that has been
damaged by harmful influences, such as hepatitis viruses or alcohol. In a
controlled trial, Chinese patients with chronic viral hepatitis were given
500 mg schisandra extract three times daily or liver extract and B
vitamins.53 Among those given schisandra, serum glutamic pyruvic
transaminase (SGPT) levels declined to normal levels in 68% compared to
44% of the control group. Lower SGPT levels suggest less liver
inflammation. There was also a reduction in symptoms such as insomnia,
fatigue, loose stools, and abdominal tension in the schisandra group. A
preliminary trial in 5,000 people with various types of hepatitis found
normalizations in SGPT or related liver enzymes in 75% of cases using an
unspecified amount of schisandra.54
Early clinical trials in China
suggest astragalus root might benefit people with chronic viral hepatitis,
though it may take one to two months to see results.55 Textbooks on
Chinese herbs recommend taking 9-15 grams of the crude herb per day in
decoction form. A decoction is made by boiling the root in water for a few
minutes and then brewing the tea.
Another Chinese herb, Chinese
scullcap, might be useful for liver infections. However, the research on
this is generally of low quality.56
Are there any side effects or
interactions? Refer to the individual herb for information about any side
effects or interactions.
References:
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AM, Bonkovsky HL, Chopra S, et al. Iron reduction as an adjuvant to
interferon therapy in patients with chronic hepatitis C who have
previously not responded to interferon: a multicenter, prospective,
randomized, controlled trial. Hepatology 2000;32:135-8.
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Doelle W, Kortum K, et al. Treatment of acute viral hepatitis with
(+)-cyanidanol-3. Lancet 1977;2:1153-5.
3. Suzuki H, Yamamoto S,
Hirayama C, et al. Cianidanol therapy for HBs-antigen-positive chronic
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4. Bar-Meir S, Halpern Z, Gutman M, et al. Effect of
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45. Suzuki H, Ohta Y, Takino T, et al. Effects of
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Hepatitis - Health - Moducare (Phytosterols)
180 tablets
52.76 US
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