Mother Earth Living

Fight Hepatitis C with Holistic Herbs

Often undiagnosed, hepatitis C affects 4 million Americans and millions more worldwide. And herbs may be the best tool for managing the disease.
By Lois Johnson, M.D.
March/April 2000
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You may have heard of hepatitis C—but how much do you really know about it? Did you know that for every one person infected with HIV, there are more than four infected with the hepatitis C virus (HCV)? Did you know that the Centers for Disease Control and Prevention estimates there are up to 230,000 new infections each year—in the United States alone?

In fact, hepatitis C is the most common blood-borne disease in the United States, according to a 1999 report in New England Journal of Medicine (NEJM). An estimated 4.5 million Americans have HCV—most of them baby boomers—with 2.7 million chronically infected. Worldwide, it’s now the most common form of viral hepatitis.

HCV is often called “The Silent Killer” because it’s a sneaky and potentially serious disease, one that can lie dormant for many years, only to surface in midlife. Sixty-five percent of the infections occur in people aged thirty to forty-nine, according to the NEJM article. Once diagnosed with hepatitis C, patients may have the option to take antiviral drugs, but these potent medicines don’t work in all cases and may have significant side effects. Some patients are told to just “watch and wait” to see if the disease worsens.

Hepatitis C primarily causes inflammation and damage to the cells of the liver, that absolutely essential organ of detoxification and digestion. The virus is unusual because only about one-fourth of people exposed to it develop an acute illness within the weeks following initial exposure. Hepatitis C can remain “latent” and undetected for many years—twenty or thirty years, in some cases. Of those exposed, 70 percent slowly develop chronic infection and liver damage. Twenty percent of those chronically infected eventually develop cirrhosis, the most severe consequence of the disease in which the liver is permanently damaged and scarred. It is estimated that 10,000 people a year die from complications of the disease.

A variety of symptoms

Symptoms of hepatitis C vary depending on the phase of the disease and its severity. In acute infection (remember, not everyone goes through this phase), common symptoms include loss of appetite, nausea, vomiting, flulike symptoms, fatigue, fever, liver pain, jaundice, dark-colored urine, headache, muscle and joint pains, diarrhea, and itchy skin. Chronic disease may be completely free of symptoms, or the symptoms may be fairly subtle: fatigue, weakness, digestive complaints, muscle and joint pain, and itching. Women may experience PMS and other problems with the menstrual cycle. The liver may or may not be enlarged and achy. Severe liver damage, as in cirrhosis, can lead to a highly toxic state, with nutritional deficiencies, bleeding, and mental confusion. People with long-term hepatitis have an increased risk of developing liver cancer. A study by Japanese researcher Masashi Mizokami released last year for the first time at the American Association for the Study of Liver Diseases suggests that, if the United States follows the path of Japan, we may soon be seeing an increase in liver cancer cases related to HCV infection.

A case study

The traditional Western treatment for hepatitis C depends on the severity and phase of the disease. No drugs exist to protect and/or heal the liver. Some antiviral medications, including interferon and ribavirin, may ease symptoms and fight back the virus, but their effectiveness depends on which strain of virus is present. Moreover, drugs don’t work for everyone, and their side effects can be significant. This is the point at which many conventional practitioners advise their patients to watch and wait.

However, experienced herbalists know that patients can definitely do more than watch and wait. For some patients, herbalists use herbs to support antiviral drugs. For the majority of patients, herbalists prescribe herbs as the main treatment. Different types of herbalism—Traditional Chinese Medicine or Ayurveda, for example—use very different herbs and protocols to treat the disease.

A general holistic approach to liver treatment may include these six steps.

Avoid liver toxins. Many substances stress the liver and make persons with hep- atitis C more susceptible to damage from the disease. Potential liver stressors include alcohol in all forms and common over-the-counter drugs such as Tylenol and ibuprofen. Consult your health-care practitioner before taking any drugs, and stay away from chemicals in general—including cleaning products, garden pesticides, and industrial products of all kinds.

Use nutrition as medicine. Eat a simple, whole foods diet with plenty of vegetables and fruits rich in antioxidants—a rainbow of green, yellow, orange, red, and purple colors. Especially good choices include parsley, beets, carrots, ginger, garlic, onions, and turmeric. If possible, choose organically grown foods.

Eat your lightest meal in the evening. Eating causes some stress to the liver, and a light evening meal will reduce the liver’s work during the healing hours of sleep. Always avoid sugar, fried foods, and large amounts of animal fats and dairy, which can be particularly stressful to the liver.

Take supplements as backup. You may want to supplement with antioxidant vitamins (the carotenes, C, and E) and the B vitamins to ensure you get enough of these healing nutrients.

Protect and heal with herbs. Many wonderful herbs help protect and heal the liver, often by dealing with the inflammation and oxidation caused by the virus. Other herbs help the body fight off the virus by making the immune system work better. But herbs take time to work—often months—so be patient.

Choose herb forms carefully. In general, avoid alcohol tinctures and use teas, glycerin-based liquid extracts, or capsules instead. (See “Reduce the alcohol in your tinctures” on page 55).

Caution: If you are taking prescription drugs, consult an experienced herbalist before proceeding, because there may be herb-drug interactions.

Herbs that help heal the liver:

(Silybum marianum)

How it works

• Stabilizes cell mem­­branes to limit toxin entry into cells.
• Scavenges free radicals as an ­antioxidant.
• Stimulates regeneration of liver cells by ­accelerating ­protein synthesis.

Clinical research

At least 300 studies show milk thistle’s liver benefits. A 1977 study shows it reverses liver cell damage in cases of chronic hepatitis. This finding is based on liver biopsies, laboratory tests, and clinical symptoms; patients were studied for one year.

Recommended dose

Capsules of an extract standardized to 80 percent silymarin, 210 to 420 mg, three times a day.

Side effects/cautions

No significant toxicity; rare diarrhea, gastrointestinal irritation. Avoid milk thistle teas and glycerites, which don’t extract active ingredients very well.

(Glycyrrhiza glabra)

How it works

• Inhibits liver cell ­injury.
• Stimulates the ­immune system.
• Inhibits growth of the hepatitis C virus.
• Inhibits and scavenges free radicals.

Clinical research

Several studies have shown licorice reduces liver enzymes and improves symptoms in chronic hepatitis cases. Decreases long-term incidence of liver cancer by up to 50 percent in hepatitis C patients.

Recommended dose

Tea: 1 teaspoon dried root to 1 cup of water. Simmer for 10 minutes; drink two to three cups a day.
Glycerite: 1/8 to 1/2 teaspoon two to three times a day.
Capsules: Follow directions on package.

Side effects/cautions

High doses may increase blood pressure, raise sodium levels, lower potassium, and cause fluid retention. Avoid licorice if you have high blood pressure or heart disease, or if you take medications for these afflictions. Avoid during pregnancy.

(Schisandra chinensis)

How it works

• Protects liver fromdamage.
• Accelerates liver detoxification enzyme systems.

Clinical research

A study of 189 patients with chronic viral hepatitis shows that schisandra lowers liver enzyme levels and improves overall symptoms.

Recommended dose

Tea: 1 teaspoon dried berries to 1 cup of water. Simmer for 10 minutes; drink three cups a day.
Glycerite: 1/4 to 1 teaspoon 3 times a day.
Capsules: Follow directions on bottle. A typical dose might be four 580-mg capsules per day.

Side effects/cautions: None

Bupleurum falcatum; B. chinense; B. scorzoneraefolium)

How it works

• Reduces inflammation.
• Inhibits liver damage by decreasing fat oxidation.
• Balances the ­immune system.

Clinical research

A year-long study shows significant improvement in liver enzymes.

Recommended dose

Tea: 1 teaspoon dried herb to 1 cup of water. Simmer for 10 minutes; take three cups a day.
Glycerite: l/8 to 1 teaspoon three times a day.
Capsules: Follow manufacturer’s directions.

Side effects/cautions

Large doses reported to cause rare cases of excess anger.

How it works

• Protects liver against damage.
• Fights inflammation and oxidation.
• Stimulates bile flow.
• Supports detoxification.

Clinical research

Many clinical studies show turmeric helps protect the liver, but none has specifically tested the herb’s effect on chronic hepatitis.

Recommended dose

Tea: 1 teaspoon dried root to 1 cup of water. Simmer for 10 minutes; take 3 cups a day with food.
Glycerite: 1/8 to 1 teaspoon, three times a day with food.
Capsules: (Powdered root) 250 to 500 mg three times a day with food.

Side effects/cautions

May upset stomach. May generate excess “heat” (e.g. in women with hot flashes).

(Taraxacum officinale)

How it works

• Highly nutritive, traditional liver tonic.
• Stimulates bile flow.

Clinical research

Two studies show improvement in symp­toms resulting from a variety of liver diseases, including hepatitis.

Recommended dose

Tea: 1 teaspoon of dried root to 1 cup of water. Simmer for 10 minutes; drink three cups a day.
Glycerite: 1/4 to 1 teaspoon, three times a day.
Capsules: 250 to 500 mg, three times a day.

Side effects/cautions: None

(Phyllanthus amarus)

How it works

• Traditional Indian liver herb; fights viral infections.

Clinical research

Shortens duration of acute infection in patients with hepatitis C.

Recommended dose

Capsules: 900 mg, three times a day.

Side effects/cautions: None

(Camellia sinensis and gambir Uncaria gambir)

How they work

• Both herbs contain catechin, a plant flavonoid with strong antioxidant ­effects.
• Stimulate the immune system.
• Stabilize liver cell membranes to make them less ­susceptible to toxic damage.

Clinical research

(Using catechin extracts, a compo-nent of these herbs)
• Improve liver tests and symptoms of acute hepatitis about twice as fast as placebo.
• Improve situation in chronic hepatitis.

Recommended dose

Catechin: 1 g of extract three times a day.
Green tea: 1 teaspoon dried herb to 1 cup of water, steep for 10 minutes, drink 3 cups a day.
1 standardized extract capsule containing 80 percent polypohenols, 300 to 400 mg.
Gambir: 1 g of extract three times a day.

Side effects/cautions

Green tea: Contains small amounts of caffeine; avoid if intolerant.
Gambir: None.

(Ganoderma lucidum)

How it works
• Stimulates immunity.

Clinical research

Two studies show it improves liver enzyme tests and reduces sy­mp­toms in up to 94 percent of hepatitis B patients.

Recommended dose

Tea: 3 to 4 g dried root in 1 cup of water. Simmer for 30 minutes; drink three cups a day.
Glycerite: 1/4 to 1 teaspoon, three times a day.
Capsules: Follow manufacturer’s directions.

Side effects/cautions: None

Gentian (Gentiana lutea), Wormwood (Artemisia absinthum), Mugwort (Artemisia vulgaris)

How they work

• Stimulate bile flow.
• Improve digestion.

Clinical research

• None specifically for hepatitis.

Recommended dose

Tea: 1/2 to 1 teaspoon of dried herb to 1 cup of boiling water. Steep for 10 minutes. Take 1 cup three times a day with meals.
Glycerite: 1 to 2 droppersful three times a day with meals.

Side effects/cautions

Rare diarrhea. Avoid if you have stomach or duodenal ulcers or if you have pain in the right upper abdomen (which indicates excessive stimulation of bile).

Not effective in capsule form; bitterness must be tasted to stimulate bile. Along these lines, any herb that tastes bitter in the mouth may be as effective as gentian, wormwood, or mugwort.

Who should get tested?

One of my patients, whom I’ll call John, never had acute hepatitis, but he thinks he was infected in the early 1970s, when he used intravenous drugs briefly—“just a few times!” (for more on John’s history, see page 53.) Sharing contaminated needles is one way you can get hepatitis C. Blood transfusions given around 1992, prior to the time we had tests to detect this virus, are another cause. (Blood transfusions are now screened for hepatitis C and are no longer risky.) Unsafe sexual practices are another possible risk factor. However, in up to 40 percent of the cases of hepatitis C, no clearly identifiable risk factor can be found.

Lois Johnson, M.D., has a busy primary-care holistic practice in Sebastopol, California, where she integrates the best of Western medicine with herbalism, nutrition, and lifestyle counseling. She graduated from the University of Nevada Medical School in 1984 and is board certified in internal medicine.

Additional Information Books

Hobbs, Christopher. Natural Liver Therapy. Botanica Press, 1997.
Murray, Michael and Joseph Pizzorno. The Encyclopedia of Natural Medicine. Prima, 1991.
Murray, Michael. The Healing Power of Herbs. Prima, 1995.
Hoffmann, David. The New Holistic Herbal. Element, 1991.

This site, hosted by C. Everett Koop, ­offers comprehensive information concerning hepatitis C.
A resource center for current information on HCV.

A final bit of advice: Don't stress out!

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