Many people with hepatitis C pursue complementary or alternative approaches to treatment (herbs, supplements, acupuncture, etc.) due to the drawbacks and limitations of conventional treatment. Common complementary therapies thought to help people with hepatitis C include milk thistle (active component silymarin or silybum marianum), licorice root (active component glycyrrzhin), sho-saiko-to (a mixture of seven plants, including licorice), ginseng, thymus extract, and vitamins and antioxidants.
Some people with hepatitis C also make adjustments to their diet, given the importance of the liver in metabolizing food.
The general goals of nutrition and of complementary/alternative medicine (CAM) are to reduce the potential for liver damage from hepatitis C, and to offset symptoms and side effects. Herbs and supplements are often touted for their potential to boost the immune system, decrease inflammation or oxidative stress, and/or reduce elevated liver enzyme levels. Neither nutrition nor CAM alone can cure hepatitis C, but some approaches may help protect the liver and make it easier to live with the virus.
Right now there’s no definitive research showing that CAM or nutrition benefits people with hepatitis C. We need well-designed clinical trials to investigate the impact of CAM approaches on hepatitis C – do they really protect the liver? Are they really safe? Who do they work best for?
A lot of doctors disapprove of their patients trying CAM approaches. It’s good to keep in mind that herbs can have dangerous properties, including their own side effects. Some herbs and supplements are actually harmful to the liver. Interactions between herbs and prescription medications may increase drug side effects or lower blood levels of a drug, making it less effective. For that reason, it’s important to tell your doctor about any complementary or alternative therapies that you’re using or thinking about.
It’s also important to remember that herbs, supplements, and vitamins are a big business that’s largely unregulated by the Food and Drugs Administration (FDA; see FDA's Tips for the Savvy Supplement User: Making Informed Decisions and Evaluating Information [Spanish version]). That means that the purity and levels of active ingredients of the products you can buy in health food stores and on-line can vary a lot. It also means that you can’t believe everything that you read or hear about these products – if it sounds too good to be true, it probably is.
Share your experiences and decisions with CAM and nutrition for hepatitis C by clicking on the 'comments' link beneath this post.
Here are some resources for learning more about CAM and nutrition:
Hepatitis C and Complementary and Alternative Medicine: 2003 Update [PDF version] from the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health
Sho-saiko-to clinical trial for hepatitis C at Memorial Sloan-Kettering Cancer Center in New York City (see also their review of Sho-saiko-to information on their About Herbs, Botanicals & Other Products section, a good place to look for information on CAM, with entries written in two versions, for consumers and health care professionals -- see also entries on milk thistle and licorice)
CAM therapies for HIV/AIDS and/or chronic hepatitis - a listing from the Foundation for Integrative AIDS Research (FIAR), a New York-based organization working with researchers at Mount Sinai Medical Center on developing a study of milk thistle in people co-infected with hepatitis C and HIV (more information here)
Alternative Therapies for Hepatitis C from the Veterans Affairs National Hepatitis C Program
Hepatitis C: Choices manual [PDF version] from the Hepatitis C Caring Ambassadors Program -- nearly 400 pages of information about hepatitis C, including detailed chapters on various forms of CAM and on nutrition (order a copy here)
Treatment (Alternative Medicine) and Nutrition sections of the Hepatitis C Frequently Asked Questions (FAQ), better known as Peppermint Patti's FAQ (Spanish version), maintained and updated by the Hepatitis C Education & Prevention Society of British Columbia (HepCBC)
CAM (PDF file) and nutrition (PDF file) chapters from the Pediatric Hepatitis Report (also available in Spanish, Russian, and Chinese – links to PDF files of the Table of Contents for each language, which includes links to PDF files of individual chapters) from Parents of Kids with Infectious Diseases (PKIDS)
Hepatitis C: Nutrition Care - Canadian Guidelines for Health Care Providers [PDF version] - information from Dietitians of Canada; includes chapter on Complementary and Alternative Therapies; see also related fact sheets and online course for health professionals here
The Hepatitis C Reader is a companion to the Harm Reduction Coalition's national hepatitis C training program (contact Paul Cherashore for information about trainings)
also from this site:
Hepatitis C Certified Practitioners List (PDF file) (a national listing of licensed acupuncturists who completed Misha Cohen’s Hepatitis C Professional Certification Course)
Complementary and Alternative Medicine and Hepatitis C Infection, a detailed article on making decisions about CAM from Hepatitis Neighborhood (free registration required), a service of the specialty pharmacy Priority Healthcare (see also articles on Sho-saiko-to and Herbs to Avoid in Liver Disease and their section on Food and Nutrition, particularly Nutritional Challenges in Liver Disease)
Complementary and alternative therapies in the treatment of chronic hepatitis C: a systematic review (Journal of Hepatology) by JT Coon and E Ernst, 2004 - abstract here - concluding "We identified several promising complementary therapies, although extrapolation of the results is difficult due to methodological limitations. More research is warranted to establish the role of these and other therapies in the treatment of hepatitis C."
Medicinal herbs for hepatitis C virus infection (Cochrane Review) by JP Liu et al., 2004 - abstract here - concluding "There is no firm evidence of efficacy of any medicinal herbs for HCV infection. Medicinal herbs for HCV infection should not be used outside randomised clinical trials."