Treatments for Hepatitis C
Hepatitis C is a serious communicable
(contagious) disease of the liver that is caused by the
hepatitis C virus (Hepatitis C Virus). Hepatitis C and its implications were
identified only recently. There still is much to learn about
the disease, the virus that causes it, and treatment
options—both conventional and alternative.
About 3 million Americans are infected
with Hepatitis C Virus, and many of them do not even know they have it.
Other forms of viral hepatitis usually resolve without
treatment. But most people with Hepatitis C Virus—85 percent—develop
chronic (frequent or long-lasting) hepatitis C. The majority
of people infected with Hepatitis C Virus show no symptoms for up to 20 to
30 years. During that time, though, the infection may be
slowly damaging the person's liver.
The virus can be found in a number of
organs of the body. However, the infection is spread mainly by
contact with the blood of an infected person. Once a person is
infected, the body's immune (disease-fighting) system cannot
combat the virus very well.
Most people with chronic hepatitis C
develop long-term liver disease, which interferes with the
liver's ability to work properly. Some patients eventually
develop cirrhosis (scarring of the liver); some get liver
cancer; and some even die from liver disease.
Repeated injections of regular
("conventional") drugs, like interferon, currently
available to treat chronic hepatitis C get rid of the virus
only in approximately 30 to 40 percent of infected people. In
addition, these drugs can produce unbearable side effects. So,
many people are looking to complementary and alternative
therapies for help.
No complementary medicine or alternative
medicine therapies have been scientifically proven to cure or
even ease symptoms of hepatitis C.
However, some people are turning to
herbs for relief. They use herbs either to help with hepatitis
itself or to deal with side effects of interferon. These
harmful side effects can include: sudden hearing loss; anemia
and other forms of low blood cell counts; headaches; heart,
eye, liver, or kidney problems; and disorders of the mind,
including depression. Among potential herbal therapies
(including licorice root, ginseng, ginger, and St. John's wort)
for hepatitis C, the most promising alternative treatment
seems to be the herb commonly called milk thistle.
Preliminary studies in animals show that
milk thistle may help protect the liver from injury by a
variety of toxins ("poisons" such as drugs, viruses,
alcohol, radiation, and poisonous mushrooms) and limit the
damage from them. To date, the most reliable, and also quite
preliminary, studies on people show that milk thistle does not
cure liver disease, but that it may improve the way the liver
works in patients with cirrhosis. However, there is no current
evidence to indicate that milk thistle directly affects Hepatitis C Virus.
In Germany, where many herbs are
regulated and prescribed like drugs, health authorities have
approved milk thistle as a complementary treatment (given in
addition to conventional drugs) for cirrhosis, hepatitis, and
similar liver conditions. But a great deal of research still
is needed before this alternative therapy could be considered
a standard treatment option in the United States.
Milk thistle originally is from Europe,
but now it also is grown in the United States. Its scientific
name is Silybum marianum. The ingredient that experts
believe is responsible for its medicinal qualities is called
silymarin. Silymarin is found in the fruits of the milk
thistle plant. Studies in animals have shown that this active
ingredient promotes the following activities:
Liver Cell Growth—Silymarin
appears to promote the growth of some types of cells in the
may be an effective "antioxidant," which means it
may help fight a destructive chemical process in the body
known as "oxidation." In oxidation, harmful
substances produced in the body (called free radicals) can
damage cells. Some studies suggest that silymarin can prevent
these substances from damaging liver cells.
suggest that silymarin can block various types of toxins from
entering and injuring liver cells.
is thought to prevent inflammation (swelling) of the liver;
this may be described as displaying anti-inflammatory
Milk thistle is not used to prevent Hepatitis C Virus
from causing liver disease. Rather, it is used with the hope
that it would minimize the damage to the liver that Hepatitis C Virus can
Studies of Milk Thistle in People
Although studies in animals provide a
good deal of information on potential new treatments, studies
in humans are needed before it can be determined if these
therapies are appropriate, safe, and effective in people. The
most rigorous type of study to establish a scientific basis
for use of a new therapy in people is a randomized,
double-blind, placebo-controlled (RDBPC) trial.
Although not focused primarily on Hepatitis C Virus
disease, the most relevant existing research data regarding
milk thistle's use as a therapy for hepatitis comes from two
RDBPC trials of silymarin's effects on cirrhosis. The two
studies produced conflicting results.
The first, reported in 1989, examined
170 patients with cirrhosis from various causes, including
alcohol abuse. Approximately half (87) of the patients
received silymarin (140 milligrams 3 times a day for 2 years).
The others (83 patients) received a placebo. Because 24
patients dropped out of the study, a total of 146 patients (73
in each group) finished the 2-year study.
The doctors in this study noted that the
number of patients who died in the 4 years after the study was
31 percent lower in the group that received the silymarin than
in the group of patients who received the placebo. The
beneficial effects of silymarin were especially seen in the
patients who had cirrhosis as a result of alcohol abuse. The
doctors did not report that any patients experienced side
effects from silymarin treatment.
A more recent RDBPC trial, however, did
not find silymarin to have any significant benefits for
patients with cirrhosis. In this study, reported in 1998,
doctors examined 200 patients with cirrhosis caused by alcohol
abuse. Approximately half (103) of the patients received
silymarin (150 milligrams 3 times a day for 2 years). The
other half (97) received a placebo. A total of 125 patients
(57 in the treatment group and 68 in the placebo group)
finished the 2-year study. To measure effectiveness, the
doctors measured (1) time to death and (2) the worsening of
Survival was similar in both the
silymarin and placebo groups, and silymarin did not seem to
improve the course of the disease in the treatment group. The
doctors who performed the experiment did not note side effects
in any of the patients.
Although small, one randomized
controlled trial on hepatitis patients suggests that a
specific component in silymarin may be beneficial in managing
chronic hepatitis. In this study, reported in 1993, 10
patients with chronic hepatitis were assigned to the treatment
group and 10 others were assigned to the placebo group. The
treatment group received 240 milligrams of silybin, a
component of silymarin, two times a day for 1 week. The
results of tests that measure how well the liver is
functioning showed significant improvement in the treatment
group, suggesting that silybin may help treat chronic
Milk thistle in the treatment of liver
disease needs to be studied further. Fortunately, negative
side effects have not yet been reported, and this herbal
therapy may be much less expensive than conventional drug
therapies. Yet, it should be mentioned that conventional
therapies have been proven to work in a substantial portion of
Because milk thistle does not dissolve
well in water, the herb is not effective in the form of a tea.
It currently is marketed in the United States as a dietary
supplement in the form of capsules containing 200 milligrams
of a concentrated extract with 140 milligrams of silymarin.
Other Herbs That May Help
use tea made with licorice root to manage some of the effects
hepatitis has on the liver. The scientific name for licorice
root is Glycyrrhiza glabra, and its active component
is called glycyrrhizin. Studies suggest that licorice root
displays antiviral and anti-inflammatory properties.
Licorice root does come with a warning,
however. If taken regularly (more than 3 grams of licorice
root a day for more than 6 weeks, or more than 100 milligrams
of glycyrrhizin a day), this herb can cause the following
conditions in some people: high blood pressure, sodium and
water retention, low potassium levels in the bloodstream, and
disturbance of an important electrolyte balancing system in
Signs and symptoms of excessive licorice
root consumption may include headache, sluggishness, puffiness
and swollen ankles, and even heart failure or cardiac arrest
(when the heart suddenly stops beating).
Glycyrrhizin has been used in Japan for
more than 20 years as a treatment for chronic hepatitis.
In a 1998 review of several randomized controlled trials,
researchers reported that treatment with glycyrrhizin is
effective in easing liver disease in some people. Several of
the trials reviewed indicated improvements in liver tissue
that had been damaged by hepatitis. Some of them also showed
improvements in how well the liver does its job.
A 1997 experiment suggested that
glycyrrhizin also may help prevent the development of liver
cancer in patients with chronic hepatitis C. The use of
glycyrrhizin as a complementary therapy (in addition to
conventional use of interferon drugs) has been studied, but no
significant benefit has been found yet.
animals and on human tissues suggest that ginseng may help the
body's disease-fighting and glandular systems. Tests in small
animals also suggest that ginseng may help improve the way the
liver works and reduce damage to liver tissue caused by
hepatitis and similar conditions. However, a search of
the current literature shows no studies in people that test
ginseng's helpfulness for hepatitis. Only one study, conducted
in Italy, shows that ginseng may be helpful for elderly people
with liver conditions similar to hepatitis.
There are two true ginsengs—American
ginseng (Panax quinquefolius) and Asian ginseng (Panax
ginseng), which includes Chinese, Japanese, and Korean
ginseng. Siberian ginseng (Eleutherococcus senticosus)
is not a true ginseng. It is hard to get authentic ginseng
products. Companies that market herbs for sale have poor
quality control, so the quality of the different brands varies
widely. A 1990 analysis of 54 available ginseng products
revealed that 85 percent of them contained little or no
ginseng at all! Ginseng most often is taken as a tea.
Herbs That May Ease Interferon's Effects
years, the Chinese have used ginger (Zingiber officinale)
to treat nausea. Some, but not all, research studies confirm
that ginger may reduce nausea. This herb may relieve nausea
and vomiting caused by interferon drug therapy in some
patients with hepatitis C. Ginger generally is recognized as
safe and is not known to cause any serious side effects.
Ginger is relatively inexpensive and readily available. It
most commonly is taken in the form of a tea.
St. John's Wort—Some
patients with hepatitis C take the herb St. John's wort (Hypericum
perforatum) to treat depression caused by interferon drug
therapy. Although St. John's wort is not a proven treatment
for depression, studies have shown that it does have
antidepressive effects over the short term. Although research
largely has been done using capsules of this herb, St. John's
wort also is taken as a tea. There is no proof yet that St.
John's wort is effective and safe over the long term.
St. John's wort does not require a
prescription, and it is less expensive and may have fewer side
effects than prescription antidepressant drugs. Tests in
people reveal it may cause side effects such as fatigue, dry
mouth, dizziness, digestive tract symptoms, and increased
sensitivity to sunlight.
If You Have Hepatitis C
Get an accurate diagnosis from your doctor.
Hepatitis C infection can be diagnosed only by using
sophisticated blood tests available to all doctors.
Tell your doctor about all of the medications
you are taking, even any over-the-counter drugs or herbs or
other alternative therapies you may be using. Because the
liver plays a key role in processing drugs, alcohol, and
toxins in the bloodstream, medications, alcoholic beverages,
and certain herbs can make the disease worse.
Consider being vaccinated against hepatitis A
and B. Unlike hepatitis A and B, previous infection with Hepatitis C Virus
does not make you immune to it in the future. Infection with
Hepatitis C Virus also does not prevent you from becoming infected with
other types of hepatitis (hepatitis A, B, D, E, and G).
Do not try to treat the disease yourself.
Do not donate blood.
Do not drink alcohol, because it can further
damage your already diseased liver.
Do not share needles if you use injection drugs.
being tested by the experiment.
systems, therapies, and techniques that mainstream Western
(conventional) medicine does not commonly use, accept, study,
understand, or make available. Alternative medicine includes
practices usually used instead of conventional medical
practices. Alternative health care practices include a vast
array of treatments and beliefs, which may be well-known,
exotic, mysterious, or even dangerous. They are based on no
common or consistent philosophy or school of thought. A few of
the many alternative medicine practices include the use of
acupuncture, homeopathy, herbs, therapeutic massage, and
traditional oriental medicine to promote well-being or treat
medical systems used in conjunction with or in addition to
conventional medicine to further promote health. For example,
a person may use herbal remedies to ease some of the side
effects, such as nausea, of certain conventional drugs.
Patients who do
not receive the treatment being studied; the experimental
group is compared to the control group to objectively evaluate
the treatment’s effectiveness.
A type of study
in which neither the participants nor the doctors giving the
treatments know who is getting the active treatment and who is
getting the placebo.
A large gland
in the upper abdomen that is essential to life. Important
liver functions include: helping the body produce or make use
of the fats, sugars, proteins, vitamins, and most other
compounds it needs; and reducing the ill effects of poisons,
such as alcohol and nicotine, in the body.
pharmacologically inactive or “fake” treatment. If in the
form of a pill, a placebo sometimes is referred to as a
“dummy pill” or “sugar pill.”
A type of study
of usually one group of subjects to distinguish the specific
and nonspecific effects of the active treatment. Randomized
Study participants are assigned without bias to particular
arms of a study.
usually undesirable, reactions that result from a treatment.
A tiny organism
that can only grow in the cells of an animal or a person.
Several hundred viruses have been found to cause diseases in