Hepatitis

ALTERNATIVE DOCTOR, LLC

Hepatitis, Viral

Hepatitis is a serious inflammation of the liver. Viral hepatitis, the most common form, usually appears as type A, B, or C. Type A (HAV), the most common, often affects schoolchildren. Type B (HBV) and Type C (HCV) affect people of all ages.

Signs and Symptoms

	Jaundice (yellow discoloration of skin and whites of eyes)
	Abdominal discomfort or uneasiness
	Fatigue, loss of weight
	Nausea, vomiting
	Dark urine, colorless stool
	Aversion to cigarettes

What Causes It?

	HAV: usually transmitted from feces on unwashed hands (putting dirty hands into the mouth) and by ingesting contaminated food and water.
	HBV: usually transmitted by injection of contaminated blood, through intravenous (IV) drug use, and through sexual activity.
	HCV: usually transmitted in a blood transfusion, through IV drug use, and possibly during sexual activity.

What to Expect at Your Provider's Office

Your health care provider will feel and tap your chest and back to determine if your liver or spleen is enlarged or tender. Your provider will request a blood test, possibly a urine test, and, in a few cases, a liver biopsy. Tell your provider if any of the following apply to you.

	Work in health care, such as in a medical laboratory or in dialysis
	Have a parent, sibling, or child infected with hepatitis
	Engage in unprotected sex
	Inject drugs
	Live in or are exposed to unsanitary conditions
	Consume possibly contaminated food or water
	Eat or handle raw shellfish

Treatment Options

Treatment Plan

Your treatment will depend on the severity of your disease. While the hepatitis is active, you will need to rest, drink a great deal of fluids, and eat a well-balanced diet. How active you can be will simply depend on how tired you are. Alcohol should be strictly avoided until liver tests return to normal. Various drugs can help reduce your symptoms.

Drug Therapies

Prescription

	Metoclopramide, compazine, hydroxyzine—reduces nausea; various side effects
	Corticosteroids—for chronic active hepatitis; serious possible side effects
	Immunomodulators—such as azathioprine or interferon alpha-2b for chronic active hepatitis; serious possible side effects

Over the Counter

	Acetaminophen (Tylenol)—helps abdominal discomfort
	Benadryl—reduces nausea; various side effects

Complementary and Alternative Therapies

Alternative therapies can help support and protect the liver.

Nutrition

	Reduce or eliminate alcohol, caffeine, refined foods, sugar, food additives, and saturated fats (meat and dairy products).
	Small, frequent meals are suggested to optimize digestion.
	Increase intake of grains, vegetables, fruits, vegetable proteins (legumes such as soy), and essential fatty acids (cold-water fish, nuts, and seeds). Foods that support the liver are beets, artichokes, yams, onions, garlic, green leafy vegetables, apples, and lemons.
	Green tea can decrease inflammation. 2 to 3 cups per day.
	Acidophilus supplements (one capsule with meals) helps keep healthy levels of the "good" bacteria in your body. Low vitamin K levels may be supplemented with 100 to 500 mg per day.
	Vitamin C (1,000 to 1,500 mg per day), beta-carotene (100,000 IU per day), vitamin E (400 to 800 IU per day), and zinc (30 to 50 mg per day) strengthen your immune system. B-complex (50 to 100 mg per day), especially folic acid (800 to 1,000 mcg per day) and B₁₂ (1,000 mcg per day) are needed for good liver function.
	Selenium (200 mcg per day) is needed to keep your liver healthy.
	Desiccated liver and thymus extracts can improve liver regeneration.
	Glutathione (500 mg twice a day) or N-acetyl cysteine (200 mg two to three times per day) provide liver cleansing and antioxidant support.

Herbs

Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Three to four liver-supportive herbs should be combined with two to three antiviral and immune-stimulating herbs. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.

Herbs for liver support include the following.

	Milk thistle (Silybum marianum, 200 to 250 mg three times per day) protects the liver. It may also be used as phosphatidylcholine-bound silymarin (100 to 150 mg three times per day).
	Chinese thoroughwax (Bupleurum falcatum) contains steroid-like substances that reduce inflammation.
	Globe artichoke (Cynara scolymus) promotes liver regeneration.
	Schizandra berry (Schizandra chinensis) protects liver health.
	Eclipta alba, usually used with phyllanthus.
	Phyllanthus amarus (200 mg three times per day).
	Turmeric (Curcuma longa, 250 to 500 mg three times per day). Combine with bromelain (250 to 500 mg three times per day between meals) to enhance its effects.

Immune support and antivirals include the following.

	Licorice root (Glycyrrhiza glabra, 250 to 500 mg three times per day). Do not take licorice if you have high blood pressure.
	Astragalus root (Astragalus membrinaceus)
	Coneflower (Echinacea purpura)
	Goldenseal (Hydrastis canadensis)

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Castor oil pack. Apply the oil directly to your right upper abdomen, cover with a cloth, plastic wrap, and a heat source; let sit for 30 to 60 minutes.

Acupuncture

Acupuncture may help support your liver function.

Massage

Therapeutic massage may be helpful to your immune system.

Following Up

If you have jaundice, it should disappear in two to eight weeks.

Special Considerations

HBV and HCV can be transmitted during pregnancy or childbirth.

Supporting Research

Andreoli TE, Bennett JC, Carpenter CCJ. Cecil Essentials of Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 1993:327–334.

Batchelder HJ. The Protocol Journal of Botanical Medicine. Ayer, MA: Herbal Research Publications, Inc.; 1995: Vol 1, No 2, 133–137.

Batchelder HJ, Hudson, T." The Protocol Journal of Botanical Medicine. 1995;1:138–140.

Barker LR, Burton JR, Zieve PD, eds. Principles of Ambulatory Medicine. 4th ed. Baltimore: Williams & Wilkins; 1995:507–515.

Dambro MR. Griffith's 5-Minute Clinical Consult–1999. Baltimore, Md: Lippincott Williams & Wilkins; 1999:408-409.

Dharmananda S. The Protocol Journal of Botanical Medicine. 1995: Vol 1, No 2: 151-158.

Ergil K. The Protocol Journal of Botanical Medicine. 1995:Vol 1, No 2:145–150.

Kiesewetter E, et al. Results of two double-blind studies on the effect of silymarin in chronic hepatitis. Leber Magen Darm. 1977;7:318–323.

Stein JK, ed. Internal Medicine. 4th ed. St. Louis: Mosby-Year Book; 1994:586–601.

Stoller JK, Ahmad M, Longworth DL, eds. The Cleveland Clinic Intensive Review of Internal Medicine. Baltimore, Md: Williams & Wilkins; 1998:573-756.

Scalzo R. Therapeutic Botanical Protocol for Viral Hepatitis. The Protocol Journal of Botanical Medicine. 1995:Vol 1, No 2, 159-160.

Sodhi V. The Protocol Journal of Botanical Medicine. 1995:Vol 1, No 2, 141-144.

Stedman's Medical Dictionary. 26th edition. Baltimore, Md: Williams & Wilkins; 1995:784-786.

Thyagarajan SP. Effect of Phyllanthus amarus on chronic carriers of hepatitis B virus. Lancet. October 1, 1988:764–766.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.