Debbie Bridges, MD
When you're living with a disease like hepatitis C, it's natural to want to try any treatment possible to relieve your symptoms and improve your quality of life. Standard hepatitis C treatment has come a long way towards curing the disease. However, the drugs don't always work and they can have side effects.
For some patients with the disease, hepatitis C complementary and alternative treatment offers another option. "One of the things I always say is that, obviously, Western medicine does not have all the answers," says Paul Martin, MD, FACP, chief of the division of hepatology and professor of medicine at the University of Miami. "Patients who have been treated in the past and failed to respond are interested in exploring various therapeutic options."
Yet the research on hepatitis C complementary and alternative medicine has been limited, and no study so far has proven any alternative remedy safe and effective for treating the condition. It's difficult to draw any conclusions from the research because studies on alternative remedies are typically not as rigorous as those used to test medications.
"A lot of what the FDA does is not only prove drugs are effective but also that they're safe," according to Martin. "There isn't the same sort of scrutiny of the production of these compounds as there is for prescription and over-the-counter medications."
Determining whether herbal remedies are safe and effective for hepatitis C will become easier as investigators begin to take a more traditional approach to their research, says Victor Navarro, MD, professor of medicine in the division of gastroenterology and hepatology at Thomas Jefferson University in Philadelphia. "We're [testing them] like pharmaceuticals so we can really know if there is any benefit."
"I think it's possible that in the future, some of the therapies may actually have some benefit," Martin says.
In the meantime, if you are going to try such therapies for hepatitis C treatment or any other condition, talk to your doctor first. Even though herbal remedies are "all natural," they can still have side effects, and many can interact with medicines you're already taking. "The appropriate thing is to explore all the options for your particular liver disease with a specialist," Martin says.
Hepatitis C complementary and alternative treatments range from herbal remedies such as milk thistle, licorice root, ginseng, and thymus extract, to therapies like massage, chiropractic care, and relaxation techniques. Up to 40% of people with hepatitis C who have failed conventional treatment say they have tried other therapies, and many report less fatigue, an immune system boost, and better gastrointestinal function as a result.
Here are some of the most popular hepatitis C complementary and alternative treatments, and what the research has to say about them:
Milk thistle (Silybum marianum) is the most popular herbal remedy for hepatitis C and among the best studied. Milk thistle is thought to both reduce liver inflammation and have an antiviral effect on the hepatitis C infection. A very small study presented at the 2008 European Association for the Study of the Liver conference suggested that milk thistle might decrease levels of the hepatitis C virus in patients who didn't respond to standard medical treatment. However, a previous larger review that looked at several studies concluded that milk thistle does little to reduce the complications of liver disease or improve the results of liver function tests. Though the evidence on milk thistle is so far inconclusive, the herb appears to be very safe with few side effects reported.
Licorice root (Glycyrrhiza glabra) uses the active component found in the dried root of the licorice plant. Some studies indicate that it might reduce some of the complications of hepatitis C (including liver cancer) and improve liver function. Licorice root is either taken on its own or combined with other herbs. In one study, patients who took a combination of licorice root, milk thistle, and several other herbs had improved measures of liver enzymes (a marker of liver damage and inflammation) and tests of liver function. Licorice root should be used carefully because it can have significant side effects, including high blood pressure, salt and water retention, and potassium loss. It also can have potentially dangerous interactions with medications such as diuretics, certain heart medications, and corticosteroids.
Thymus extract comes from the thymus gland of cows. Because the thymus helps regulate immune function, it has been speculated that its extract might boost the immune system in hepatitis C patients, but too few studies have been done to confirm this theory. A small study of Complete Thymic Formula, a dietary supplement containing thymus extract, as well as vitamins, minerals, and enzymes, found that this supplement did not benefit hepatitis C patients who had failed conventional treatment. Although this study noted only one side effect (a drop in blood platelets), there is concern that thymus extract might be prone to contamination because it comes from animals. People with immune problems (such as HIV/AIDS) should use caution when taking thymus extract.
Ginseng has been used to boost the immune system, and there is some evidence that it might help people with other types of liver conditions. However, it hasn't been studied well enough in people with hepatitis C to show any benefit. And because ginseng can decrease blood sugar and increase risk for bleeding, it should be used very carefully.
Schisandra is a plant that has been used for centuries as part of traditional Japanese medicine. In one small study, a Japanese herbal medicine called TJ-108 containing schisandra fruit had an antiviral effect on hepatitis C. However, the researchers aren't sure whether the schisandra or other ingredients in the herbal remedy were responsible for this effect.
St. John's wort has gained popularity for treating mild to moderate depression. Some patients with hepatitis C take the herbal remedy to counter the side effects of conventional treatment, but there is no evidence that it works.
Lactoferrin is a protein found in milk, as well as in the tears and saliva. A few small studies have found that when it is taken as part of a dietary supplement, lactoferrin may lower levels of the hepatitis C virus in the blood and improve liver function. It may be useful when taken together with standard medication, but this remains to be seen in future trials.
Other hepatitis C treatments include massage, acupuncture, and relaxation therapy. Although none of these treatments has been shown in scientific studies to work, there is anecdotal evidence that they may help relieve hepatitis C pain and ease some of the side effects of standard treatment.
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