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Better Health Update #53 - Monte Kline, Clinical Nutritionist

Hepatitis

Hepatitis is an increasing common health problem that I find myself regularly asked to comment on. Hepatitis is inflammation of the liver, usually associated with a contagious viral infection. The most common symptoms of viral hepatitis include:

Dark urine
Fatigue
Loss of appetite
Nausea
Fever
Vomiting
Headache
Abdominal discomfort
Light stools
Muscle pain
Jaundice
Elevated liver enzymes

Hepatitis occurs in three or more forms. Exposure to a given hepatitis virus generally confers lifetime immunity, but only to that particular type of hepatitis. A typical hepatitis illness may last for six months, although about five percent of cases continue in a chronic form. Fatality rate for all types of the disease is one percent, though it is likely higher for Hepatitis B.

HEPATITIS A

Hepatitis A (HAV) refers to a viral hepatitis previously known as infectious hepatitis. It is usually a mild illness with symptoms of sudden onset of fever, nauseas, malaise, weight loss, abdominal symptoms, and jaundice after a few days. HAV is medically diagnosed by finding IgM anti-HAV antibodies in the blood serum during the early stages of the disease. HAV is spread through various means of personal contact associated with its excretion through the feces - often from contaminated foods and contaminated water.

One regularly hears of outbreaks associated with restaurants or food processing plants via an infected worker that didn't pay any attention to the signs telling them to wash after doing their business. Common foods associated with outbreaks include cold cuts, sandwiches, fruits, fruit juices, milk, milk products, vegetables, salads, shellfish, and iced drinks.
HAV is contagious two to three weeks before and one week after jaundice appears. Approximately 23,000 cases are reported annually in the U. S. Disease outbreaks are common anyplace with poor sanitation and crowding - institutions, housing projects, prisons, military camps, etc. However, 50-60% of the population over age 50 test positive for the virus antibodies, suggesting that most people have had the disease in a very minor form.

HEPATITIS B

Hepatitis B (HBV) is relatively rare in the U. S., but is epidemic in parts of Asia and Africa where hundreds of millions may be infected. HBV is spread through the use of contaminated syringes, needles, blood transfusions, blood sucking insects and sexual relations. It is believed to affect 85% of the homosexual population. Most of the transmission of the disease in Western countries relates to intravenous drug use and promiscuous homosexual and heterosexual activity. HBV can also be transmitted from mother to to infant at the time of birth. This is the primary means of transmission in the areas of the world where the disease is endemic. Hepatitis B is extremely contagious and can be fatal.
Hepatitis B virus can cause either acute or chronic hepatitis. Chronic infection is much more likely to affect babies and young children. Symptoms can range from relatively minor ones to hepatic failure, the later in 2% of cases. Typical acute infection symptoms include loss of appetite, nausea, vomiting, fever, abdominal pain and jaundice.
Medical diagnosis is done by blood test for hepatitis B surface antigen (HBsAg) and hepatitis Be antigen (HBeAg). Diagnosis is confirmed by liver biopsy. Chronic carriers of the disease, who are asymptomatic and have normal liver enzymes, usually show little if any inflammation on biopsy. Symptomatic individuals show varying degrees of liver inflammation on the biopsy, and may show fibrosis or cirrhosis (increased connective tissue) of the liver as well.
The only approved conventional medicine treatment for HBV is alpha-interferon. Other possibilities under investigation include nucleoside analogues and lamivudine (3TC).

HEPATITIS C

An additional category of hepatitis is called "Non-A Non-B Hepatitis." Prior to the discovery of Hepatitis C (HCV) in 1989, the non-A, non-B label was given to hepatitis following a blood transfusion that was not caused by hepatitis A or B. Hepatitis C, also known as parenternally transmitted non-A non-B hepatitis, is now believed to be the cause of most non-A non B hepatitis.

Approximately four million people in the U. S. are affected with HCV, the virus being primarily transmitted by blood and blood products. Sexual transmission between monogamous couples is rare, being much more common with the sexually promiscuous. Transmission between mother and baby at or around the time of birth is possible but rare. About 85% of those acutely infected with HCV become chronically infected (disease lasting more than six months). Some will have only minor symptoms without complications. Others will definitely manifest chronic hepatitis symptoms, 25% of whom will go on to develop cirrhosis of the liver. Of those with HCV and cirrhosis, about 20% eventually develop end-stage liver disease. Finally, those with cirrhosis from HCV are more likely to develop liver cancer.

Hepatitis C diagnosis is made from patient history, blood tests and liver biopsy. Most victims of HCV are either asymptomatic or have generalized symptoms, like fatigue, which could have many causes. The presence of anti-HCV antibodies in a high risk individual usually indicates hepatitis C.

HEPATITIS D

The alphabet soup of hepatitis continues with some forms most people have not heard of. Hepatitis D infection only occurs in the presence of hepatitis B infection. Like hepatitis C, hepatitis D is also transmitted by blood and blood products, most often infecting intravenous drug users. Alpha interferon is again the only approved medical treatment.

HEPATITIS E

Hepatitis E (HEV) is also called enterically transmitted non-A non-B hepatitis (ET-NANBH). HEV presents virtually identical symptoms to hepatitis A - malaise, weight loss, abdominal pain, joint pain, and fever. This form of hepatitis is usually associated with contaminated drinking water with major epidemics occurring in Asia and Africa. There have been no outbreaks of the disease in the U. S.

HEPATITIS G

In 1995 and 1996 several new viruses were identified that can cause acute and chronic hepatitis. Genelabs Technologies identified one as hepatitis G virus (HGV). This is currently under investigation, though it is unlikely that HGV causes very many cases of hepatitis. It is similar to hepatitis C and may be largely associated with intravenous drug use.

DIETARY APPROACHES

With hepatitis the diet should be low fat, low sugar, low protein, and high fiber. Saturated fats are generally bad for the liver and gall bladder. Research indicates that a high fiber diet increases the elimination of bile acids, drugs and other toxins from the system, thus helping the liver. Specific dietary suggestions include:

1. Avoid Animal Products - The higher you eat on the food chain, the more potential toxins you take in. The animals you eat were likely fed with grains that contained pesticides or herbicides, and probably had hormone and antibiotic injections as well. All that toxicity creates extra stress on your liver. Dairy products would have this same problem.

2. Avoid Caffeine - Coffee, black tea, cola, chocolate, cocoa should be avoided due to their stimulating effect on the liver.

3. Avoid Tap Water - Tap water contains chlorine, fluoride, and potentially other chemicals and disease organisms that your liver cannot handle. Drink only distilled water.

4. Avoid Junk Food - So-called "foods" composed of refined sugar, refined flour, hydrogenated oils, and various chemical additives destroy your health. Eating these adds stress to your liver.

5. Eat whole grains

6. Eat lots of vegetables and drink vegetable juices

7. Limit fruit intake to 1-2 pieces per day

8. Use soy milk or rice milk

SUPPLEMENTS FOR HEPATITIS

1. Milk Thistle - The silymarin content of this herb is a potent remedy for all manner of abnormal liver function, having been used in Europe for centuries for this purpose. Steven Bratman, M.D. and David Kroll, Ph.D. in the Natural Health Bible note that, "Preliminary double-blind studies of people with chronic hepatitis have shown significant improvement . . ." It has also demonstrated positive effects on cirrhosis, fatty infiltration of the liver and gall bladder inflammation.

2. Other Herbs - Various herbs have been used with liver problems over the centuries. Common remedies include dandelion, black radish, globe artichoke, and licorice root. We often use an herbal combination containing several of these.

3. Catechin - This flavonoid, derived from the herb, Uncaria gambier, has been shown in various studies to benefit liver problems. It decreases serum bilirubin levels in all forms of hepatitis. It also increases clearance of hepatitis antibodies from the blood and reduces liver enzyme levels. One study found that catechin improved liver blood tests about twice as fast as compared to a control group. It has antioxidant and free radical reducing properties, it stimulates the immune system, and stabilizes membranes

4. Liver Glandulars - Glandular supplements made from hormone-free beef liver have been used in the treatment of liver diseases for over 100 years. Studies have shown that these supplements promote liver regeneration and are effective in helping chronic liver disease including hepatitis.
5. Vitamin C - Large doses of vitamin C have been found to greatly improve viral hepatitis within two to four days and to clear jaundice in six days. One study found that just two grams of vitamin C per day totally prevented hepatitis B in hospital patients, while 7% of a control group not receiving that amount of C developed hepatitis. With hepatitis, vitamin C should be taken up to the point of bowel tolerance - typically 8 - 15 grams per day before diarrhea happens.

6. Vitamin B-12 and Folic Acid - Intravenous and oral administration of these B vitamins has been shown to shorten the recovery time from hepatitis.

7. Choline - Helps break down fats in the liver.

8. Methionine - This amino acid has a liver detoxifying effect.

9. Free Form Amino Acids - Free form amino acids are already broken down into the form the body can use, thus removing strain from the liver for protein digestion. This is the best way to get supplemental protein with a hepatitis condition.

10. Emulsified Vitamin A - This form of vitamin A bypasses the liver, unlike beta carotene, which has to be converted by the liver to vitamin A
.
11. S.O.D. (Superoxide Dismutase) - S.O.D. is a free radical destroying enzyme. This antioxidant is helpful to liver and various other problems affected by free radical damage.

Overall, the idea is to remove the stress from the liver, provide the nutrients it needs, and get lots of rest to facilitate the long healing process.

DISCLAIMER: The information contained in this publication is for educational purposes only. It is not intended to diagnose illness nor prescribe treatment. Rather, this material is designed to be used in cooperation with your nutritionally-oriented health professional to deal with your personal health problems. Should you use this information on your own, you are prescribing for yourself, which is your constitutional right, but neither the author nor publisher assume responsibility.