Natural treatments for viral hepatitis
Natural treatments for viral hepatitis encompass various herbal and dietary approaches aimed at supporting liver health and managing symptoms associated with different forms of the disease. Hepatitis is an infection of the liver caused by viruses, with types A, B, and C being the most prevalent. While conventional medical treatments are limited, particularly for initial infections, several traditional medicinal systems propose natural remedies. For instance, traditional Chinese medicine includes herbal combinations such as Shosaiko-to, which has shown some promise in improving liver function, although comprehensive long-term studies are lacking. Similarly, Ayurvedic practices suggest combinations like Kamalahar, which have demonstrated benefits in clinical studies.
Despite these potential treatments, evidence supporting the overall effectiveness of many natural remedies remains inconclusive or of poor quality. Certain herbs, such as milk thistle and Picrorhiza kurroa, have mixed results regarding their efficacy in treating viral hepatitis. Caution is advised, as some natural products may pose risks of liver toxicity, particularly when used without medical supervision. Additionally, the regulation of herbal supplements is often inadequate, raising concerns about potential contaminants. Therefore, individuals exploring natural treatments for viral hepatitis are encouraged to consult healthcare professionals to ensure safety and efficacy.
Natural treatments for viral hepatitis
Definition: Treatment of viral infections of the liver.
Principal proposed naturals treatments: None
Other proposed natural treatments: Astragalus, Ayurvedic herbs, Cordyceps, lecithin, licorice, liver extracts, milk thistle, phosphatidylcholine, Phyllanthus amarus, reishi, SAMe, schisandra, taurine, thymus extract, traditional Chinese herbal medicine, vitamin C, whey protein
Herbs and supplements to use only with caution: Barberry, beta-carotene, blue-green algae, borage, chaparral, coltsfoot, comfrey, germander, germanium, greater celandine, kava, kombucha, mistletoe, pennyroyal, picrorhiza, pokeroot, sassafras, skullcap, spirulina, traditional Chinese herbal medicine, vitamin A, vitamin B3
Introduction
Hepatitis is an infection of the liver caused by one of several viruses, the most common of which are named hepatitis A, B, and C. Hepatitis A is spread mainly through contaminated food and water, whereas hepatitis B is transmitted by sexual contact and by the use of contaminated needles. The route of transmission of hepatitis C is not completely clear but is believed to be similar to that of hepatitis B.
The first sign of hepatitis is called acute hepatitis. Hepatitis can also become a long-term disease known as chronic hepatitis. All forms of hepatitis cause jaundice, liver tenderness, and severe fatigue. Hepatitis A is the mildest form and seldom causes symptoms to continue longer than a couple of months. Hepatitis B and C produce more severe symptoms, which last two or three times longer and can become chronic.
Chronic hepatitis consists of persistent liver infection and inflammation that lingers long after the primary symptoms of the disease have disappeared. It can produce subtle symptoms of liver tenderness and continued fatigue and, over time, can gradually destroy the liver. Chronic hepatitis also appears to increase the risk of liver cancer.
The best treatment for hepatitis is prevention. One can avoid hepatitis A by practicing good hygiene and using the conventional preventive treatment, known as immunoglobulins, while traveling in areas where the disease is common. Hepatitis B can be prevented by immunization and by the same precautions used for preventing human immunodeficiency virus (HIV) infection. HIV precautions almost certainly decrease the transmission of hepatitis C, too.
Conventional medicine has little in the way of treatment for the initial hepatitis infection once it has started. Treatment for chronic hepatitis is developing but is still quite imperfect. The most effective methods involve varieties of interferon.
Proposed Natural Treatments
Traditional Chinese herbal medicine. Viral hepatitis has long been a serious problem in China and other parts of Asia, and for this reason, many herbal formulas to treat it have been devised. The traditional Chinese herbal combination Shosaiko-to (minor Bupleurum) has been approved as a treatment for chronic hepatitis by the Japanese Health Ministry. However, a search of the literature uncovered only one large-scale, double-blind, placebo-controlled study supporting its effectiveness. In this twenty-four-week trial, the efficacy of Shosaiko-to was tested in 222 people with chronic active hepatitis using a double-blind, placebo-controlled, crossover design. Results showed that the use of Shosaiko-to significantly improved liver function measurements compared with placebo. Although these results are promising, an absence of long-term evaluation limits their meaningfulness.
Other combination Chinese herbal therapies have also shown some promise for the treatment of chronic hepatitis, including those therapies named Bing Gan Tang, Yi Zhu decoction, Fuzheng Jiedu Tang, and Jianpi Wenshen recipe. However, the quality of most of these studies was again quite poor.
A well-designed, double-blind, placebo-controlled study evaluated a mixture of traditional Chinese herbs for people with hepatitis C and symptoms of fatigue. The tested mixture contained Radix astragali (6 percent), R. acanthopanax (8 percent), R. bupleuir (8 percent), R. et tuber curcumae (10 percent), R. glycyrrhiza (4 percent), R. isatis (14 percent), R. paeoniae rubra (14 percent), R. salviae (14 percent), Rhizoma polygonum (10 percent), and Herba taraxaci (12 percent). However, the mixture failed to prove more effective than placebo regarding symptoms or objective signs. Another complex Chinese herbal combination has also failed to prove effective. One Chinese herb widely advocated for chronic hepatitis B, Sophorae flavescentis, has not been shown effective, according to a comprehensive review of studies.
There are many incidents in which the use of Chinese herbs for treatment of hepatitis appears to have caused serious liver injury. Therefore, using Chinese herbs for hepatitis, except under the supervision of a physician, is not recommended.
Ayurvedic medicine. Ayurvedic medicine, the ancient medical system of India, has many traditional treatments for hepatitis. Some of these have undergone scientific evaluation. One such is a combination treatment called Kamalahar, which contains Tecoma undulata, Phyllanthus urinaria, Embelia ribes, Taraxacum officinale, Nyctanthes arbortristis, and Terminalia arjuna. In a double-blind, placebo-controlled study, fifty-two people with acute hepatitis were randomly assigned to receive placebo or this combination of herbal therapy at a dose of 500 milligrams (mg) three times daily for fifteen days. The results indicate that the herbal combination improved liver function to a significantly greater extent than did placebo.
Another combination therapy contains Capparis spinosa, Cichorium intybus, Solanum nigrum, T. arjuna, Cassia occidentalis, Achillea millefolium, and Tamarix gallica. In a poorly reported, five-week, double-blind, placebo-controlled study of thirty children with hepatitis A, the use of this combination formula apparently improved the rate of recovery compared with placebo. Benefits were also seen in a six-week study of thirty-four people with acute hepatitis. A third double-blind, placebo-controlled study evaluated the effectiveness of this combination in the treatment of a variety of liver conditions, including chronic and acute hepatitis, and found some evidence of benefit.
Single herbs have also been tried. In a double-blind trial of thirty-three people with acute viral hepatitis, the use of the herb Picrorhiza kurroa at a dose of 375 mg three times daily significantly speeded recovery time compared with placebo. The herb P. amarus has also been extensively studied as a treatment for chronic viral hepatitis, but it does not appear to be effective. Its close relative P. urinaris has also failed to prove effective. The quality of the reported studies remains poor, and Ayurvedic herbs cannot be regarded as a proven treatment for viral hepatitis.
Other herbs and supplements. The herb milk thistle has been proposed as a supportive treatment for viral hepatitis. However, study results are mixed, regarding both chronic and acute viral hepatitis. A 2007 review of all published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials and, even in those, milk thistle did not show more than a slight benefit. A subsequent review of nineteen randomized trials failed to find evidence of a favorable effect on viral hepatitis.
Chronic hepatitis can cause cholestasis (backup of bile in the liver). In a two-week double-blind study of 220 persons with cholestasis, the use of the supplement S-adenosylmethionine at a dose of 1,600 mg daily significantly improved liver-related symptoms compared with placebo. Most participants in this study had chronic viral hepatitis.
The supplement phosphatidylcholine has shown some promise for hepatitis. In one double-blind study, it enhanced the effect of interferon in people with chronic hepatitis C, but not in those with chronic hepatitis B. However, in an open study, phosphatidylcholine failed to produce improvements in persons with acute hepatitis.
One small double-blind study found the herb picrorhiza more effective than placebo for reducing signs of liver damage in people with acute viral hepatitis. However, this study was preliminary and had numerous flaws. Another study failed to find N-acetylcysteine at a dose of 600 mg daily helpful for acute viral hepatitis.
In Japan, an injectable combination of the herb licorice and certain amino acids is used for chronic hepatitis. However, it is not clear whether the treatment actually works. Even if this were established, the results would not imply that oral licorice would have a similar effect; furthermore, the high dosages used for treatment of chronic hepatitis may cause an elevation of blood pressure and other serious medical problems. Licorice designed for oral use should not be injected.
Thymus extract has been tried as a treatment for hepatitis B and C. However, the results of small double-blind trials have not been positive. One study of antioxidant supplements also failed to find benefit. Other common natural medicine recommendations for hepatitis include astragalus, Cordyceps, reishi, schisandra, taurine, vitamin C, and whey protein. However, there is no meaningful scientific evidence that these approaches work.
In Uganda, a cross-sectional study of 310 newly-diagnosed patients. While the results of the study failed to render confirmatory results regarding the efficacy of various natural remedies on hepatitis C, other valuable results were uncovered. The prevalence of herbal medicine use was high, but the knowledge and education surrounding the substances were low. Additionally, the belief in these substances' effectiveness in the public stemmed from individuals who began taking them while also changing lifestyle or diet habits, which worsened their condition. Rather than the addition of the natural remedy, the improvement the individual felt likely came from the change recommended by their doctor.
Herbs and Supplements to Use with Caution
Many natural products have the capacity to harm the liver. Furthermore, because of the generally inadequate regulation of dietary supplements, there are real risks that herbal products may contain liver-toxic contaminants even if the actual herbs listed on the label are safe. People with liver disease should not use any medicinal herbs except under the supervision of a physician.
All forms of vitamin B3, including niacin, niacinamide (nicotinamide), and inositol hexaniacinate, may damage the liver when taken in high doses. (Nutritional supplementation at the standard daily requirement level should not cause a problem.)
Many herbs and supplements have known or suspected liver-toxic properties. These include barberry, borage, chaparral, coltsfoot, comfrey, germander, germanium (a mineral), greater celandine, kava, kombucha, mistletoe, pennyroyal, pokeroot, sassafras, and various herbs and minerals used in traditional Chinese herbal medicine.
In addition, herbs that are not liver-toxic in themselves are sometimes adulterated with other herbs of similar appearance that are accidentally harvested in a misapprehension of their identity (for example, germander found in skullcap products). Furthermore, blue-green algae species, such as spirulina, may be contaminated with liver-toxic substances called microcystins, for which no highest safe level is known.
Some scientific articles claim that the herb echinacea is potentially liver-toxic, but this concern appears to have been based on a misunderstanding of the herb’s constituents. Echinacea contains substances in the pyrrolizidine alkaloid family. While many pyrrolizidine alkaloids are liver-toxic, those found in echinacea are not believed to have that property.
Whole valerian contains liver-toxic substances called valepotriates. Valepotriates, however, are thought to be absent from most commercial valerian products, and case reports suggest that even very high doses of valerian do not harm the liver.
Bibliography
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Yuen, M. F., et al. “Traditional Chinese Medicine Causing Hepatotoxicity in Patients with Chronic Hepatitis B Infection.” Alimentary Pharmacology and Therapeutics, vol. 24, 2006, pp. 1179-1186.