The part that caused me pause was.... "...1. Unsaturated fatty acids (corn oil, fish oil) exacerbate alcoholic liver injury by accentuating oxidative stress, whereas saturated fatty acids are protective."
I have NASH (and hep C), and I take omega 3 in the form of salmon oil. Am I exacerbating my cirhotic condition?
Polyunsaturated fatty acids (PUFAs) are more prone to oxidative reactivity/lipid peroxidation. They get rancid quicker for that reason, thats why all these food industries have originally introduced the trans fats.
On the other hand, the need for omega-3 PUFAs is so fundamental - see other threads- , that this handicap has to be overcome in other ways, As long as ALA ( alpha lipoic acid), NAC/Vit C, Taurin and possibly Q-10 are at proper availibility, the local antioxidant system will prevent the excessive Lipidperoxidation of PUFAs. You also take Resveratrol, that is very likely to be protective in that context.
There exist now precise, reliable ways to measure the oxidative damage to lipid molecules in a human, by determining endproducts of such chemical damage to fatty acids, by using a typical example - that is arachidonic acid. Its unwanted oxidation products ( by oxidative attack), are called Isoprostanes and are excreted in the urine where they can be precisely measured and they are very stable, providing reliable, reproducible parameters of general oxidative damage in vivo, in an actual person.
Using these advanced methods of determination of oxidative damage, I was actually able to show in the last few month, that, despite a very high intake of omega3 PUFAs, the lipid peroxidation can be held at extremely low levels, provided that all the protective measures are in place.
So since you are using all these other means, you should be fine and able to enjoy the dramatic benefits of w3-PUFAs without an increase in de facto oxidative damage in the liver. I assume that your daily DHA and EPA intake is around 600mg each.
Of course all the measures ( like diet, exercise, enteral Eubiosis) to reduce the NAFLD as previously discussed have to be pursued high level, because fatty liver exacerbates all these problems.
Thank you, I will stop worrying as I am on the liver lover supplements, (with the exception of Taurin?)
You mentioned PPC to take concurrently on tox; should I take begin taking it pre-tox? Any of these supplements to avoided while on tox? Thank you much.
Whether to avoid these protective supplements during Tx is the billiondollar question. It might work both ways - as improvementof SVR rates - as shown with PPC - or by "protecting" HCV infected hepatocytes to be wiped out, by reducing inflammation - delaying SVR.
Since people fail tx/SVR for any number of reasons, nobody wants to be responsible/accused of having given any advice that is not mainstream. Thats also why everyone will avoid milk thistle while on tx - well mainly because everyone says so. Since both mechanisms -see above- can be envisioned I do not know the answer to this unfortunate dilemma myself. The argument in favor of a good glutathione system ( by NAC/Vitc, ALA, Taurine, SAMe)eg is that it also fosters functionality of the immune defense, thereby quite probably improving the chances for SOC, by that token...
Right, reading between the lines here.... No hard data and it may be a **** shoot, and of course I will ultimately have to make this decision alone, and live with the end result entirely on my own. Not a problem. Um, by the way, what might you do in a similar situation? Just wondering is all.
Thanks for the link and info. For some reason hadn’t paid much attention to AFLD.
There’s a Journal just on Alcohol and related diseases, bugger!
Alcohol (the Journal) has heaps of interesting articles in it. The issue with the article you posted has 4 or 5 related ones. Have to consider subscribing to it. Pity it costs $300, oh well.
What struck you about the article may have been the link between polyunsaturated fats and steatosis, but for me it was this.
Polyenylphosphatidylcholine may prevent liver injury by down-regulating cytochrome P450 2E1 activity, attenuating oxidative stress, reducing the number of activated hepatic stellate cells, and up-regulating collagenase activity.
Now where have I seen this mentioned B4??
Anyway thought you might be interested in this smallish study.
Insulin resistance and response to therapy in patients infected with chronic hepatitis C virus genotypes 2 and 3
Journal of Hepatology 48 (2008) 28–34
Results: The overall SVR was (77%). Patients with a SVR had lower mean serum insulin (10.7 ± 0.8 lU/ ml vs. 22.2 ± 4.9; P = 0.03), fibrosis stage (1.9 ± 0.1 vs. 2.7 ± 0.3; P = 0.007) and insulin resistance measured by the homeostasis model (HOMA-IR) (2.5 ± 0.2 vs. 6.1 ± 1.5; P = 0.03). Age, gender, ethnicity, alcohol consumption, treatment regimen, viral load, portal activity and steatosis did not influence the SVR.
By linear regression, body mass index (P < 0.001) and fibrosis stage (P < 0.001) were independently associated with HOMA-IR. After adjusting for fibrosis stage, patients with HOMA-IR of <2 were 6.5 times more likely to achieve SVR than those with HOMA-IRP 2.
Conclusions: Even in treatment-responsive genotypes 2 and 3, high HOMA-IR is associated with a reduced response.
Improving insulin sensitivity may be a useful adjunct to anti-viral therapy in these individuals
Thanks for that. My doc suspects I may have failed treatment due to steatosis (as geno 3, prone to this). And I am on diet and excercise regimen to improve this. My insulin has not been checked yet but he says he may prescribe something to offset this condition. I will have to take careful notes when next I see him. I take PPC.
I've been doing the fat thing with my riba pills. I've been trying to use mostly 'healthy fats' like avocado, walnuts and olive oil. I also use the 'bad' stuff like milk, cheese, and eggs too. The only supplement I take is vit D. Would it be better for me to stick with the 'bad' stuff or take those supplements you mentioned?
Is there anyway to get all that stuff through diet? I'm kind of NOT rich.
I think there are two different issues here. One, what type of fats (and how much fat) might be good for your liver pre and post treatment. The other issue is that ribavirin absorbs better with fat during treatment. Therefore, eating "healthy" might be a priority before and after treatment, but during treatment -- at least for me - I ate what I would term "survival" -- meaning I ate whatever I could tolerate (which was little) with the intent of not losing too much more weight which might have kept me off treatment.
I also tried to include whatever fats I could tolerate (some foods made me nauceous) when I took my riba. Fortunately, my cholesterol went way down during tx (because of the interferon) so probably no real damage done.
Thanks for posting. Very interesting. You might find this site helpful when posting those very long URL's like in this post. That way the width of the thread remains within the computer monitor :) http://tinyurl.com/
Off treatment Omega 3's (flax, nuts,seeds) are good because they are anti-inflamatory by nature but on treatment a more pro-inflamtory effect is desired from the omega 6's (egg yolks, olive oil, dairy and red meat). Look up Archiodonic Acid in Omega 6's and Interferon treatment.
Just lay off the flax seeds or other fiber supplements within 2-3 hours of taking your ribavirin during treatment. In theory impedes riba absorption. Same with antacids. A meal with fat in it, on the other hand, inhances the bioavailablity of ribavirin.
Good advice. Fortunately I had no problem with food on tx. (actually gained weight) so downing the Riba after ice cream should pose no problem for me. Unfortunately ,I will probably have to suspend the Reservatrol on tx as it is blasting everything right through me!
Hello all......was reading the above threads and what HR said alarmed me for I was told by my doc it was Ok to take Milk Thistle and I take Essentail Fatty Acids (omega 3's/6's) along with a multi, extra C, ALA, extra E and Selenium. He knows about these and said fine to take. I have always supplemented my diet but added the MT and altered the supps once I was DX this last summer. I also take fiber as needed and he did tell me to take that in the middle of the day with lunch and never with the Riba.
If it matters I have no other medical issues at all such as fatty liver or diabetis.
Have I been led astray? I don't think he really "knows" and probably just does not put much credence in supplements, herbs and vitamins.
Could the Milk Thistle or the others be causing a negative impact on my treatment. Should I discontinue? I will do shot 6 of 24 tomorrow. Is it too late since I am past the so important 4 week mark? I am waiting for that viral load test to come back.
Thanks.....I think....jury still out I guess. Same on the milk thistle? HR's comment scared me. If you find out anything good, please let us know.
I did not mean to get off track because the subject of fat is what interested me. I seem to have cravings for the kind of fats I should not eat so I take the good fats in supplement form since I have become a picky eater. Some foods just taste weird.
I am new here, but my understanding is that fiber can in essence absorb any thing you take with it as part of creating the bulk. Dont know if this is fact or speculation. I have also heard not to take it with supplements and vitamins for the same reason.
The fat as I understand it binds with the Ribavirin making it's "shelf life" longer. Stays with you longer I guess or perhaps keeps the blood level more even.
Hope that helps. Hopefully some of the "oldies" can shed some more light on this. The tip about the fiber my doc seemd very strict about when I gave him my list of supplements. He did not seemed concerned about when I took the vitamins, Omegas and milk thistle.
I asked him about taking the EFA's (essential Fatty Acids/Omegas) and since they are "fat" said would be OK to take with the Riba. Hope he is right about that and that Milk Thistle is OK. It's all such a Cr*p Shoot!
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