Should I wait to see if Milk Thistle help before I start Interferon+Riba Therapy ?

[JackABCD]

Hi friends,
I have completed all the preparations for the therapy, 3 months ago I did the biopsy and the doc recommended me to start with the treatment.
My liver status is like that: HCV from 1980 after blood transfusion because of injury and liver rupture, geno: 1b, last bx said: stage 2-3 grade 2-3, doc say these results are similar to the results from previous bx from 12 years ago, Alt is around 300, VL fluctuate between 2-4 millions.
10 weeks ago I have started with MT (milk thistle), MT definitely improve the general feelings. Fatigue, nausea and other sides of the disease disappeared since I take MT, but LFT and VL didn’t improve by MT. Now I consider to switch from Solgar MT which I used until now onto UltraThistle which is recommended by friends on this forum to be much more effective.
My questions are:
1) Should in my case I give a chance to UltraThistle before I start tx ?
2) What is the probability that UltraThistle will really improve my LFT ?
3) Assume that my LFT will come into norm or close to norm, does it mean that the liver doesn’t suffer further damage ? does it mean that I don’t have to do the Intereferon + Riba therapy ?
I will be happy to learn your advice.
Thank you.
Jack

[bobbyullc]

tell your dr, that we all"become older with age".
your choice.
i only look at the very real possibility that in 1-2 years tx will be very much SHORTER and much more effective. if i had the choice between 50% chance now with 48 weeks tx and 80-90% chance of svr with only 60 days tx time next year I would look at it. one year of this disease is NOT a long time.
please understand this is a laymans choice but one who did 48 weeks,is svr,and who wishes he could have waited for better tx.
best of luck and i only hope i have given you one more choice.

[JackABCD]

The doc that made the bx 12 years ago saw the reults from last bx (around 3-4 months ago) and he told me that the liver is (more or less) in the same situation (he is GI, not hepatologist, but considered as a very kowldgeable). The doc that accompany me today (he is a very good  hepatologist) said that he recommend me to do the treatement now and not to wait more years because we become older with age and there are also the posiibility that with age some other disease comes and then the overall situation become more complex.
Thank you,
Jack

[bobbyullc]

you say you stage was a 2-3...2-3 now as well as 12 years ago. if so it has not progressed at all in 12 years? may be you can wait another 12 years without progression?
i that is so you have VERY, VERY slow or no progression. i sure would wait the next year to see how tx advances.

[copyman]

jim, yes it was dr A in boston. i asked him what i should look for to know when to start treatment and he told me when my ALT increased to over 100. it has been 50-55 for the last year getting to the highest of 68 a few times. maybe he was just saying that  for my case since i had showed ALT stability for the last year?

[JackABCD]

words don't come easy to me now , you are so encouraging.
Wish the best for all of us.
Jack

[orphanedhawk]

I took silymarine, the active ingredient in milk thistle, for a year prior to beginning tx. I really didn't want to do the interferon/riba route. An herbalist made it clear to me that although it is good for the liver it will do nothing to stop the virus.

   I do have liver damage. Now that I'm done with tx, I'm taking milk thistle again. Personally, I've seen more improvement in my ALT from taking SAM-E, or at least thats what I think did it.

  There is no telling how easy or difficult tx will be for you. Its a **** shoot.        Good luck.

[Mr Liver]

Mr Liver - LFT 's indicate viral activity
-------------------------------------------------------
I would have thought it indicates Interferon activity. Cell death at least.
Not really anything to do with the virus, more our immune system.

Jack is not currently treating so I was speaking in that context. ALT is an indicator of ongoing inflammation and cell death.  Higher viral activity results in more cell death, which in turn releases greater amounts of ALT into the bloodstream.. This holds for whatever theory you ascribe to concerning liver cell death. (The most accepted theory among researchers is that  hepatocyte destruction is the result of a host-mediated immune response. In other words, our immune system is responsible for liver damage and inflammation.)

ALT is not a reliable indicator of viral activity when on treatment. As an example, many have ALT rise  substantially (I've seen 2X-3X upper normal limit) from pre-tx levels after the initiation of therapy, continue for months, and go on to SVR.

A strong host immune response coupled with the pharmokinetics of IFN may be the culprit in these cases, but I've never personally read or seen anything which supports this. Just speculation on my part.
Have a great day.
Mr Liver

[HappyDeb]

I just thought of something. When I had a hangover and had to go to work that day, I did, I sucked it up, knew I had responsibilities and went off to work feeling crappy, but made sure I took care of that commitment as good as I could that day. Being on tx. and feeling alittle funky on some days, well thats just like going to work on a hangover. You don't always feel that way, like any thing, you have good days and some bad. Oh well , that's enough  god bless again.

[HappyDeb]

You sound like a very smart man, but just alittle bit confused about treatment. Welcome to our world. Milk thistle will do nothing for your Hep.- C , THE RIBA/ INTERFURON Will, period. If you keep a great attitude, listen to your body and keep lines of communication open with your Dr. and nurse prac.about any changes in the way your feeling on tx. , like ringing in ears, fatigue, upset stomach, insomnia, these things can be delt with through meds. that will take the symptoms away, and you will feel fine and be able to function fine. Just take care of yourself on off times and rest. Don't ever feel bad that you do. You are helping your body. So let's see, try to stay off tx. and keep on getting worse till maybe it is very damaging, you will start to feel the effects of the Hep. c, and it feels just as bad as if you are on treatment, but on tx. you can get med.s to knock out those side effects, and keep on going till you are cleared of the DRAGON. You will function just fine on tx. if you listen to your body and rest it when you can and have a Great attitude on the goal of recovery.I work, take care of my house and dogs, and fiance'. I have a horse that I try to ride as much during the week, but if I can't , I wont get down on myself I will go there and just take care of him if I still have alittle energy after work, or if i am tierd, I listen to my body and go home and rest. You cannot feel guilty on tx. because you are helping yourself to get healthy again and live a longer life. I want to some day see my two daughters get married after collage and god spares have grandchildren for me, etc.... in other words there is so much more to do on earth with all the years left I have and I want them all, I don't want a virus to take away any years. I want to be in control of my own body. Yes, we get alittle weiry from time to time on tx. , but just look around at those times and see all those faces that love you, or the nature of life and that will take you back to why it is so important to get cleared and live life !!!!!!!!!!!!!! Tihs forum is a god sent, I don't always ask questions , but I always read the threads and when I do need some help from people that understand, we are always here for one another for a pat on the back, alittle shove or some info that we need with there knowledge of going through it longer then you. So I hope you make a desicion based on the facts and not the feeling of worry, ( or we all would have never have grown up if we always listened to our worries) there just that, worries, because we are not educated enough on a matter. Educate yourself and make an educated desicion instead of a push it off cause we don't understand desicion.



                                     God bless you, and you will prevail :)

                                         Debbie

[JackABCD]

I deeply appriciate your advice, I have to take the decision.

Acctually my ALT along the years flactuating between 100-370, it came once into the norm range and that was after a severe GB attak (later on the GB had been removed), I don't know if there is any relation but I had a liver rupture on 1980 and resection (part of the injury) of the right lob had been done then, so maybe LFT are impacetd also from the resection (I don't know).

My main concern about the Interferon therapy is if I will be able to manage my demanding work together with the therapy, .. but I must take the decision earliest.

Deeply appericiate your feedbacks and advice.
Jack

[jmjm530]

Interesting about the "ALT over 300" but not sure if that is a general thesis or based on your particular history. Right after taking some Chinese Herbs (and a Hep b shot) my ALT shot sky high (800 or so) and my doc likened it to an acute attack and told me to postpone treatment until my ALT's returned back to baseline.

The other thing is that ALt is not linear, so ALT 300 is not three times as bad as ALT 100, and in fact, a very renowned expert in liver disease told me that he usually isn't concerned how much ALT is elevated (within limits), once it's elevated. That said, I'm assuming it's the Boston doc that told you that, and he happens to be one of the best. So go figure.

FWIW I was able to bring my LFT's into normal range (high normal range) from slightly elevated (low 100's) by going on a Pritikin type of diet where total fat calories are around 10 per cent or under. Basically a high complex carb, low protein, very low fat diet.

-- Jim

-- Jim

[FloridaMouse]

I concur with copyman.

Mouse

[copyman]

glad you are feeling better. the milk thistle may make you feel better but will not stop the damage. your alt is very high at 300. earlier this month i saw one of the best hepatologist in the counrty and he told me to treat if i see my alt go over 100. some people with cirrhosis even have normal alt. just my personal opinion but if i was a stage 2 & high alt like you i would treat ASAP.

[CockSparrow]

Mr Liver - LFT 's indicate viral activity
-------------------------------------------------------
I would have thought it indicates Interferon activity. Cell death at least.
Not really anything to do with the virus, more our immune system.

Milk Thistle may reduce Sx and lower ALTs but does NOTHING to HCV, only masks damage, why bother?
CS.

[Mr Liver]

There are conflicting studies over the benefits of MT. I think the evidence is strong that it has certain hepatoprotective properties. Whether it has anti-viral properties is disputed by some, but the general consensus among researchers is that it has no apparent negative effect on HCV replication, nor does it eradicate virus through direct contact.

LFT 's indicate viral activity. It directly correlates to inflammation and ongoing injury to the liver.

Even if your LFTs should normalize, you still have a chronic disease, which is moderately advanced.
One-third of those with HCV have normal LFT's. Normalized ALT/AST is not a reliable indicator of whether there is any ongoing damage, although normalized LFT's do point to low viral activity which is better than the opposite.

I know nothing about specific brands of MT. Personally, I feed the stuff to the mountain finches whom I think will derive greater benefit from it than me. They go nuts over it and it only costs about $5 a pound !



Mr Liver