Milk Thistle while taking Interferon:

[illo]

One last time....
Milk thistle & Interferon--Dr. Weil's answer:

http://www.drweil.com/drw/u/id/QAA326618

Q  
Looking for a Liver Cure?
Is it okay to take milk thistle with interferon injections?
A
Answer

You definitely can - and should - take milk thistle if you're being treated with interferon (for chronic hepatitis B or C, I assume). Milk thistle (Silybum marianum) is an herb that protects the liver from toxic injury and stimulates regeneration of the liver. It does this by enhancing the metabolism of hepatocytes, the working cells of the liver. Milk thistle products are available in health food stores. Look for standardized extracts in tablet or capsule form, and follow the dosage on the label. You can take milk thistle indefinitely.

I've known a number of patients who have reversed hepatitis C using milk thistle in conjunction with another natural remedy, Schizandra (Schisandra chinensis), the fruit of a Chinese plant. Schizandra berries, like milk thistle, are nontoxic and support healthy liver function. I usually recommend them as part of a natural treatment protocol developed by Dr. Qingcai Zhang in New York. (www.dr-zhang.com)

Hepatitis is an inflammation of the liver. There are several forms of viral hepatitis (the type treated with interferon, an anti-viral drug). Hepatitis C is a progressing disease that slowly destroys liver cells even while infected people remain symptom-free. It typically is diagnosed after a patient complains of fatigue or abdominal tenderness or after routine blood tests show elevated liver enzyme levels. Hepatitis C is transmitted by infected blood (via blood transfusions, hemodialysis, or by sharing needles with intravenous drug users). The disease usually becomes chronic, and in about 15 percent of cases (over a period of 20-30 years) leads to cirrhosis of the liver and, sometimes, liver cancer.

Hepatitis B, also due to a viral infection and common in parts of Asia, becomes chronic in only five to 10 percent of cases. It is transmitted via blood transfusions, IV drug use, sexual contact, or from an infected pregnant mother to her fetus. Symptoms include jaundice, loss of appetite, nausea, vomiting and fatigue. Milk thistle can be safely used with the medical treatments available to treat either type of hepatitis.

Andrew Weil, M.D.

[jmjm530]

In all due respect to Dr. Weil -- first, he's not a hepatologist (liver specialist) and second, a number of us have been told NOT to take milk thistle during treatment from our hepatologists. Personally, I would not want to take any chances with something as the unstudied interaction of milk thistle and SOC. Most doctors feel milk thistle is OK to take before and after treatment, but again, not on treatment. One member posted that their doctor wanted them off milk thistle for several months before starting treatment.

-- Jim

[illo]

Like I said before, my hepatologist at yale, who's also on the NE liver foundation, said to take it.

[illo]

Another point to consider.  If they all knew what they were doing, we'd all be SVR.  They don't and we aren't.  No one is an expert in this disease or there'd be a cure.  Do what you feel in your heart.

[jmjm530]

Child: How do they know the chances of SVR taking Milk Thistle along
with SOC??? confused (again
-----------------------------
I think that's the point. It's never been studied to my knowledge.

Illio, I didn't realize your doctor told you to take Milk Thistle because you posted what Dr. Andrew Weil (not a hepatologist) said, who I assume is not treating you.

As you so correctly stated, if all the experts knew what they were doing we'd all be SVR and we often find well-respected experts on two sides of the same issue.

I'm certainly not saying your doctor is wrong, just pointing out what some other doctors have said, as well as my personal opinion which is don't add too much stuff that affects the liver to SOC that  hasn't been studied. So, given my view, if half the docs said take milk thistle and half said don't, I'd probably take the conservative viewpoint and not take it, and if memory serves me some here reported that their pretty big hitters said don't take it during treatment.

-- Jim

[jmjm530]

Here's a little reading on milk thistle both on and off treatment (scroll down for the second article). The third article brings up the possiblity that milk thistle could interfere with the action of peg and riba but that a controlled study is necessary. Apparently one such study was underway six years ago, and maybe someone so motivated might try and track down the results.

http://www.hcvadvocate.org/news/newsLetter/2004/advocate0704.html
http://www.clevelandclinicmeded.com/hcv/litreview7.htm
http://tinyurl.com/35w9wb

[orphanedhawk]

  I am glad you brought this up. Everyone gets all shook up when you say Milk Thistle. Believing in conspiracy theories like I do, I figure its the pharmaceutical companies that don't like anything they can't regulate and therefore make big bucks from, who are to blame for the controversy.
    My heptologist has no problems with me taking it.
jm: Are there studies showing the effect  using basil on your pizza? Basil is very strong herb.   Milk thistle has been used to assist the liver for generations in Europe.

[jmjm530]

OH: Are there studies showing the effect using basil on your pizza?
--------------------------------------------------------------------
As a conspiracy theory afficinado, you're probably aware that the pizza industry has been suppressing all basil studies for years. Speaking of which, ever wonder why they stopped tossing pizzas in the air around ten years ago? Well, I have my theories and that's why I quicken my pace when passing any pizza shop.

-- Jim

[orphanedhawk]

LOL. Thankyou so much for the laugh.
    My emotions are so all over the place, I get nervous when I see someone writing back to me, wondering which foot is stuck in my mouth this time.
    The truth is those botchagaloops can't toss a pizza because they couldn't make a good crust if their mamas hit them with a rolling pin. I do know of a few secret pizza parlors where they still toss the pizza. Makes the crust even.
        Pizza. Blessed be the holy pizza, found coast to coast and on all continents. Peace be to the pizza makers.   :)
  
  

[jmjm530]

OH: I do know of a few secret pizza parlors where they still toss the pizza.
---------------------
Oh, the good ole' days! If docs could treat as well as the oldtimers could throw the pie, we'd all be in better shape.

Be well,

-- Jim

[R Glass]

I am glad this was brought up. I am sure that Milk Thistle is an old topic for the Veterans of this Forum. This forum seems to get new members daily, like myself, are rookies to the knowledge of HepC. I spoke to my Dr. a few weeks ago and I was surprised at how receptive and interested he was when I told him, I am taking Milk Thistle for my Liver and plan to start Gluconutrients for my immune system. He said it wouldn�t hurt anything. He wants to check my blood in July for changes. I didn�t know to ask him about taking it when treatment starts in October. This will be added to the list of questions to ask him on my next visit. My list would be short if it wasn�t� for this forum. Thanks again, R. Glass

[jmjm530]

Yes, Milk Thistle is a topic that comes up a lot. Overall, the consensus seems to be that it can be helpful before and after treatment, with a split decision during treatment. I've found the current discussion educational and have learned a few things not previously posted. I hope others have as well.  

Personally, I only took milk thistle once before treatment but it made me sleepy. Same with St. John's Wort. So maybe I'm just a sleepy folk :) Still, I might try it again at some point but right now I'm off all supplements and even vitamins. I didn't stop taking Vitamins because of the recent news stories, but they are interesting if anything to show how many different ways there are to look at things. Sometimes I think a ouije board would be helpful.

For those interested, here are some recent news stories about vitamins.
http://news.google.com/news?hl=en&ned=us&q=vitamins&btnG=Search+News

All the best,

-- Jim

[gazebo1]

My doctor is a respected researching hepitologists in Chicago  and has been involved in several trials and studies (he is leading a current one involving diabetes and various HVB combo treatments). When I was preparing for my TX he said Milk Thistle would not have any effect on effectiveness of antivirus therapy. . . and he has never seen any evidence to suggest the contrary.  Told me to continue if I wanted. He has been treating for 15 years.  

Regards,  G

[mikesimon]

Inhibition of T-cell inflammatory cytokines, hepatocyte NF-kappaB signaling, and HCV infection by standardized silymarin.

Polyak SJ, Morishima C, Shuhart MC, Wang CC, Liu Y, Lee DY.

Department of Laboratory Medicine, University of Washington, Seattle, Washington; Department of Microbiology, University of Washington, Seattle, Washington; Department of Pathobiology, University of Washington, Seattle, Washington.

Background & Aims: Chronic hepatitis C is a serious global medical problem necessitating effective treatment. Because standard of care with pegylated interferon plus ribavirin therapy is costly, has significant side effects, and fails to cure about half of all infections, many patients seek complementary and alternative medicine to improve their health, such as Silymarin, derived from milk thistle (Silybum marianum). Milk thistle's clinical benefits for chronic hepatitis C are unsettled due to variability in standardization of the herbal product. Methods: In the current study, we focused on the anti-inflammatory and antiviral properties of a standardized Silymarin extract (MK-001). Results: MK-001 inhibited expression of tumor necrosis factor-alpha in anti-CD3 stimulated human peripheral blood mononuclear cells and nuclear factor kappa B-dependent transcription in human hepatoma Huh7 cells. Moreover, MK-001 dose dependently inhibited infection of Huh7 and Huh7.5.1 cells by JFH-1 virus. MK-001 displayed both prophylactic and therapeutic effects against HCV infection, and when combined with interferon-alpha, inhibited HCV replication more than interferon-alpha alone. Commercial preparations of Silymarin also displayed antiviral activity, although the effects were not as potent as MK-001. Antiviral effects of the extract were attributable in part to induction of Stat1 phosphorylation, while interferon-independent mechanisms were suggested when the extract was biochemically fractionated by high-performance liquid chromatography. Silybin A, silybin B, and isosilybin A, isosilybin B elicited the strongest anti-NF-kappaB and anti-HCV actions. These effects were independent of MK-001-induced cytotoxicity. Conclusions: The data indicate that Silymarin exerts anti-inflammatory and antiviral effects, and suggest that complementary and alternative medicine-based approaches may assist in the management of patients with chronic hepatitis C.
Mike

[GrandmaA]

Fascinating study. Dr. Zhang told me not to take milk thistle while on tx, but I am taking 3 other of his herbs and stopped another one. I'm glad we can have an honest disagreement without a big fight.

[mauilady]

My hepatologist said Milk Thistle SHOULD be taken during Tx... so I've been taking it all along, and so far with good results.

[Mr Liver]

I wouldn't mess with MT unless the doc advocating its use could produce a convincing study showing no reduced efficacy of tx drugs. At this time I believe that to be an unsurmountable task. The two largest studies ever done on this topic yielded conflicting results, indicating that more research was needed . A definitive answer as to the effectiveness of MT alone, or during tx has yet to reach a concensus among the medical community.

This debate always reminds me of the AIDS/HIV community some years ago when they were told by the research medical community that the St John's Wort they had been taking for depression the whole previous decade had been rendering the most important drug in a 4 drug combo useless because of a drug interaction.. Some folks went to a grave perhaps a little sooner than  they should have as a result.Keep in mind that this practice amongst the AIDS community to use St John's Wort for depression was done so because it was 'natural' . It was in widespread use for ten plus years before the discovery was made through research.

So, until the the research is done (if ever) there is only anecdotal evidence for doctor's to rely upon for their advice in this area. And since there has never been anecdotal evidence to suggest a higher SVR rate if using MT during tx, I'm left wondering why these doctors advocate the use of MT on tx in the absence of hard evidence showing it has no intereaction with tx drugs.. I strongly disagree with this type of advice. And the content , as well.

[geterdone]

My thoughts also, Why? would anyone take anything other than what the present research has shown in combating this virus. Why the supplements? (rescue drugs) To me, it�s just one more chemical interacting with the poisons we are now taking. I take a Iron and Vitamin C supplement prescribed by my doc. and that�s it other than the Interferon, Procrit and the all in-cumbersome Ribirvin. Dose it make me crazy, all the time. The magic pill does not exist as of yet. Some say the Iron is toxic to the liver, show me a study, I�ve looked and there is not much out there to be all inclusive as some have Advocated.  

jasper  

[mikesimon]

See: http://www.liverdisease.com/diet.html
IRON AND HEPATITIS C
The liver plays an important role in the metabolism of iron since it is the primary organ in the body that stores this metal. The average American diet contains about 10- 20 mg of iron. Only about 10% of this iron is eliminated from the body. Patients with chronic hepatitis C sometimes have difficulty excreting iron from the body. This can result in an overload of iron in the liver, blood, and other organs. Excess iron can be very damaging to the liver. Studies suggest that high iron levels reduce the response rate of patients with hepatitis C to interferon. Thus, patients with chronic hepatitis C whose serum iron level is elevated, or who have cirrhosis, should avoid taking iron supplementation. In addition, one should restrict the amounts of iron rich foods in their diet, such as red meats, liver, and cereals fortified with iron, and should avoid cooking with iron coated utensils.

[SJL]

This might not be the right time for this question-but-I am a 2 time relapser(100 + wks.) and I am not considering another round of chemo, unless it is ABSOLUTELY necessary.

My Hepatologist has told me that I can try anything out there & it certainly could do no damage. At one point I bought herbal supplements, but I have never started them?

I am contemplating Hypnosis, Herbals, Chiropractic, Acupuncture--anything & everything.

Any thoughts as to which to try first? Also, if anyone is on alternative meds, could you please supply me with a list of these with amounts taken? Their seems to be a huge controversy on amounts.

I am a 1B, stage 3. grade 4, with beginning cirrhosis. F, age 63, and have been left with a mutitude of related??? problems due to interferon therapy.

Somehow, Someway, Someday-I must get rid of this disease & back to a semi-normal state. This has been going on for 4 yrs., and I can't take much more! Life as I once knew it does not exist.

Please, don't hesitate to give your opinions.

Sandy

[mikesimon]

I don't have a lot of faith in hypnosis or chiropractic care as a treatment for HCV or liver injury/damage. Of course, a postive outlook helps with most situations and if you can achieve that from those approaches they could be of help. I doubt that any of the things you mentioned will improve your liver architecture but if you haven't been biopsied or undergone the new less invasive Fibroscan since treatment then you might find that the two years of treatment may have improved your liver architecture some. Improvements have been seen in some patients who underwent TX yet didn't eradicate the virus but those who achieve SVR generally enjoy a more beneficial result. The study I cited suggests that milk thistle extract does exhibit beneficial properties on HCV so that might be a good place to start. This is the only "apparently" reputable study I've seen on milk thistle and HCV and treatment so I am not convinced that the conclusions are valid but from a distance they look good. Good luck, Mike

[jmjm530]

Sandy: I am contemplating Hypnosis, Herbals, Chiropractic, Acupuncture--anything & everything.
-------------------
Certainly not all that knowledgeable in alternative medicine, but of the list presented, I'd think that "Herbals" would present you with the best chance of slowing down fibrotic progression. That said, herbals also carry the most risk, if the wrong herbs are used.

For that reason, I'd suggest finding an herbalist with experience in treating Hep C patients. Two that come to mind are Dr. Zhang in NYC and Misha Cohen in California. I have no personal experience with either but have heard good things here about both. In addition, I would monitor your liver enzymes frequently, especially in the beginning of any herbal treatment -- and once every week or two wouldn't seem too much, espcially when introducing a new herb into your regimen. In addition, you might want to more closely monitor your actual fibrosis level. In addition to needle biopsy, the Fibroscan device and the Fibrosure blood test come to mind, with Fibroscan being the most desireable. Fibroscan is at trial centers in Boston with Dr. Afdhal and a few other places here: http://clinicaltrials.gov/ct/search?term=fibroscan&submit=Search
It is also privately available in Miami with Dr. Schiff and with HR (for selected patients) in CA. For "HR", best to address a post to "Forseegood" who can put you in touch.

Also, I have heard that a number of medical centers are starting to order Fibroscan privately, so checking the research hospitals in your area make sense.

Outside of treatment, I think an agressive herbal approach -- possibly with the addition of acupuncture -- combined with frequent monitoring -- needle biopsy every 3 years -- and both Fibroscan and Fibrosure at least once a year, and liver enzyme and other blood tests at least monthly, would be an approach I'd personally take if in your position. That way you can tell if the herbs are doing any good.  

All the best,

-- Jim

[mikesimon]

Do you think it's realistic to think she could get a script for monthly or semimonthly labs? That's is frequent for someone treating with medically approved drugs let alone herbs. I would guess that if she got a script for monthly or semimonthly labs she would have to pay out of pocket for them and that ain't cheap. Mike

[jmjm530]

I'm 14 months post treatment and still get my labs covered. Probably average around once every other month for this or that. My usual labs are a full panel that includes liver enzymes, a full metabolic panel, CBC and every four months or so a thyroid panel. Recently I've been testing for testosterone which seems lower after treatment and I always throw in the aforementioned panel.

I have no idea what Sandy's insurance situation is like, but what I've found is that if the doctor feels the tests necessary and writes an RX, the insurance will pay, and if for some reason the required dx code isn't supplied, most experienced liver specialists know what code is applicable. In any event, the fact that Sandy has HCV and has treated, seems to warrant, at least to me, medically necessitated follow-up tests.

In the event the insurance does not pay, then I suppose Sandy could order the minimum testing required by her doctor to monitor any herbals, which I assume would be an enzyme panel. Probably cost less than the herbs themselves which are often not cheap. Personally, I wouldn't do any herbs unless at least my liver enzymes were frequently monitored, especially since I had a bad experience in that regard prior to treatment.

-- Jim

[jmjm530]

Regarding dx codes, etc -- in addition to liver disease and its monitoring, many different conditions call for a comprehensive metabolic panel such as diabetes, kidney problems, hypertension, as well as monitoring the effect of any rx drugs someone may be taking. Again, I never found a problem getting tests ordered, but I would think an experienced doctor would be able to find the appropriate diagonsis code for a patient if denied the first time -- especially since so many of us have multiple conditions that are being medically tracked, due both to our age and possibly to HCV or the SOC drugs.

-- Jim

[mikesimon]

As you know I get tested a lot but going from what I read here doctors are, as a rule, not inclined towards frequent testing - PCRs in particular. I don't know of anyone other that transplant recipients who get tested monthly for HCV or weekly or semimonthly for liver panel/CBC absent some aggravating circumstances. But, I would love it if everyone could get tested more frequently so if it's possible I am all for it. Mike

[jmjm530]

I agree that doctors on the whole don't do what I'd consider frequent PCRs, although more frequent testing is starting to become standard with the more current hepatologists. Dr. Jensen, for example, in the Dieterich/Jensen video at Clincial Options recomending monthly VL testing during tx. My doctor did same with weekly VL testing until I was non-detectible.

In Sandy's case, while periodic VL testing would be ideal, more important (and I assume easier to get an rx for) would be periodic enzyme testing to make sure that any herbal regimen isn't aggravating the liver, plus some form of actual or virtual biopsy to track progress or lack thereof.

I know for example that my doctors would want to track my liver enzymes if for example, I started Statins. Lately, I just checked my liver enzymes because I had the Hep B vaccine and wanted to make sure I didn't have a bad reaction as may have happened last time. In the statin example, I believe my doctor recommended enzyme testing after three months but would have no problem if I tested it after one month. Always seems like there's a reason to check liver enzymes, if you and your doctor thinks it important.

All the best,

-- Jim

[jmjm530]

I don't want to leave the impression that it will be easy to get all the tests I suggested, because we've both read the same posts over the past couple of years, and as you suggest, doctors on a whole seem what I'd call "stingy or imprudent" (others may call it prudent or economical or reasonable) with both the types of tests ordered and their frequency.

My doctor once told me when I asked for a test he hadn't ordered (or when I asked for a test more frequent, can't remember 0 something to the effect -- the more information the better. So, what I really want to say is that there are doctors out there who will test more frequently if they think it reasonable and there are insurance companies that will support these tests. Hopefully everyone will get the tests they need, with "need" sometimes being hard to define.

-- Jim

[geterdone]

Thanks for the link mike, the one thing that stick out to me in the post is....
>Studies suggest< that high iron levels reduce the response rate of patients with hepatitis C to interferon.

Here is the other side of the coin, responder vs non responders

http://www.springerlink.com/content/l2894n2212h771q8/


Abstract  To date, there are no firm clinical, demographic, biochemical, serologic, or histologic features predicting which patients with chronic hepatitis C are more likely to respond to therapy with interferon- . Serum iron, total iron-binding capacity, transferrin saturation, and ferritin were measured in the fasting state. The amount of stainable iron in liver biopsy specimens was evaluated histochemically as well. All patients received subcutaneous recombinant human IFN- 2a three million units thrice weekly by self-administration. Eleven of 13 (84%) responders had low to normal serum iron levels as compared to one of 26 (4%) nonresponders (P<0.001). The serum transferrin was similar in both groups, but iron saturation was significantly lower in responders (30�10%) than in nonresponders (53�12%) (P<0.001). Serum ferritin and hepatic iron content were higher in nonresponders (NS). It is suggested that increased serum iron and transferrin saturation blunt the action of interferon, as they have opposite effects on the immune system. Iron overload can thus lead to a poor response to interferon.

>It remains to be seen whether reducing iron overload will improve the response to interferon therapy<.


The Iron is working for me and has helped in so many ways especially in the serotonin area. My liver enzymes from the latest CBC and full panel test 05/50/07 as I'm told by the doc. are in the normal range.
Thanks
jasper

[Mr Liver]

There are many studies that show iron is toxic to the liver. How much vitamin C are you taking per your doctor's orders ? Anything over 65 mg is not good for someone with a compromised liver. Unless you suffer from iron deficient anemia you should not be taking supplements of iron, or vitamin C.

A few facts that any liver doctor should know:
Vitamin C increases the absorption rate of iron in the liver (not a good thing). Iron stimulates stellate cells which produce collagen. Collagen, of course, is what makes up fibrotic strands. Stimulating the production rate of collagen is not a good thing at all.

Yours in truth,
Mr Liver

[geterdone]

Vitron-c // 125mg Vc and 200mg I // 1 tab daily, I am Iron deficient and have been on procrit 40k for the last 6 weeks for the anemia. The latest cbc 05/05/07 shows that my WBC 2.9 / RBC 3.78 have come up slightly and platlets are now 131 from 142, not sure what to think about them.

jasper

[Mr Liver]

"My Hepatologist has told me that I can try anything out there & it certainly could do no damage."

That has to be the most irresponsible comment attributed to a "hepatologist" I have ever heard ! I hardly know where to start with such a remark.

It is a medical fact that a person with a more compromised liver will not tolerate toxins as well as one less so. Toxic levels can be reached with lower exposure in someone with a compromised liver v a healthy one. In other words, it is easier to damage a compromised liver with toxins. And it is exactly this type of person who should make all attempts to avoid anything that could possibly cause harm to the liver.

Nearly one-third of all imported Chinese herbs are contaminated with various drugs, arsenic, lead, and other heavy metals. You play Russian roulette when you play with imported herbs. It is beyond comprehension why a doctor, ANY doctor, let alone a hepatologist, would make such a comment regarding experimentation with a severlely damaged liver, such as yours.

I could name a few more non-traditonal treatments that can cause great harm to the liver that you should avoid at all costs. Colloidal silver, for one.

Those of us with very little liver left have to be kind to it. Your doc has it all wrong. We are the ones who have to guard against doing irreparable harm to our livers more than anyone else on earth.

Your in Truth,
Mr Liver

[Mr Liver]

jasper,
Tx-nduced anemia as a result of ribavirin is hemolytic, and has absolutely nothing to do with iron defiency. Procrit is not intended to increase iron levels. This is not the mechanism by which it works. If these are the reasons you are taking iron supplements I believe you should re-evaluate that position. Now, if your actual iron levels are low , then iron supplements are reasonable under your doc's supervision. BTW, your vitamin C intake is not that high. Still, for those with severe liver disease its best to be even lower.(65 mg)

Yours in truth,
Mr Liver

[geterdone]

no they are two seperate issues.

Thanks
jasper

[GoofyDad]

OBJECTIVE: Nonalcoholic steatohepatitis (NASH) is a common cause of liver disease. Although usually indolent, this disease can progress to cirrhosis in some patients. There is currently no proven medical therapy for the treatment of NASH. The aim of our study was to evaluate the efficacy of combination alpha-tocopherol (vitamin E) and vitamin C in reducing histologic inflammation and fibrosis. METHODS: This was a prospective, double-blind, randomized, placebo-controlled trial with a total enrollment of 49 patients; 45 patients completed the study. All patients were randomized to receive either vitamins E and C (1000 IU and 1000 mg, respectively) or placebo daily for 6 months, based on their initial histologic diagnosis of NASH. Additionally, all patients were given standard weight-loss counseling and encouraged to follow a low fat diet (<30 fat g/day). The pre- and posttreatment liver biopsies were reviewed by a single pathologist, who was blinded to the patient's medication. Biopsies were scored based on a modification of the scoring system published by Brunt et al. (Am J Gastroenterol 1999;94:2467-74). A score of 0-4 was possible for fibrosis, and a score of 0-6 was possible for inflammation and hepatocyte degeneration and necrosis. In addition, body mass index, glycohemoglobin, lipids, and liver enzymes were followed throughout the study. RESULTS: Forty-five patients completed 6 months of therapy without significant side effects. Vitamin treatment resulted in a statistically significant improvement in fibrosis score (p=0.002). No changes were noted in inflammation with treatment.Vitamin E and vitamin C, in the doses used in this study, were well tolerated and were effective in improving fibrosis scores in NASH patients. No improvement in necroinflammatory activity or ALT was seen with this combination of drug therapy. A larger, multicenter, longer-term trial with vitamin E and vitamin C seems to be warranted.

From here:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14638353&dopt=Abstract

[Mr Liver]

Nowhere in the abstract you posted does it say that Vitamin C improved biopsy scores.

This was a poorly conceived study as it does not differentiate between the vitamins separately, just combined, versus placebo. Moreover, their interpetation of the results is highly questionable. How can you improve biopsy scores without reducing inflammation, which was not seen in their small study?  If they have found a way to improve bx scores without reducing ALT, or inflammation , they have a big story on their hands. Indeed.
Yours in truth,
Mr Liver

"One theory of the development of liver disease is that oxidant stress promotes liver cell injury and also stimulates specialized cells in the liver called stellate cells, to produce the main fibrosis protein,collagen. Iron is a catalyst for oxidant injury by promoting formation of 'free radicals' that can initiate injury and fibrosis.
Supplemental vitamin C may be of potential benefit because of its antioxidant properties. HOWEVER, vitamin C may promote iron absorption and lead to excessive accumulation of iron in the live. The latter effect could actually increase oxidant injury. A reasonable,middle-of-the-ground approach is to take the daily FDA- recommended amount of vitamin C (65 mg) and to avoid excessive supplemention."  Excerpt from Living With Hepatitis C,3rd Edition, by Dr Gregory T Everson,MD,F.A.C.P., Director of Hepatology, Chief of the Transplant Division, University of Colorado Health Sciences Center.
pg 80

[Forseegood]

Not trying to show favoritism cause Goof's a friend, the both of us can get into disputes here and have a few times...I believe in arguing points on their merits or negatives, no matter if we're talking to friends...this is a discussion board after all, with many of us trying to sort out information for ourselves...

But in your evaluation of Vitamin C by a doc, there was no study at all (course it's late and I might of missed it) just an evaluation from a doc, and we all know that conflicting info can come from studies, as well as docs...there aren't many studies done on vitamins, (unfortunately) and while I would not conclude that the information culled from this particularly study is definitive, I would say that it is compelling...

I've been taking about 500 to 1000 mg's of Vitamin C for years and years, and 400 of vitamin E...(Not every day, and I think that's key) (along with some other supplements) and I have no indication of excess iron, etc...in fact, I've had this disease over 30 years, and my labs have remained very good, with my viral load never going over 200,000 and my labs have been more or less been consistenly good in terms of alt, ast, etc....in the 20's and 30's respectively...On a recent fibroscan I scored a low  to middle 2...course this is completely anecdotal for your purposes, but this is *my* truth...truth being a relative concept...respectfully...

[GoofyDad]

I don't stand behind this study, I just thought it presented a reasonable counterpoint to your 'few facts' in C33. Still, to call it 'poorly conceived' seems a little harsh. It wouldn't seem far-fetched to infer there was some evidence of synergy with Vits E and C to cause them to study the two combined. Clearly it doesn't prove vitamin C as a single agent will reverse cirrhosis - but it does call into question your suggestion that vitamin C will advance fibrosis progression - which was my point in posting it.  

"How can you improve biopsy scores without reducing inflammation"

Don't understand why you're asking, but surely this is possible. In a healthy liver environment, there is ongoing apoptosis and necrosis. This cell death results in the laying down of cologen - which is eventually absorbed. Ideally there is a balance, and the cologen levels don't build as we see when fibrosis is progressing. In an inflamed liver, of course more cologen is layed down, and the balance can tip towards fibrosis. If we can speed up the breakdown and absorbtion of that cologen, we can make headway against the fibrosis, even in the absence of reduced inflamation (inflammation).

At the end of the day (literally here) we have a double blind study with biopsies on both ends showing significant histological improvement on a regimen that includes vitamin C, balanced against a hepatologist with great credentials saying vitamin C *could* increase oxidative stress.

We've heard from two sides, each with merit. Take from it what you will, and please pass the OJ ;-)    

[Mr Liver]

"it wouldn't seem far-fetched to infer there was some evidence "

You can't "infer" that there is evidence. There is either evidence, or there is none. In this case, there is absolutly none, whatsoever. This is science, not a guessing game.

You cannot lower bx scores while inflammation is ongoing and unaffected. Natural aptosis is accounted for in the range of ALT/AST. This is why the normal lab value for ALT and AST enzymes in not 0. To see fibrosis improve, while inflammation remains unchanged, goes against all the known medical science on this subject. As you noted yourself, inflammation leads to fibrosis.

There is absolutely no doubt that vitamin c increases the rate of iron absorption. There are many studies to support it. Just Google "vitamin c and iron absorption". When a reputable doctor says something "may" do something it does not mean there is a question in their mind, in this case, of the known vitamin c/iron interaction. He is saying "may" because nothing is 100% and universal. There might be someone for whom this phenomenon does not hold  true for. An irresponsible doctor might have said 'will" in its place.  This would be all-inclusive and incorrect verbiage. Scientists, like Dr Everson, deal in exact meanings.

I've come here for just a couple of days and one thing sure stands out-alot of folks here like to argue. To save you and the others time, I can assure all of you that I do post anything that I cannot back up from a reputable source. I do not "guess", make "inferences" out of incomplete information, say "if this" and "if that". (Such as in "IF we speed up the breakdown of collagen....")  I do not post studies I do not understand myself. You will find your time much better spent studying hepatitis c , rather than arguing with me .

Anyone can see that the information you posted was entirely useless.There is no way to tell if a synergy exists. How would you do that ?
There is no way to tell if it was just the vitamin e. Now if you don't see how  this study fails to disclose anything meaningful, I can't help you.

Yours in truth,
Mr Liver

[Mr Liver]

Just Google "vitamin c and iron absorption."

There was absolutely no value in the abstract that Goofydad posted when it cames to defining what role, if any, vitamin c plays in improving histology. So, how you can take a side on the issue based on that is truly amazing. There is no possible way to tease that data out of that study. That was my point to Goofydad, and the point still stands.

You can take all of the vitamin c you want personally, but in light of the science I would hope you wouldn't encourage anyone with a compromised liver to follow your suit. 65 mg is all your body needs. The conservative approach is wise with all things when you have a diseased liver.

Yours in truth,
Mr Liver

[GoofyDad]

It's hard to know where to start....

Of course one can reasonably infer evidence exists. OJ got arrested - I infered there must be some evidence that tied him to the crime. See how that works?

You're quick to fault the 'ifs' and 'mays' in my post, but the paragraph in which they're used makes the point that something is *possible* happen. That is made clear in the leading sentence. Ifs and mays are the bedfellows of coulds,  and possibles. It's worth noting that the excerpt upon which you base your case contains two 'may's and one 'could'.

Here's the point. You want science - I posted science. You posted conjecture taken from page 80 of a book. Simce your a fan of science proof - how's about a controlled study that proves Vitamin C will advance fibrosis? Anything short of that strikes me as suppositition.

As far as the abstract - the point here is that yes - vitamin C increases iron absorbtion - and iron causes oxidative stress, but the anti oxidant properties of vitamin C 'seem' to outway the oxidative properties of the iron. I don't stand behid it, but it's a worthwhile data point.

You seem to view your manners in contrast to the people here who like to argue, then go on to state that my posted information posted information is 'entirely worthless'. Me thinks those words are inflamatory and argumentative, and perhaps there's a leetle bit of the pot calling the kettle black. I think this horse has been plogged more than enough. Take care and be well Mr Liver - I'm done.  

[Forseegood]

I can't help but think there is a bit of arrogance in your last few posts...we're all posting on a site here, typing away...some people back up things they say with studies, some don't...some of these studies are contradicted by other studies, years later...a few of us actually know each other offline, but most of us don't...we are, for the most part, a lot of people with hep c, and we take a lot of what we read here on faith...the support here is wonderful, but we do argue points and premises as well...

It would be very presumptuous for me to suggest that I have the last word on many of these issues...In terms of discussing and arguing "points" I am merely positing my opinions, like everyone else here....none of us are doctors....or professional experts in these fields....we're laymen...or at least the vast majority of us...you have not stated what, if any, professional capacity you have.

Being around here as long as I have, has convinced me that not all doctors are right all of the time, not by a long shot...I don't really "know" you, and you don't know me...you can state your opinions, and the rest of us will either agree with you, or not...the same goes for me and everyone else here...When you say, that you will *never* infer, or guess, and never post studies that you don't completely understand, how on earth would I know that? Because of your assurances? So much of this is subjective, for you to even make statements like that is puzzling...I'd rather read your arguments as to why you support your contentions and not mine (you seem to be an intelligent gent) then to be assured by you...that I shouldn't even bother arguing with you...what absolute twaddle...And are you not arguing my contentions now? You must like to argue yourself...

There have been more then a few "experts" here in past few years I've been here...Who boldly stated that they alone had the real "facts" about this disease, and inferred or stated that the rest of us were merely amateurs and/or onlookers to their golden truths.....so we might as well not even bother to argue with them....I just don't buy it. While some people are more knowledgeable (generally speaking) then others...No one here is infallible...you might be a much better *student* of hepatitis then I am....but we are both students after all....

Until "science" is advanced enough to wipe out this disease completely...and they then supply all the supporting data for their grand cure....A lot of this is testing out various drugs on patients, and theory and speculation based on statistical data - and imperfect studies...A few highly credentialed "experts" have told me as much...

And while the experts are making such great strides and advances, and yet they still stumble and fall so often.... how on earth can any one of us be assured of the fact that we know so much? - that other members needn't even bother arguing our points?...And really, how can you emphatically state that 65 mg of Vitamin C is all that anyone needs with a compromised liver? Not every hepatologist agrees with this.....That would seem to go against your well taken point - that these elements are not universal in the way they effect patients with liver disease, there are just *way* too many variables...Let's talk case by case basis. I certainly don�t know for sure one way or the other, I just do what seems to be working for me, considering the consults that I have had....these are my opinions only...respectfully...

[Mr Liver]

Get back to the topic and save your philosophy for someone else. Vitamin C is not good in large doses for those with a compromised liver. This is well known medical science as you must know by now. It has nothing to do with Dr Everson. I told you to Google it. If you did, then you know the truth. If  you didn't, then you do not want to know the truth. I've been coming here off and on for the last seven years. Long enough to know who makes the rules. And it ain't you.
Yours in truth,
Mr Liver

[Mr Liver]

I am glad you are done. Each post by you gets successively less relevant to the facts.

First off, you inferred a connection between two things with NO EVIDENCE at ALL See the difference ? You cannot infer that one thing is responsible for an outcome if there is no way to derive that inference form the facts presented.

You posted poor science. I showed you the flaws. Nowhere in that article can you determine what role,if any, vitamin C played. Argue the point all you want, but it won't change that fact. YOU interpeted the study INCORRECTLY as shown by your header subject for that post. "Vitamin C improves fibrosis".
Why don't you just admit you did not understand the study ?

It was you that posted mere speculation and conjecture. I posted science. And just like I told your companion, go Google it if you want to learn. I gave you the keywords. Then come back and apologize if you are man enough.
Yours in truth,
Mr Liver
ps-ganging up won't work--I've dealt with people like you before.

[Forseegood]

and it ain't you either...

[Forseegood]

no one's ganging up on you, you took issue with both of us individually, and the both of us answered you individually....and I stand by my contention that Vitamin C for one person, might not play out the same as for another person...having known many hep c patients who take more then 65mg without any excess iron issues...These things should be looked at on a case by case basis as I stated before...as youre posts are getting a little hostile, and youre not really answering my contentions, I wonder if I HAVE met you before, but I'll let it go at that...well, we beat this little horsie enough, good day to you....

[Mr Liver]

Case by case basis???It would be foolish and a giant waste of time and money. Since taking vitamin c in large doses is known to increase iron absorption, and since vitamin c is not required above 65 mg ,it is much easier to make a recommendation for everyone NOT to take excessive amounts.  I know people who drank and smoked heavy all of their lives and lived to be 110. According to your logic no one should advise someone not to do these things because a few people have succeeded at longevity despite their addictions to substances that carry significant KNOWN health risks. Do it on a case by case basis. Take your logic a step further. We should all ignore warnings and precautions on medicines and take it all on a case by case basis,too. We should run to the doc with every tube and bottle of whatever and say " you know this stuff says not to take it if you have a liver problem, but I want to see if I can get away with taking it anyway." When the sign says " Keep Off the Ice" on a lake are we to hire someone for the winter to sit there and weigh everyone on a case by case basis, because we can assume that someone might be light enough to get on it ?Get real would you ?

You have no way of knowing whether your excessive doses of vitamin c have contributed to a faster fibrosis rate. I do know that it IS POSSIBLE because the facts say so. I think you are having a hard time admitting that you have been doing something all these years that you thought was helping ,when in fact, the evidence strongly suggests the opposite is more likely. Like I said, you'll never know.

I took issue with no one first.
Your buddy was so eager to be a contrarian that he made up an untruthful header. He had to invent a header out of nothing and state it so it was in direct contradiction to my post.You came in and jumped on the bandwagon immediately just to side with him. I don't believe you read the abstract he posted for one second. Because, if you did you would have realized that there was no basis whatsoever for that untruthful header "Vitamin C improves fibrosis"
No, you wanted to be part of the action, too. Before checking out the science for yourself, you immediately jumped in and said you sided with the Gooyfydad. That means you sided with a lie. Because his header was not the truth. Now the only reason I can think of why you would support a lie would be to get in on the action. Right ? Wanted to be part of the "we'll show him" mentality ? Perhaps politely asking me for some ideas where you could find pertinent and relevant information to support the idea then perhaps you would have met with a kinder response. Instead you suggested that it wouldn't matter what I supplied as doctors and studies are always wrong.You implied that the doctor could be wrong . Yeah, the head of the transplant division, and chief hepatologist in the hospital that did the world's first liver tp doesn't know what is good for HCV patients ? And the books he writes all have footnotes and bibliography. Quite a common practice in books. You could have asked for the supporting references couldn't you ? You also implied that the studies can't be trusted. Strangely though, the study by your buddy was OK. lololol

You are so easy to see through. Now, if you want the last word, PLEASE take it. And next time, watch who you choose to disagree with, just for the sake of disagreeing. I won't be bullied by you and your pal.

[Forseegood]

nice to see you in good form...

[mikesimon]

I would think I'd recall your name if you've been here for 7 years - especially with a name like Mr. Liver. What name did you use before this one?
Mike

[Forseegood]

I think I read somewhere that you were doing some kind of sport? you sound good...I'm glad for you...

[mikesimon]

Sport? I don't think you heard that about me. But, I'm doing and feeling well. Mike

[mikesimon]

I forgot to ask you if you recall seeing Mr. liver here before very recently? Mike

[Forseegood]

I guess I got confused, won't be the first time! I thought I heard where you were diving or something?...anyway, as to that other matter, I'd rather just focus on having a nice weekend...hope you have one too....be well...

[mikesimon]

Gee, I didn't mean to cause you additional stress by asking you such a sensitive question. Yikes, he is scary - isn't he? Mike

[Mr Liver]

Does Billy Reuben ring a bell ?

[Forseegood]

I'm going way, way out on the limb on this, and I'll probably regret it...I can just hear the salvos coming my way with a few people who will read this, reckless irresponsiblity, among others...everyone is entitled to their opinions...but haven't you ever thought, that maybe you could go on a more aggressive vitamin/and or herbal treatment then you are presently on? If you can't do present SOC anway, cause of Auto Immune issues, etc? I mean, what do you have to lose if you monitor it properly?....

You could "titer up" take just a few things and slowly build up from almost nothing, (and 65 mg of Vitamin C is almost nothing) just a few things that "supposedly" work synergistically...consult with a well-credentialed nutritionist or other expert? Misha Cohen works with Dr. Gish in San Francisco, and gives references...if you don't go a Chinese route, then, just a few more supplements, monitored very, very closely... say, one herb like Schizandra berry and/or Milk Thistle...

I know you go to a renoun doctor, but most docs just don't know beans about these treatments, they don't learn about them in medical school, and it's not FDA sanctioned, it's just not in their sensibility, culture, etc. and there is a lot of prejudice, perhaps rightly so in some cases, I will admit....

But still and all, there aren't many doctors who really study these things or experiment with them...I mean really, what do you have to lose? And you might GAIN something, like cut down on the inflammation that the disease is subjecting your liver to, which is ultimatley a good thing, if not a huge thing...You say youre not very advanced in your liver disease, you could try this, and then closely monitor it by taking labs every few weeks, or monthly, etc...

If your alts go up appreciably, or any other untoward thing happens, just stop taking them and cut your losses, and that will be the end of it...(though some people report when they first introduce these regimens into their system, there is a temporary uptick in the alts, then they "can" go down)

I've been taking these things for years, have had this over 30 years, and my labs are excellent considering...doc told me I have lowgrade, smoldering hepatitis C and that my immune system has seemed to do an excellent job at keeping this virus down...(course I am looking at a trial to get into, I want to rid myself of the virus, and not just sustain status quo, finally)

I know many people will not attribute this to my regimen, I know many others who will agree with me though, because of their own experiences. The only time I stopped my regimen for 3 months, my alts went up, if you want to think that's a coincidence, so be it.....I think it's a lot of things, my lifestyle, diet, and my regimen, even my attitude...in the whole time I've been testing the last 7-8 years, my viral load has never gone beyond 2 hundred thousand.

I am only throwing this out in the ether, I am not going to debate this with you...I already know your feelings about this, and they are negative. I only think this is something you 'might' consider, if you wanted to, and I realize you probably won't, and you'll probably feel highly offended. Fine. I will not argue this with you. It's not about that, I dont like debating with you. I just figured, since I read that you had gotten a little more ill with this virus, that I would just throw this out there, that's all. Say what you will, I will not debate this.

[Mr Liver]

I appreciate your suggestions, but you are indeed talking to the wrong person about this. Just a FYI. I met my doctor at a seminar 8 years ago sponsored by the ALF. His presentation for that day ? Complementary and Alternative Medicine ( CAM ). He helped to set up CAM guidelines at the NIH. So, he does know quite a bit about the subject. When you take your profession seriously , you recognize the necessity to be able to answer the questions your patients ask and then advise them. The alternative medicine industry which generates 20 + billion dollars a year in sales has found its way into mainstream society more each year and as a doc you gotta keep up on this stuff. By the way, those sales are higher than the total out-of-pocket yearly medical expenses  for the entire population in the U.S. .

Vitamins are some of the most studied substances in the body. Our bodies need just a trace amount of vitamins. When you discuss vitamins you enter the nano world. We're talking  a few molecules in some cases as a total amount needed for a day. The best way to get vitamins is the old tried and true method: a good diet. With modern shipping and agricultural methods, there is no reason someone cannot have an adequate diet to supply it with what it needs year round in all but the most remote locations in the US.

Another consideration for me: I am stable and don't want to upset the apple cart with any unneeded substances. You know the old saying..If it ain't broke...

I only like to put food and non-alcoholic drinks in my system. But if I have to put something else, I want it to be tested, purified, regulated, and based on evidence obtained through the scientific process.

Yours in truth,
Mr Liver

[Forseegood]

I wonder where all these studies and trials are about vitamins, I look, but I can't find them, particularly if they are studied as much as that! And if there are soooo many people buying them, a lot of that must be repeat business, even if your making statistical judgments, if that many people are taking them, maybe something to it huh? but then I went against my promise, you tend to get hostile and I don't want to stick around for that...

[mikesimon]

No, I do not recall that name. And I ran a quick MH search of Billy Reuben and didn't get any results. If you have been here for 7 years you've either been silent, very inactive or posted under another name. Mike

[revenire_1]

Mr. Liver ain't me despite the rumors so why not let the guy alone with the 40 questions game and let Angie think it is me?  Does it matter?

[revenire_1]

Go to the cops would you? I'd like to see that.

Mr. Liver just ain't me so keep guessing. I come as revenire and that's that. I don't need permission or anything else and I don't care either.

You tell your pals to leave Mr. Liver be. You're barking up the wrong tree.

Like I said: post the emails I sent you and I will post the ones you sent back.  

Don't give me these creeped out BS either. If you were creeped out you'd have called a cop or at least cried a river of fake tears.  

Just take some Paxil and move on. If Paxil doesn't work try something like Xanax or heroin. That will take the edge off and you can get over the horror of revenire.

If I want to come here I just sign up as revenire and do so. I don't need fake names so you misfits can play "find the rev".

Some of your lives are so empty, so devoid of any worth that hepatitis has become the most interesting thing about it.

BTW, any new candles?

[mikesimon]

No, it doesn't really matter. I didn't read any speculative post that Mr. Liver is you simply because it's too much reading to read all of the posts and particularly so with the more verbose members' posts. I just got curious when he said he'd been here 7 years because I don't recall any person by that name and that's not a name I'd be likely to forget. Hope all is well with you and your family, Mike

[revenire_1]

C52 and C60 ... this person makes it clear good old Angie thinks I am Mr. Liver.

Come on Mike.  

Tell Angie to go to the cops if she feels harassed, or give it a rest.

Better yet, when the coven gets together later Califia can tell her how to handle this.

I assume I will be gone again shortly so hi to everyone and hope all attain SVR this year.

Scott

[mikesimon]

I didn't read either of those threads until just now - 5/28/07 12:27 AM Eastern time. What do you mean "come on" - do you think I am lying about this? You know me  better than that. The guy's name is Mr. Liver and he says he's been here for 7 years - aren't I allowed to ask him who he is? Come one Scott. Mike

[revenire_1]

In my book, and I keep one, you are allowed to do anything.  You're a top fellow and have my respect and you always will.  It was a misunderstanding and I do apologize if you got lumped in with the more paranoid part of Med Help.  

You're a person I can call a friend and we go back a ways at this place.

Thanks for all the help over the years and best to you.

Scott

[Mr Liver]

How 'bout Al Bueman ?

[Mr Liver]

Those who seem to be overly obsessed by names will love this one. Either we are two different people, or you are posting to yourself. The more paranoid and obsessed ones will actually believe the latter.  lol
And thanks for your words. I just come by once in a blue moon to lend info and support and all of a sudden I find myself in the midst of mindless controversy over vitamin c with some paranoid delusionals who have reading comprehension disabilities. This site was much better when the docs were here.

Your in truth,
Mr Liver

[mikesimon]

You said: "This site was much better when the docs were here."

Well, I don't remember that either and I have been here for quite a long time. Are you sure you know where you are ..... let alone who you are?

Mike

[revenire_1]

Ha ha, I sometimes forget where I am.

[revenire_1]

Not very long ago a few people here thought I had like 50 names and instead of being concerned about their disease the main reason they came here was to be involved in soap opera style dramas and guessing who is revenire today.  Med Help booted me like a dozen times but I am a perfect gentleman.  Ask anyone.

As I said, you seem like a fine addition to the site and if I can be so bold to offer you advice: there is a coven here that gangs up on people.  They conspire together to get people banned on specious grounds.  It is wicked and sinful.  

Some of them haven't even treated but just go to message boards. One stays the same age no matter what year it is.  

I've already said too much.  

Med Help will probably boot me when they come back from vacation, or wherever they are, so I wish you well and hope you beat this damn disease. I am a 1a, went 88 weeks, relapsed and am gearing up for round #2 and will never let this thing beat me.

My name is Scott.  But if I am talking to myself I already know that.

[Mr Liver]

Well, it would appear I have seniority over you.
Yes, this forum used to have docs. They were hepatologists from Henry Ford.
Yours in truth,
Mr Liver

[Mr Liver]

Scott,

Nice to meet you and thanks for the welcome and advice. I know of the types you refer to. I read a few days of posts before jumping in, and I spotted a few of those to whom you refer.

Yours in truth,
Mr Liver

[mikesimon]

Indeed it appears that you do have seniority over me and I stand corrected. I think I've been here since 2002 and I don't think there were doctors at the Hepatitis side then so you do go back aways. Mike

[mikesimon]

Don't give it another thought. I like and respect you so we can disagree or misunderstand one another on occasion - it's no big thing. Stay well, Mike

[Mr Liver]

No biggie mike. Hope you are having a fine day. I'm about to get walloped by a thunderstorm so I better get off the 'puter.

Yours in  truth,
Mr Liver

[Philo60]

Don't forget there's "NO MONEY in the CURE" we all are battling an inevitable progressive life threatening disease treated with drugs in the category of "lets try this one and see what happens". My spouse and I are battleing Hep C 1a with coninfection of Hep B from hemodyalisis  And knowing that Hep C treatments and post transplant medications are BIG BUSINESS for pharmaceutical companies we have little faith in them actually finding a cure in the near future. As one writer stated follow what's in your heart; your life and your liver is in your hands. I agree with being warry of products from China they are full of pesticides that your liver has to filter (causing further damage), I agree that there's not enough research and don't expect there will be why not??  again because there's NO MONEY in the CURE. Do what you feel is right for you, pray to whatever GOD you believe in (if it's about GOD it all GOOD") and live you life to the fullest. My husband is going to start antiviarl treatment soon but we are also incorporating Milk Thistle and Acai berry from Amazon Thunder and lots of prayer. What I'm saying is indulged yourself go to accupuncture, meditate, take your herbs (however do be mindful of herb to herb interactions as well as drug to herbs) if the outcome is good or less than desireable that's just the way it was supposed to be.

Wishing all of you
PEACE,LOVE, and HARMONY
         Philo

[CockSparrow]

OK I know this is an old thread but thought I would comment anyway.

The following comes from Projects in Knowledge Care and Council
Helping Patients Stay the Course on Treatment for Hepatitis C
Patients should be instructed to:
1. Maintain good nutrition, including adequate intake of niacin and vitamin C.

So are they wrong.

And the following from Liver International ISSN 1478-3223
Plasmatic vitamin C in nontreated hepatitisC patients is negatively associated with aspartate aminotransferase

Abstract
Objectives: To evaluate the possible relationship between aminotransferases levels and markers of oxidative stress in chronic hepatitis C patients.

Design and methods: Patients without treatment for hepatitis were divided in to
group I (15–39 U/L);
group II (41–76 U/L) and
group III (81–311 U/L) of activity alanine aminotransferase (ALT).

Blood markers of oxidative stress [catalase (CAT), glutathione peroxidase (GPx), thiobarbituric acid-reactive species (TBARS), nonprotein and protein thiol (NP-SH and P-SH) groups and vitamin C] were determined. Results: P-SH and NP-SH levels, TBARS, GPx and CAT were not different between groups. Vitamin C was significantly decreased in groups II (P = 0.03) and III (P = 0.001) when compared with group I and correlated negatively with aspartate aminotransferase (AST; r =_0.29, P = 0.042).

Conclusion:
Vitamin C levels were negatively associated with AST, suggesting that vitamin C could be an additional indicator of hepatitis C severity.

Now I am no Doctor but wouldn’t the above suggest that extra VitC should be taken.
CS

[sfbaygirl]

I was told by many here and my Dr. not to take Milk thisle on tx. Perhaps afterwards or pre tx.....seems like this thread got off track from the original question.  There are some anti fibrotics to take during tx that may help.  Oxymatrine is one that comes to mind...If not on tx check out Gauf's profile and see HR's diet for ant fibotics. On tx, I sure wouldn't take Milk thisle. You don't want to mess with these tx drugs.  

[CockSparrow]

I know this was only done in a lab but still interesting especially point 4.
When combined with interferon alpha, both silymarin and sho-saiko-to inhibited HCV replication more than interferon alone

So maybe taking MT is not such a bad idea after all.

From http://www.hivandhepatitis.com/2007icr/aasld/docs/120407_b.html
Experimental Botanical Therapies for Hepatitis C
Silymarin and Sho-saiko-to Section

The activity of the 2 therapies was studied in the laboratory in human hepatoma liver cell lines (Huh 7 and Huh 7.5.1) infected with JFH-1, a genotype 2a strain of HCV that can replicate in vitro.
Results
1. Silymarin inhibited expression of TNF-alpha in anti-CD3 stimulated human peripheral blood mononuclear cells and NF-kappa-B dependent transcription in Huh7 cells.
2. Both silymarin and sho-saiko-to inhibited infection of Huh7 and Huh7.5.1 cells by JFH-1 virus in a dose-dependent manner.
3. Both compounds also displayed prophylactic and therapeutic effects against JFH-1 infection.
4. When combined with interferon alpha, both silymarin and sho-saiko-to inhibited HCV replication more than interferon alone.
5. The antiviral effects induced by silymarin involved both JAK-STAT pathway dependent and independent signaling.
6. Sho-saiko-to enhanced interferon-stimulated response element (ISRE) transcription via p38 MAP kinase activation.
7. High performance liquid chromatography fractionation of the herbal preparations permitted identification of specific components eliciting antiviral actions.

“The data demonstrate that standardized silymarin and sho-saiko-to have antiviral action against in vitro HCV infection, and that silymarin has immunomodulatory and anti-inflammatory actions,” the researchers concluded. “Therefore, CAM-based approaches may assist in the management patients with chronic hepatitis C.”

CS

[Myown]

I think the biggest problem that we face as far as what supplements or herbs that we should or shouldn't take while on tx is that we are asking or depending on answers from our hep doctors and MOST, if not nearly ALL, have not studied nor read anything about supplements or herbs ever. The majority of us are being treated by doctors that have studied ONLY"conventional medicine" and here we are seeking their advice on what supplements we can take while on tx:) - . My hep doc told me he is open minded and I do think he is, but an example is this year he told me that now they have found out that low level of vitamin D may effect whether or not you SVR. But I already knew that vit D effects the immune system and made sure my level was good last year before that tx started. As a matter of fact I know the story of how Dr.Cannell discovered that vitamin D boosts the immune system because I have subscribed to Dr. Julian Whitakers newsletter for many years - along with other news letters such as Dr. Williams etc. So little by little conventional doctors are comming around and seeing how some naturral foods/vitamins/herbs can help us MAYBE to achieve SVR.

The more I try to understand this disease,why people relapse, why we have non responders,,the more it makes me realize that we are in deep trouble that our doctors haven't much of a clue to how they can and should help the immune system somehow 'balance itself" through the use of natural methods PRIOR to txing. This "lets role the dice again" to see if you clear is all they do because "that's all they have." THEY (conventional doctors) are very limited in how they can help us, except to put us back on the trolley track. I am not saying this as a knock, cause I thank God that we have our doctors, and I do like my doctors though I don't agree with everything they say and I feel we have a right to question our own tx.

I just read something so well written but I dare not post it because it happens to be written by a lay person and I don't feel like hearing "he's not a doctor blah blah blah," but anyhow, this guy is so on the money IMO,, and he discusses what he has found in his own research concerning autoimmune, our bodies response - so many other things that its just too much to mention - btw also mentions the sinus problems, brain, liver etc. Its so well written though and the more I read - the things he touched on and just the way he compiled the whole thing,,, it just amazed me,, and what really amazed me is that he has said things that alot of us have touched on in our own 'trying to put the puzzle together' discussions.

But anyhow my opinion is we need more doctors like HR who has an understanding of both sides of the coin - conventional medicine and alternative because it is going to take both to find a real cure. Thats just my opinion though.

Have a good weekend everyone!

[sfbaygirl]

I JUST discovered my Vit D was low, really low. It could have been throughout tx. I am now on a Vit D RX once a week for several months. Perhaps this could be one of the reasons my immune system didn't support the tx....who knows?  I am glad I did find out about the Vit D. My rhemy prescribed it and said it would help my bone and joint pain. Not sure if it has, as I am on Lyrica now for that. I sure feel better!  

Linda

[Myown]

Most likely IMO most heppers are low in not only Vit D, but all the other supplements that support the immune system, such as E, selenium, zinc etc.

I say this because when the immune system is trying to fight the virus, it would seem that it would be drawing on the vitamins that support the immune system and the E, selenium etc,also fights free radicals.

What was so interesting to me is that I had a zillion tests before tx and I have the report and in the report is shows that I am low in ALL the vitamins that support the immune function - though I was taking large doses.

The other thing that you have to make sure you take PLENTY of is the Probiotics cause they support immune function too. HR talks about them alot and thats probably why.

But again, in mentioning the conventional docs are behind the times, OKay, they now tell us to take vitamin D, but I have not had one conventional doc tell me to make sure I am taking probiotics especially to make sure plenty prior to tx. They just don't know all this stuff.

Though I take a lot of them, a test I had just prior to dx,showed NO lacctobacillus at all! The doc (holistic) was very surprised and so was I, cause I faithfully take them,,but then after hep dx, it all made sense to me, and even more sense now cause I may have had the guiardia back then too and so all of this was draining my immune system IMO. BTW my feeling on the protazoa was that it was always there as my PCP always says we all have para's etc,,,,,BUT I think cause I went into such a panic/shock upon hep dx, that my immune system took a nose dive and thats when I had overgrowth of paraisites/candida in my intestines. Just a theory of mine. (theory # 4,0097:)

[susan400]

Just so that you are aware, Dr. Schiff in Miami does NOT have a fibroscan available at this time.  I contacted his office to inquire about getting one for myself and this is what I was told.    I'm going to start trying to save the money (even though it will take me quite awhile), to fly out to California and get HR to do one for me.

Susan400

[eureka254]

very curious to know who your hepatologist is @ Yale.  My husband's doc is too, and he nearly hit the roof when we mentioned "alternative" treatments.

[debster39]

I have been on milk thistle since diagnosed 3 yrs ago.  Gastro put me on it because I wasn't ready for tx.  I have been on tx since Aug. 07 and have continued taking the same amount everyday just like always.  No problems.  When I first went to my gastro for my diagnosis my viral load was 2 ml.  When I decided to go on tx they, of course did another vl and it was down to 480,000.  All I was taking was the milk thistle.  Now I'm on the tx and my vl has continued to drop but not at zero yet.  I'm six months in to it and hope I can find someone to give me good news about being a responder but not as quick as the Dr. wanted.
I dropped the vl on milk thistle more than I have on the tx.  On tx I started out at 480,000 and have only come down to 1500.
I wish I knew all the long term effects of staying in and fighting to zero another 3 months.  I made the decision to keep going but I'm questioning myself.  
Debbi

[debster39]

I have been on milk thistle since diagnosed 3 yrs ago.  Gastro put me on it because I wasn't ready for tx.  I have been on tx since Aug. 07 and have continued taking the same amount everyday just like always.  No problems.  When I first went to my gastro for my diagnosis my viral load was 2 ml.  When I decided to go on tx they, of course did another vl and it was down to 480,000.  All I was taking was the milk thistle.  Now I'm on the tx and my vl has continued to drop but not at zero yet.  I'm six months in to it and hope I can find someone to give me good news about being a responder but not as quick as the Dr. wanted.
I dropped the vl on milk thistle more than I have on the tx.  On tx I started out at 480,000 and have only come down to 1500.
I wish I knew all the long term effects of staying in and fighting to zero another 3 months.  I made the decision to keep going but I'm questioning myself.  
Debbi

[CockSparrow]

Sorry to have to tell you this but if you are not clear by 24 weeks your chances for SVR are fairly slim less than 3% with 48 weeks tx.

You might want to consider stopping the Milk Thistle.
CS.