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Avatar universal

herbal support while on tx

I know that many doctor's advocate avoiding everything, including vitamins while on tx - which is something I do not understand. Not to say I disagree with it. I just simply do not understand other than the liver is in a condition where it can't process many things.

I start tx in December. I currently take

fish oil (omega 3)
multi
ginseng
gingko
zma
milk thistle (started recently)

Here's the angle I'm concerned with: I know many have said to AVOID all supplements. Has anyone spoken with their doctor and were ENCOURAGED to take anything? Also, has anyone gone through treatment and decided to take any supplements without their doctor's encouragement? What were your experiences?

Thanks!
23 Responses
619345 tn?1310345021
Interesting questions another one would be taking the herbal support pre tx and blood tests does it affect the viral load or other blood results

My GI just told me to stay away from the obvious Alcohol Cigarettes Fatty Foods Sugar and do to my Colon Woes no fiber so he said not much you can eat some fish some chicken low fiber veggies no cereal etc wish I could follow this not much appetite lately and when I do have appetite it is for all the wrong foods of course
but
I did tell him I was on Omega 3 and I also just started Milk Thistle with dandelion He didn't seem to care but I am not on treatment as yet He thought that was good

I am sure you will receive a lot of response on this and there are in the archives more info on herbal remedies questions are for me what is processed through the kidneys versus the liver or are all herbal meds processed through the liver and truthfully is there a difference when on tx

I have not seen enough info or studies on the subject to comment but I will be interested in others comments;
as to what extra meds or resue drugs affects SVR  with what I have recently seen here about iron and niacin and certain supplements that are not good as well as foods
it for sure is an interesting subject
148588 tn?1465782409
Without my Rxing docs encouragement?

Ling Zhi  9%
Chi Shao  9%
Huang Qi  8%
Gou Qi Zi  8%
Dan Shen  8%
Yin Chen Hao  8%
Bai Hua She She Cao  8%
Zhi Zi  8%
Yu Jin  8%
He Shou Wu  7%
Wu Wei Zi  6%
Chuan Lian Zi  5%

Supplements Qi and blood, clears damp-heat, dredges the liver, invigorates blood, clears heat and resolves toxins, relieves pain.

The formula I took also included Chai Hu  8%, but Chai Hu has its own set of psych sx and doesn't mix well with IFN.
Avatar universal
i'm on my 8th week of tx, still feeling good, no bad sideefffects,  i took my 8th shot last friday then went out all day with my family yesterday.
3 months before my tx my doc started me with:
one a day multivitamin for men
folic acid
vitamin b12
aside from that also taking:
fish oil
milk thistle
glutathione
alpha lipoic acid

my doc said it's fine if i take extra supp. maybe this is why i don't any bad sx. i feel really good everytime i take my tx. it's like the viruses died.
619345 tn?1310345021
what do the percentages represent?
148588 tn?1465782409
Percentages of herb in the compound. I intentionally gave the Chinese names so people wouldn't actually try self-medicating with these herbs. Run the list past Misha Cohen if you see her and see what she thinks.
I also took Vit C and CoQ10 with my gastros permission.
Avatar universal
Scarredliver, thanks for your feedback. I'm very glad you aren't experiencing side effects. I hope that those sups you are taking are contributing to that because I'd really like to experience the same kind of tx!! lol

To bajawoman: I was curious about vitamin c as it boosts the immune system and fights fat accumulation - also CoQ10 seems good too - i'd assume it would help with the RBC count and shortness of breath.

Another thing that I'm thinking about taking is Apple Cidar Vinegar - really does a good job of metabolising fat and increasing energy, plus is a known blood cleaner. I take it already and feel great on it. Just a teaspoon in the morning and afternoon. Tastes like ****, though - mix in water. Make sure you use unfiltered.
Avatar universal
Reason why they say to take no sipplements is because even the doctors dont reallyu know how the SOC drugs will really react with other foods and supplements....i think the idea is to try and keep it simple as to cut down the chances of any kind of negative impact with the SOC drugs....i will admit i did some supplements with my last round of tx and i didnt clear...this tima all im gonna eat is just simple foods...lotsof organic veggies and protien from low fat sources...KEEP IT SIMPLE is my motto...BTW...these tx drugs are special and who relly knows if they do or do not react with certain herbs and supplements...im playing safe this time....you may think its just a food supplement,,,,but i say play it safe...MY 2 CENTS
619345 tn?1310345021
I do not have a lot of resources here not sure what CoQ10 is either but will check it out on the net  Misha will be down soon I expect if not xmas then after new years I will check in with the local health food and alternate medicine stores  We do have a couple
here
food sources I have on my list
beetroot carrots celery parsnips yellow squash pumpkin sweet potato yams turnip fennel
parsley chicken fish kale chard
spices garlic black pepper ginger cayenne pepper ginsing cinammon horse radish
dillweed
millet oats barley rice
tea not coffee  another withdrawal to face I like caffeine
148588 tn?1465782409
Actually, I believe CoQ10 is more important for it's effects on mitochondrial health than it's cardio benefits.
148588 tn?1465782409
Coenzyme Q 10 occurs naturally in your food, but we don't absorb it as well once we hit forty. It's been shown to be important to the health of the cells' mitochondria. It's somewhat expensive.
Since mitochondrial health is being recognized as a factor in IFN response, if I had to choose one supplement to spend my money on, it would be this. I'm also currently taking n-acetyl cysteine (NAC), but that's more for my occupational exposure to toxins.
619345 tn?1310345021
It sounds like something that I may be very interested in after reading a bit about it
I will see if I can get it  here will check with my GI next time I see him does it have a brand name or manufacturer name my farmacist can order it for me
thanks  
Avatar universal
If you guys are taking all these supplements while on tx drugs....you are taking a chance the tx drugs wont work....dont you realize this?
148588 tn?1465782409
http://www.medhelp.org/posts/show/346752
If you take the time to read this thread, you may find the evidence that there are supplements that do just the opposite of what you fear.
619345 tn?1310345021
that is a good question for me I just want to be the best shape I can be before tx so I have a better chance of SRV and if there is any data out there which is seems there is not as there has always been a battle between homeopathic or other types of cures out of the norm of Western Medicine
It was a long time before Chiropractors were considered as well as Acupuncture were accepted as bonified
they were always referred to as quacks not that long ago
I at this point am willing to try anything to make me feel better before tx Hate to start as bad as I have been feeling  
How about anyone else out there did they tx feeling really bad and did they feel better or worse on tx from what I have read I did not read a whole lot of the history of each of the people before tx and their conditions
some of us older folks who just got diagnosed come with a lot of baggage whether from hep c and not knowing they had it for many years some here never had a symptom

I really am not sure all my chronic  symptoms all along  and recently have gotten a lot worse have not been from Hep C

I do know I had three relapes before the mid 80's with jaundice once and bed ridden never went to the doctor as I knew what it was from the first time I had it the relapses if in fact is what they were
only lasted a little over a week compared to the month when I first had it. I know definatley it was not the flu as my stools were white and urine dark just did not turn yellow
Since I did not go to the doctor with each relapse I just figured it was from being run down from partying too much those were the days
Avatar universal
Ive been there and done that....last tx....this time im goona do the opposite ...im keeping it simple this time...ill get what i need from my organic foods..most docs say dont take any supplements while on tx....befrore and after its ok of course...just because you read a few studies on the supplment taking with SOC dont nean its a sure thing....KEEP IT SIMPLE...i had the exact same way of thinking as you do last time i tx....like i said....smartest thing to do is to keep supp;emnts to a bare minium if you must....just my opion here of course...you can take wahtever you heart desires...GOOD LUCK and i pray you SVR
Avatar universal
Granitekonig: It's definitely not the case the doc's don't subscribe supplements when on treatment. They freely prescribe all kinds of drugs. I know they are not herbals, but if they were so concerned they wouldn't be dispensing drugs so freely. I conclude that there are many categories of drugs that do not impact the treatment, or docs wouldn't be so free dispensing all the things they do.

A few points: It's a mistake to think any of the herbals can assist in any way in the cure of HCV. There is zero evidence that any does. I know you weren't suggesting that, but it's still worth saying.

I think the question of the herbals has to do with underlying health issues. If your liver is basically healthy and it can process things, then I don't see the harm. If there are underlying health issues, the situation is different. For example, I tolerated statins with HCV, even though they are known to interact adversely with the liver in some cases but my level of damage with modest, and the statins led to know change in ALT or AST.

For myself, I take fish oil and am glad I do. I don't take milk thistle. It is expensive and the evidence seems to suggest that it has no positive impact on the condition of a liver with HCV. I also have frequent massages and see a chiropractor on a regular basis. All seem to help with the side effects of treatment. I'm not expert on herbals, but of the ones I know on your list, they don't seem particularly risky.

Good luck!
264121 tn?1313033056
I am taking sups now but I didn't while treating (except I ended up getting a lot of IV potassium to keep my levels up).  I did take a LOT of pharmaceuticals, many or most of which I've discontinued now.  I ran it all by my treating doc first.  

179856 tn?1333550962
Most all of us have been advised not to take milk thistle while on treatment because it can effect the interferons efficacy.  That is pretty darn standard advise from most of the biggie docs out there.  That is a pretty well known common fact here and was repeated by all of the NY doctors that I went to.

The fact that your doctor would NOT discourage you from taking it says to me that they really don't have any idea what the effects could be.

Since nobody knows what these herbs and minerals might do to the course of treatment one would say it's foolish to take them during tx.  I agree with Rocker on this fact if you don't know ABSOLUTELY for sure you are not dimineshing the effects of the inf/riba why would you take these things guessing that they might help?

Stay way from milk thistle and iron and many other supplements during treatment or risk relapse.  It's pretty standard advise.
179856 tn?1333550962
PS if you are taking amulti with iron in it you are making a huge mistake - PLEASE make sure it is a men's or silver type and does NOT have Iron. Also additional A&K during treatment aren't very wise because we don't need MORE of the m and the liver does have trouble to process them is what I was told as were many others here.

Avatar universal
My doc told me to continue to take my Calcium+D and he was okay with me taking Centrum Silver Multi (no iron).  He absolutely told me NOT to take milk thistle during TX so I quit taking it two weeks prior to starting TX.
Avatar universal
Nygirl - Can you cite a study that establishes the negative interaction of milk thistle with treatment? I doubt there is one but I'd love to stand corrected.

Thanks.
408795 tn?1324939275
I personally don't think you will find anything totally supporting the use of MT with SOC.  I also don't think you will find anything totally supporting not using it.  I do think that most doctors would just automatically not want it used by their patients for the reason that since it may mess with your numbers why would you want it to possibly interfere.  Actually this study says that the there was no improvement with serum alanine aminotransferase or RNA levels.   good luck whatever you decide

Herbal product use by persons enrolled in the hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial.

Seeff LB, Curto TM, Szabo G, Everson GT, Bonkovsky HL, Dienstag JL, Shiffman ML, Lindsay KL, Lok AS, Di Bisceglie AM, Lee WM, Ghany MG; HALT-C Trial Group.
Division of Digestive Diseases and Nutrition, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA. ***@****

Herbal products, used for centuries in Far Eastern countries, are gaining popularity in western countries. Surveys indicate that persons with chronic hepatitis C (CHC) often use herbals, especially silymarin (milk thistle extract), hoping to improve the modest response to antiviral therapy and reduce side effects. The Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial, involving persons with advanced CHC, nonresponders to prior antiviral therapy but still willing to participate in long-term pegylated interferon treatment, offered the opportunity to examine the use and potential effects of silymarin. Among 1145 study participants, 56% had never taken herbals, 21% admitted past use, and 23% were using them at enrollment. Silymarin constituted 72% of 60 herbals used at enrollment. Among all participants, 67% had never used silymarin, 16% used it in the past, and 17% used it at baseline. Silymarin use varied widely among the 10 participating study centers; men were more frequent users than women, as were non-Hispanic whites than African Americans and Hispanics. Silymarin use correlated strongly with higher education. No beneficial effect of silymarin was found on serum alanine aminotransferase or hepatitis C virus (HCV) RNA levels. Univariate analysis showed significantly fewer liver-related symptoms and better quality-of-life parameters in users than nonusers, but after reanalysis adjusted for covariates of age, race, education, alcohol consumption, exercise, body mass index, and smoking, only fatigue, nausea, liver pain, anorexia, muscle and joint pain, and general health remained significantly better in silymarin users. In conclusion, silymarin users had similar alanine aminotransferase and HCV levels to those of nonusers but fewer symptoms and somewhat better quality-of-life indices. Because its use among these HALT-C participants was self-motivated and uncontrolled, however, only a well-designed prospective study can determine whether silymarin provides benefit to persons with chronic hepatitis C.
PMID: 18157835 [PubMed - indexed for MEDLINE]



Avatar universal
Fretboard – Thanks.

I'll tell you my suspicion. I'm sure when they were doing the basic studies regarding combination therapy, they didn't want people on milk thistle because of concern it would bring down your numbers and mess with the study. I suspect that grew into the idea that milk thistle was incompatible with treatment, but I think it's an urban legend. There's no evidence it's incompatible with treatment.

The HALT study had a very large sample. If there had been adverse interactions between milk thistle and interferon they would have found them. Although they found that milk thistle had no positive impact on outcomes, it also had no negative. It's from this study that I deduce it probably doesn't do any harm, although also not a lot of good..
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