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Part 5: Alternative Medicine

There have been few research trials to check the effectiveness of natural therapies, but many people report positive benefits. If you decide to use natural therapies, it’s vital that you see a practitioner who is properly qualified, knowledgeable and well-experienced. It’s also advisable to continue seeing your regular doctor or specialist. If a natural therapist suggests that you stop seeing your medical specialist or doctor, or stop a course of pharmaceutical medicine, consider changing your natural therapist. Ask searching questions of whichever practitioner you go to:

  • Is the treatment dangerous if you get the prescription wrong?
  • How have natural therapies helped people with hepatitis C?
  • What are the side effects?
  • Are you a member of a recognized natural therapy organization?
  • How much experience have you had of working with people with hepatitis C?
  • How have you measured the health outcomes of the therapy?
  • How do you plan to help me?

Most typical health insurance will not cover alternative medical procedures, but that’s beginning to change. Many alternative procedures are now covered under medical insurance in the states of Washington and Oregon, and it looks like it’s a trend which is beginning to spread.

Alternative Health Insurance Services of Thousand Oaks, California covers both allopathic and complementary/alternative treatments.

Patients may choose any provider, M.D. or N.D., or D.O. or D.C.

Subscribers must meet a deductible of up to $1000, and the plan pays 80% of the first $5,000 eligible medical expenses in a year, then 100 percent thereafter, with a $2 million maximum. The plan includes prescription drug cards, with a $5 copayment, as well as “named partner” coverage for homosexual or non-married couples and their families. Alternative Health Insurance Services: 1-800-966-8467.

Another plan is offered by American Western Life Insurance Co. in Foster City California: Prevention Plus. It covers a full range of alternative therapies. Enrollees use a naturopath as their primary care physician, or the gatekeeper who refers to other alternative practitioners. There is a $5 copayment for prescriptions, including herbal medicines. The company also has a 24-hour 800 Wellness Line staffed by naturopathic physicians, saving on doctor visits where possible. (American Western Life: 1-800-925-5323)

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5.0.0 Known herb-drug interactions

Although the area of herb-drug interactions is under-researched, there are some interactions we do know about.

Echinacea, if used for more than eight consecutive weeks, could cause liver toxicity and should not be used with drugs such as anabolic steroids, amiodarone and methotrexate which are toxic to the liver as the effect may be additive.

Feverfew is most commonly used for the treatment of migraines. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen (Motrin, Advil) may reduce the effectiveness of feverfew. It can also inhibit platelet activity and should not be taken together with blood thinners such as Coumadin. Feverfew contains tannin, which has the ability to inhibit iron absorption, and should not be used for longer than four months without medical supervision. The recommended dosage is 125 mg daily; each dosage unit should contain at least 0.2% parthenolide.

Garlic: Most recent uses for garlic focus on its ability to treat high cholesterol and high blood pressure. Garlic can increase the risk of bleeding and should not be used concurrently with blood thinners. It has been reported to induce heartburn and flatulence, sweating, lightheadedness and allergic reactions. The German Commission E (Germany's equivalent to the FDA in the United States) recommends a dosage of 4 g of fresh garlic daily.

Ginger is often recommended for motion sickness, nausea and for loss of appetite. It has also been shown to prolong bleeding time and its use with aspirin or Coumadin should be avoided. Excessive consumption of ginger may also interfere with cardiac and anti-diabetic therapy. It is usually well tolerated but may cause stomach upset or heartburn in some people. For motion sickness it is taken one hour before traveling. The total daily dose is 2-4 g.

Ginkgo biloba is one of the most popular plant extracts in Europe and has recently received approval in Germany for the treatment of dementia. There have been reports of spontaneous bleeding in people taking ginkgo and again, it should not be used with blood thinners. People who take anti-convulsant medications, such carbamazepine and phenytoin, or phenobarbital should not take gingko without the knowledge of a physician, because it reduces the efficacy of these medications. Ginkgo is generally safe and well tolerated with the most common adverse reactions being stomach upset, headache and dizziness. German Commission E recommends a dosage of 40 mg of ginkgo three times daily with meals for at least four to six weeks. Preparations should be standardized to contain 6% terpene lactones and 24% ginkgo flavone glycosides.

Ginseng is used to combat overall debility, as well as lack of energy and concentration. It has also been used as an aphrodisiac. There is tremendous variation in products labeled as ginseng; in one study, only 25% of the commercially available products actually contained ginseng. Nevertheless, ginseng enjoys widespread popularity. Siberian ginseng has been associated with falsely elevated digoxin levels (a heart drug used to treat congestive heart failure) by interfering with the test used to determine digoxin blood levels.

Ginseng may also affect fasting blood glucose levels, so people who need to control their blood glucose levels should take ginseng with caution. Concomitant use with warfarin, heparin, aspirin and NSAID's should be avoided.

 Additionally, ginseng may cause headache, nervousness, and manic episodes in patients with manic-depressive disorders or psychosis or those on anti-depressants, particularly the monoamine oxidase inhibitors (MAOI) such as phenelzine (Nardil). Side effects include high blood pressure, restlessness, nervousness, insomnia, skin eruptions, edema and diarrhea. German Commission E recommends Asian ginseng be taken as 1-2 g of crude herb daily or as 100-300 mg of ginseng extract three times daily. Commercial products should contain at least 4%-5% ginsenosides.

Kava Kava is recommended for anxiety, as a sedative and as a relaxant. Excessive sedation may result when Kava Kava is taken with other sedatives (flurazepam, temazepam) or anti-anxiety drugs, particularly alprazolam (Xanax). The toxicity of kava is increased if taken with alcohol. Until the clinical significance of Kava's action on platelet activity is determined, its use with blood thinners should be cautioned.

Long-term use is not advised and is characterized by dry, flaking, discolored skin and reddened eyes. The herb is contraindicated in patients with certain types of depression because it may increase the risk of suicide. The daily dosage is the equivalent of 60 mg to 120 mg kava pyrones. Heavy consumption of kava has been associated with increased concentrations of glutamyltransferase, suggesting potential hepatotoxicity. A case of recurring necrotising hepatitis has been reported .

St. John's Wort is most widely used to treat mild to moderate depression, anxiety and seasonal affective disorder. Adverse reactions reported include stomach upset, allergic reactions, fatigue and restlessness. Photosensitivity is usually rare and is associated with higher dosages. Fair-skinned people should be particularly cautious. Concomitant use with other photosensitizers, such as piroxicam (Feldene) or tetracycline should be avoided. St. John's Wort should not be used with MAOIs (phenelzine) or selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft or Celexa.

St. John's Wort has been reported to prolong narcotic-induced (codeine) sleeping times as well as decreasing barbiturate-induced sleeping times and caution is advised when combining these medications. The herb also contains tannin and may interfere with iron absorption. The usual dosage is 300 mg of standardized extract three times daily or 450 mg twice daily. It may take up to four to six weeks to see desired effect. St. John's Wort should not be taken with monoamine oxidase inhibitors or selective serotonin reuptake inhibitors like Prozac and Paxil until more information is available.

Valerian: German Commission E recommends valerian for use in the management of restlessness and nervous disturbances of sleep. Valerian may cause headache, hangover, excitability, insomnia, uneasiness and cardiac disturbances. Given its sedative property it would be wise to avoid barbiturates (phenobarbital), sedatives (flurazepam, temazepam) and alcohol while on valerian. Valerian is also a tannin-containing herb and may interfere with iron absorption. Persons currently taking antidepressants should take valerian only under medical supervision. The usual dosage of the extract is 2-3 g, one to several times per day.

Evening primrose oil and borage are contraindicated in patients taking anticonvulsants (e.g., clonazepam). lmmunostimulants such as echinacea and zinc should not be given with immunosuppressants such as corticosteroids (like prednisone) and cyclosporine and are contraindicated in patients suffering from rheumatoid arthritis, systemic lupus erythematosus and autoimmune hepatitis.

Feverfew, garlic, ginger, ginseng, and ginkgo biloba all affect bleeding time and should not be taken by patients using warfarin or by patients that have decreased platelet counts.

Licorice, plantain, hawthorn and ginseng may interfere with digoxin therapy and valerian root should not be taken when barbiturates are used because it could cause an increase in the barbiturate effects. (Sources: Hans Larsen, Alive Magazine March 1999 with some changes by D. Morrow and When medicine and herbs don't mix by Tammy Chernin, R.Ph. http://www3.healthgate.com)

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5.0.1 Acupuncture

Acupuncture is a form of medical therapy that involves inserting thin, solid needles into selective sites on the surface of the body. Recent studies have shown that HCV may be spread by acupuncture. Please make certain that your acupuncturist uses disposable needles and uses universal precautions. (Visit http://en.wikipedia.org/wiki/Universalprecautions)

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5.0.2 Chiropractic

Chiropractic is a healing profession in which the spine, joints, and muscle tissue are manipulated in order to
restore the proper function of the nerves. The chiropractor does not use drugs and surgery in treating

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5.0.3 Energy healing (Reiki, Hands of Light, Touch Therapy, etc

The gentle energy of Reiki (ray-kee) is an ancient spiritual practice which enhances natural healing processes. Reiki is called by various names in different parts of the world: “prana” in India, “qi” or “chi” in China, “spirit” in Western traditions, etc, and simply translates as “life force”. Reiki is a means of adding more energy to our “life force” battery to help “jump start” the healing process.

A Reiki treatment is essentially the “laying on of hands,” an ancient technique common to many spiritual traditions. In a typical Reiki treatment, the client lies down (fully clothed) on a padded treatment table. Energy is transferred to the client through the hands of the practitioner in a sequence of standardized positions where the hands are placed. In each position, the hands are simply rested on the client for 3-5 minutes.

A full treatment usually takes about an hour. A Reiki treatment is a spiritual practice because it works directly with energy, or “spirit.” There is no pressure applied and no manipulation of tissues (as in massage, for example).

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5.0.4 Reflexology

Reflexology is a specialized type of massage treatment which works on the theory that reflex areas on the feet and hands are linked to other areas and organs of the body. It is felt that blocked energy, congestion, or tension in one part of the body (generally the foot or hand) mirrors congestion or tension in a corresponding part of the body. Thus, when you treat the big toes there is a related effect in the head, and treating the whole foot can have a relaxing and healing effect on the whole body.

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5.0.5 Homeopathy

Homeopathy offers several remedies for the treatment of hepatitis. They are Mercury and Natrum Sulfuricum. Natrum Sulfuricum has clinically been found a valuable remedy for spinal meningitis, and has also found to be quite useful as a liver remedy as well.

Kalium Phosphoricum, Gelsimium, Picricum Acidum, Strychinum, Oxalicum Acidum and Zincum Phosphoricum are said to be useful for peripheral neuropathy related to hepatitis C. (Thanks to Dr Naseem Iqbal Ghumman, B.Sc, D.H.M.S, R.H.M.P. for this information.)

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5.0.6 Reticulose

(Information provided by Commonwealth Pharmaceuticals, British West Indies, manufacturers of Reticulose)
Patients with Hepatitis A and 18 patients with Hepatitis B were treated with Reticulose. 9 Patients with Hepatitis A and 17 patients with Hepatitis B were controls and treated with placebo. The treated patients received Reticulose for a 15 day period, while the control received saline. Based upon laboratory findings of several parameters: Prothrombin times, Serum bilirubin, white blood cell count, and clinical observations.

Reticulose treated patients appeared to show significant improvement. The bilirubin levels of 83% of patients with Hepatitis B, treated with Reticulose for 15 days were in the normal range in 30 days. None of the control patients treated with placebo were within normal range in 30 days.

Of Hepatitis A patients treated with Reticulose, 100% showed normal bilirubin after 30 days. Of control patients with Hepatitis A, only 22% were in normal range after 30 days. The findings in this preliminary trial lead to the conclusion that Reticulose appears to significantly reduce the recovery time and return to normal for patients with an acute episode of Hepatitis A or B. Further study is indicated.

Conclusions: In this preliminary Human Clinical Trial in 53 patients with Hepatitis A or Hepatitis B, one half of whom were treated with Reticulose, the results demonstrated positive clinical and laboratory effects. 18 patients with Hepatitis B and 9 with Hepatitis A were treated with Reticulose, compared to 17 control patients with Hepatitis B and 9 control patients with Hepatitis A treated with placebo. Patients were diagnosed for Hepatitis A or B by appropriate laboratory tests of blood, urine, x-ray and physical examination, with special attention to Anti-HAV IGM and Hepatitis B surface Antigen to carefully differentiate those with A from those with B.

We realize, however, that liver biopsy is the positive method for hepatitis diagnosis, but physical limitations prevented our using this method in this study. Based upon laboratory findings, serum bilirubin levels of 83% patients with Hepatitis B, treated with Reticulose for 15 days were in normal range in 30 days, 50% in 15 days, and 22% in 10 days. None of the control patients were in normal range after 30 days with placebo treatment. In the Hepatitis A patients treated with Reticulose, 100% showed normal bilirubin levels after 30 days, 89% after 15 days, and 33% after 10 days.

In the control patients with Hepatitis A only 22% were in normal range after 30 days, 11% after 15 days, and 11% after 10 days.

In all of the Reticulose treated patients, the white blood cell count showed significant increase, indicating stimulus to the immune system. In all of the Reticulose treated patients, the prothrombin times returned promptly to normal range while the controls did not. The results appear to demonstrate significant improvement in the patients treated with Reticulose, especially those with Hepatitis B. - “The use of Reticulose in the Treatment of Hepatitis A, B & C,” Excerpted from: Journal of the Royal Society of Health Volume 112, No. 6, pages 266-270 December, 1992

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5.0.7 Traditional Chinese Medicine (TCM)

We feel it important to caution the reader about Chinese medicines. We know many persons who have found TCM to be very helpful, but there have been many instances of unscrupulous preparation of Chinese medicinal compounds, where herbs and substances other than those indicated were used in the preparation. In some cases this has led to death. Please seek out a reputable practitioner. If possible, get the names of the ingredients in English and check them out for safety. Always consult with your doctor first.

The following is from (“Complementary and alternative medicine in chronic liver disease,” Hepatology September 2001 Volume 34 Number 3)

TCM has been practiced for roughly 2 millennia, with comprehensive records of Chinese medical theories dating back to 221 BC. TCM comprises multiple forms of ritualistic healing practices. These include the relatively well-known practices of acupuncture and herbal therapy and the lesser-known moxibustion (dermal counter-irritation therapy), massage, and exercise therapy (Qi Gong).

Chinese herbal therapy comprises over 100,000 recorded treatments, roughly 80% being combination or herbal mixtures. Most herbal mixtures comprise 4 to 5 herbs with 1 to 2 major pharmacologically active compounds (King herb), the remaining herbs playing a “helper function,” such as reducing toxicity, promoting delivery to the target site, or working synergistically with the “King.”

Regarding chronic liver disease, a limited number of mixtures (approximately 76) have been identified by screening a Traditional Oriental Medicine Database (Tradi/Med DB). A hepatoprotective extract with the highest potency and the lowest toxicity is the Plantago asiatica seed, the active component being aucubin. Aucubin appears to inhibit hepatitis B virus (HBV) replication in vitro and in animals (100 mg/kg daily for 1 month). Its use in a human trial, 10 mg/kg administered intravenously for 4 weeks, led to a 10% to 40% decrease in serum HBV-DNA levels that returned to pretreatment values after stopping therapy.

A second combination of 10 herbs, termed “Herbal Medicine 861 (HM861),” was tested for antifibrotic activity in 3 controlled clinical trials encompassing 107 patients with hepatitis B. ALT levels fell into the normal range in 73% of patients, while spleen size, portal pressure, and serum procollagen peptide and laminin levels decreased in 53%. Liver biopsies, 6 months post-treatment, showed reductions in fibrosis and inflammatory infiltrates and quantitative decreases in tissue hydroxyproline. All patients remained hepatitis

B surface antigen (HBsAg) positive. In vitro studies using human stellate cells and in vivo studies using animal models of fibrosis (CCl4 and albumin induced) showed that HM861 inhibited stellate cell activation by blocking cyclin/cyclin-dependent kinase activity in the cell cycle, and that fibrotic tissues were remodeled, with revascularization of liver sinusoids.

Transforming growth factor and collagen type I, III, and IV gene transcripts were reduced while matrix metalloproteinase I was increased, suggesting a reversal of early stages of cirrhosis through the correction of imbalance in the dynamics of synthesis and degradation of the extracellular matrix.

CH-100 is a formulation of 19 different herbs developed for treatment of liver disease. In a double-blind, placebo-controlled trial involving patients with hepatitis C, treatment with the product was associated with a significant reduction in ALT levels, although no treated person cleared the virus.

NCCAM is currently supporting a study of a 10-herb combination, referred to as 3AR. The trial will assess safety and adverse events, as well as symptoms of fatigue, quality of life, liver function, and HCV-RNA levels in patients who do not qualify for standard therapy of hepatitis C. Thus, there is increasing interest in conducting rigorous testing of candidate CTM compounds (1) as alternatives to standard treatment, (2) to augment conventional treatments, or (3) to ameliorate the side effects of current therapies.

A very good overview of TCM and HCV can be found in Matt Dolan’s book, The Hepatitis C Handbook.

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5.0.8 Ozone therapy

This is an experimental treatment, popular mostly in Europe, in which the blood is removed from the body, has ozone bubbled through it with the intention of killing the virus, and then the blood is returned to the body. I personally do not believe this is a safe practice, and would strongly recommend against it.

Ozone bubbled through blood to kill viruses in vitro damages the living cells in it as well a removing the viruses.

Ozone injected into your veins or aerated through your colon is a poison and has the very real potential of killing you rapidly.

Ozone is very reactive and not stable in the lower atmosphere and does not remain ozone very long in any reactive media.

There have been reported cases of patients acquiring hepatitis C from improperly sterilized equipment used during ozone therapy. (“Transmission of Hepatitis C by Ozone Enrichment of Autologous Blood,” Lancet, 1996;347:541)

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Table of Contents


4.4.0 Hepatitis C Treatments in Current Clinical Development

Hepatitis C FAQ

5.1.0 Herbal Treatments and Vitamins