– Hey Doc What If –

what is your basic protocol these days?

Oxymatrine
Hep C Powder
Selenium
Two of the following:  R+Lipoic Acid, Siliphos, GSH
Calcium and Lithium Orotate if Stage 2 or higher

Doc, how do heavy metals affect my Hep C?

Similar to iron overload, heavy metals have a pro-oxidant effect on hepatitis c. Liver and other organ damage occurs in hcv infection by an oxidative mechanism, in this case by the lysosomes attacking the virus with a reactive oxygen species. Iron and heavy metals fan this flame of oxidative damage.

Should I be tested for heavy metals?

Depends on your occupation, and where you live. I will often look at heavy metals if the liver enzymes won't normalize, or if blood pressure won't come down, in the face of a good treatment protocol. Usually I will treat first and if the case is not responding how I expect then I will look for interfering factors. I work north of San Francisco and there are very large mercury mines close by, so it's a front and center issue at our clinic.

Should I get a biopsy?

Biopsies generate intense attitudes among a number of people, some patients viscerally are not inclined to jab their liver with a large needle. The death rate for this minor surgical procedure is 1 in every 9,000 to 10,000 depending on whose figures you use. The danger in biopsies comes from uncontrolled bleeding which is much more likely in heavily damaged livers. Also patients are typically sore for awhile afterward. The most frequent comment that we hear, is that it feels like being punched. It's rare that we find a doctor performing a biopsy fully informing their patients of any downside.

On the other hand, biopsies are the gold standard of HepC progression. This is the definitive test for this disease. For many it alleviates a lot of anxiety about their case, because now you have clear knowledge of where you stand. Occasionally we will see, what we believe to be an inaccurate biopsy (for example one report came back 1/1 on a patient who already had advanced symptoms including splenomegaly. 3 years later a second biopsy showed her having cirrhosis). This is a rare occurrence.

As clinicians we like information, and biopsies are the best information money can buy. In our current case studies we are focusing solely on biopsy results. Yet we recognize this is a personal decision for the patients and we wish them to make their choices fully informed of both the great utility as well as the risks of this procedure.

Alternatives to liver biopsies are becoming available. A blood test called HCV Fibrosure looks at six biochemical markers in a patented algorithm to assess the amount of liver fibrosis and the progression of Hepatitis C. Also a procedure called transient elastography, whereby they measure ultrasound waves traveling through the liver is being tested. So far its only downside is the inability to use it with obese patients.

Hey Doc are there foods that I should eat, that would help with my hepatitis?Lecithin can be added to many foods. It contains phosphatidyl choline which repairs cell membranes, aiding in the healing of the liver, as well as other important compounds such as phosphatidyl serine which repairs nerves. In many ways it is preferable to taking more pills. Milk thistle can be toasted and ground up, combined with a little sea salt to make a deliciously nutty condiment.

Coconut oil contains almost 50% lauric acid, an anti-viral fatty acid that works on viruses with lipid sheaths such as HCV. It is especially useful when thyroid activity is low. Artichokes are part of the thistle family. Fresh juices especially fennel, watercress and apple are a fabulous way to bring down the liver enzymes and energize the body. Fresh greens of all types and you can't beat beets.

I feel so tired. What should I do about my energy level?

Fatigue is the most common symptom associated with HCV. It along with depression and mental confusion can often be the first symptoms. Fatigue can also be so deep that it is downright narcoleptic. The first issue in dealing with fatigue is the quality of sleep. Is there insomnia? Do you stay up late surfing the net? We will often use a herbal combination called Liver Yin Essence, along with magnesium orotate to deal with fatigue and insomnia together.

For many people eating less carbs and more protein as well as vegetables greatly increase energy levels, though if your liver function is very poor, or your ammonia levels (which is a by-product of protein digestion) are high you do not want to eat a lot of protein, especially animal protein.

Drinking fresh vegetable juices is very useful, my favorites are watercress, fennel and parsley in a carrot or apple base, with a touch of lemon. Also spirulina, blue-green algae, chlorella, barley or wheat grasses go great with the fresh juices. This also lowers liver enzymes.

My favorite supplement for fatigue is REM+. You can take up to 5 capsules 3x daily. Also squalene is useful especially in conjunction with physical exercise and/or deep breathing exercises that oxygenate the body. Be careful not to push too hard with exercise if you don't bounce back easily. With squalene use 2 capsules twice daily with meals.

Often we find that doing a detox program is what makes people feel better and this improves their energy. There are many different protocols including intestinal cleanses with coffee enemas that are effective. The program we use is similar in intent to fat flush type programs, but fairly simple. Diet is important, especially the eating of pure oils like olive or flax, with no hydrogenated fats and not much animal fats like meat or cheese.

We use 5 pellets of lidan before meals which makes the body dump bile, so that toxins collected by the bile get flushed out, rather than re-absorbed in the intestines. We also give 2 capsules of Membrane Complex, aka 2-AEP (call 877-454-4372 to order) before meals. With meals we give 3 capsules of phosphatidyl choline and 2 capsules of squalene. The purpose is to flush neurotoxins out of cell membranes where they become lodged, creating odd-chained fatty acids. Dr. Patricia Kane has detailed how these odd-chained fatty acids are used by viruses. Her work completes a link which we often seen clinically of how toxic exposures can lead to viral flare-ups. During this detox use plenty of pure oils like olive, flax and evening primrose. Please, no hydrogentated or vegetable oils. Also limit fats from animal sources other than fish from impeccably clean waters.

Is Hepatitis C sexually transmitted?

The short answer is no, though condoms are recommended when a women is menstruating.  Here is the definitive study that was done on this question.

No Evidence of Sexual Transmission of Hepatitis C among Monogamous Couples: Results of a 10-Year Prospective Study

The risk of sexual transmission of hepatitis C virus (HCV) infection was evaluated among 895 monogamous heterosexual partners of HCV chronically infected individuals in a long-term prospective study, which provided a follow-up period of 8,060 person-years. Seven hundred and seventy-six (86.7%) spouses were followed for 10 yr, corresponding to 7,760 person-years of observation.

One hundred and nineteen (13.3%) spouses (69 whose infected partners cleared the virus following treatment and 50 who ended their relationship or were lost at follow-up) contributed an additional 300 person-years.

All couples denied practicing anal intercourse or sex during menstruation, as well as condom use. The average weekly rate of sexual intercourse was 1.8.

Three HCV infections were observed during follow-up corresponding to an incidence rate of 0.37 per 1,000 person-years. However, the infecting HCV genotype in one spouse (2a) was different from that of the partner (1b), clearly excluding sexual transmission.

The remaining two couples had concordant genotypes, but sequence analysis of the NS5b region of the HCV genome, coupled with phylogenetic analysis showed that the corresponding partners carried different viral isolates, again excluding the possibility of intra-spousal transmission of HCV.

The authors conclude, “Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners.”

06/21/04