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29837 tn?1414534648

Very Interesting Reading... Part 2

Key Words: Hepatitis C - treatment - antioxidant - alpha lipoic acid - thioctic acid - silymarin - selenium Patients and Method: The 3 basic antioxidants there were used in this report are alpha-lipoic acid (thioctic acid), silymarin and
selenium (selenomethionine). The alpha-lipoic acid product was manufactured by Asta Medica at Frankfurt Am Main, Germany. The silymarin was a product distributed by NOW Foods of Bloomingdale, Illinois, and the selenium was encapsulated by Metabolic Maintenance Products Inc., of Sisters, Oregon.

DISCUSSION - ALPHA-LIPOIC ACID

Alpha-lipoic acid (ALA) is a small organic molecule with a disultide bond. It is a superb antioxidant that is soluble in both water and fat. ALA is an important coenzyme for the production of acetyl coenzyme A. Dihydorlipoic acid (DHLA), it's reduced form, is an electron donor that recycles other fundamental antioxidants (vitamin C, vitamin E, and glutathione). ALA and DHJLA are superb free radical scavenger themselves because they neutralize peroxyle radicals, hydroxyl radicals and singlet oxygen. ALA is also a metal chelator that removes mercury from tissues,
prevents calcium oxalate crystals (stones) from forming in the kidneys, chelates copper, and removes arsenic.
Lately, there has been a great explosion in ALA research. The lipoic acid/dihydrolipoic acid redox couple inhibits viral replication by stabilizing the NFK beta transcription factor, blocks the development of cataracts, protects the kidneys form aminoglycoside damage, insulates the pancreatic islet cells form inflammatory assault, inhibits thymocyte apoptosis, and stimulates the production of helper T cells. In addition, the toxic side effects of cancer chemotherapy can be attenuated with the use of ALA and it protects bone marrow from free radical damage secondary to ionizing
radiation. Numerous other studies show that ALA is useful for the treatment of diabetes mellitus and syndrome X because it increased cellular glucose utilization. And significantly reduces insulin resistance. Diabetic neuropathy originates from a decrease in blood flow to various organs. This results in an accumulation of free radicals that can destroy nerve function. In one study, ALA brought about a significant reduction of neuropathic symptoms in 23 patients. This was accomplished by abolishing the products of lipid peroxidation and increasing the entrance of glucose into the cell. Due to ALA's lipophilic characteristics, it can cross the blood-brain barrier quite easily and can scavenge free radical toxins in the central nervous system. Both ALA and DHLA protect animals from neuronal death following laboratory-induced cerebral ischemia and reperfusion experiments. This effect is explained by the fact
the ALA greatly increased glutathione levels in nervous tissue, thus protecting the nerves from the toxic products of oxidation. For many years, ALA was used as a treatment for liver disease. As of yet, however, there are not many papers on this subject, and some studies used entirely sub-therapeutic dose. Ethyl alcohol (ETOH) damages the liver by several mechanisms that ultimately lead to the proliferation of innumerable free radicals. These toxins damage
the cell membranes by lipid peroxidation. It has been reported the ALA lowers the levels of ETOH metabolic breakdown products, and in consideration of this ALA may be an effective treatment for alcohol induced hepatitis, early cirrhosis, and alcoholic coma. In the late 1960's and 1970's, there were several studies describing the successful treatment of hepatotoxic mushroom poisoning with intravenous ALA. National Institutes of Health studies reported the survival of 73 out of 79 seriously poisoned patients. In American, interest in the use of ALA for  hepatotoxic mushroom poisoning, and liver disease in general, was in the main lost, because of the growing  fascination with liver transplantation as a proposed "standard of care" treatment for serious liver disease. SILYMARIN
Silymarin is the mixed extract of the milk thistle plant (sylibum marianum) and has been used for hundreds of years as a treatment for liver disease. In the late 1960's and 1970's it was extensively used for serious hepatotoxic mushroom poisoning with excellent results. It has been demonstrated to be a proficient antioxidant, protecting the liver by neutralizing dangerous hydroxyl radicals, superoxide ions and hypochloric acid. In this way silymarin neutralized the toxins that destroy the cellular membrane systems and the hepatocyte's genetic material.
Silymarin, like ALA, increases cellular glutathione levels and decreases tumor promoter activity. Human viral hepatitis studies with silymarin demonstrate quicker normalization of liver enzymes, expeditious reduction of bilirubin
levels, and shorter hospital stays. In addition, silymarin has been shown to be an effective antidote for toluene and xylene toxicity, and drug overdoes. Alcoholic and other chronic liver disease patients lowered their liver enzymes, decreased their levels of procollagen III, and improved the histology of their livers with daily oral administration of
silymarin . Taking this intelligent reasoning into account, silymarin offers another effective treatment choice for serious liver disease.

SELENIUM

Selenium (Se) is an essential metal that is required for normal antioxidant metabolism, reproduction and thyroid function. It is also an important coenzyme for the glutathione peroxidase detoxification system. Because of this, selenium neutralized peroxides that proliferate under oxidate stress and consequently protects cell membranes from free radical damage. Selenium often combines with amino acids and forms selenoproteins. Viruses might benefit from being directly involved in this selenoprotein encoding process by monitoring selenium levels in the cell.
Consequently, this viral behavior could act as a barometer for increasing or decreasing viral reproduction. If cellular selenoprotein levels fall, the virus might become more active and produce more viruses that attack new cells. If selenoprotein levels rise, the virus may remain in a dormant state for longer periods of time or remain permanently dormant. Research papers have reported that RNA viruses, including hepatitis C virus, encode selenium-dependent glutathione peroxidase genes. In view of this concept, it is entirely possible that a specific viral gene could generate a selenium shortage in the host. And in this way, a selenium deficiency could stimulate viral proliferation and thus promote the progression of hepatitis C. To continue, in that case, the addition of selenium might act as a "birth control pill" for the virus, and thus show down it's reproduction mechanisms. According to several investigators this could give the immune system a chance to control the hepatitis C or HIV disease process.

CONCLUSION

There are no remarkably effective treatments for chronic hepatitis C in general use. Interferon and antivirals have less than a 30% response rate and liver transplantation is uncertain and tentative. This is partially due to the residual viremia; the newly transplanted liver ultimately becomes infected again. The triple antioxidant combination of alpha-lipoid acid, silymarin and selenium were chosen for a conservative treatment of hepatitis C because these substances protect the liver from free radical damage, increase the levels of other fundamental antioxidants and interfere with virus proliferation. The 3 patients presented in this paper followed the triple antioxidant program and recovered quickly form this potentially devastating viral infection. Furthermore, liver transplantation can be painful, disabling, and extremely costly.

Magum
16 Responses
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Avatar universal
I meant to type "go to NIH" but my fingers typo'd and I said 'good the NIH'         oops.

Susan400
Helpful - 0
Avatar universal
It is important to remember that one can take too much of certain vitamins and cause more harm than good.  Taking megadoses of selenium is actually not safe.  Good the NIH and check it out.  Taking too much selenium is toxic and can actually cause cirrhosis.  If you are going to take selenium as a supplement is is very important to not take megadoses of this supplement and keep it at the low end of the scale.

Susan400
Helpful - 0
29837 tn?1414534648
From one Virgo to another, I too was waiting and waiting to start treatment, but have you talked to your doctor about waiting? When was your last biopsy? I've been told several times that feeling great doesn't necessarily mean you are not in trouble. Best of luck in staying steady...

Magnum
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Avatar universal
good lookin out mag. i have tried just about most of the things on your list. i guess thats why i have no symptoms. vitamins have really helped, milk thistle, nac ,ala. it worked for me. i feel so good.  still trying to decide if i want tx.
Helpful - 0
29837 tn?1414534648
"Vitamin C—2000 mg daily (on an empty stomach to minimize the increased iron absorption caused by vitamin C)"

Isn't this an ambiguous statement?

Magnum
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144210 tn?1273088782
Some other useful info from the Life Extension website:

Life Extension Foundation Recommendations
Some herbs are metabolized in the liver and can be toxic to it, especially in high doses. The following herbal products have demonstrated liver toxicity: germander, comfrey, chaparral leaf, ma huang, pennyroyal, skullcap, and mistletoe. If one desires to use any of these herbal products, it is advisable to do so under the care of a physician and with careful monitoring of liver enzymes and hepatitis C viral counts (Harvey J et al 1981; Gossrau R et al 1990).

Hepatitis C latches on to iron to inflict free-radical damage on liver cells. One way of reducing these toxic free radicals is to lower the amount of iron in the liver. Serum iron levels should be maintained at the lowest possible tolerable levels (ideally below 60 mcg/dL of blood), and serum ferritin levels should be maintained in the low normal range of 30 to 80 ng/dL.

Another way of protecting the liver is to consume the proper antioxidant nutrients to protect cells against the damaging effects of free radicals. A healthy immune system may keep hepatitis C in check. Supplements that help maintain youthful immune function are of particular importance.

The following supplements have been shown to reduce liver oxidative damage, lower iron, and boost the effectiveness of conventional drugs:

Calcium citrate—1000 to 2000 milligrams (mg) daily with iron-containing foods to block iron absorption
Lactoferrin—900 mg daily, to block iron, in divided doses
Lipoic acid—750 mg in three divided doses daily
NAC—600 mg daily
Whey protein isolate—20 to 40 grams (g) daily
Glutathione—500 mg daily, on an empty stomach
Silibinin extract—900 mg daily, in two divided doses
SAMe—1200 mg daily, in three divided doses
PPC—1800 to 3600 mg daily
Green tea extract (93 percent polyphenols)—750 mg daily
Garlic (high allicin)—900 mg daily
Aged garlic extract (Kyolic®)—1200 mg daily
Selenium—200 to 600 micrograms (mcg) daily
zinc -200mg daily ?
magnesium 500 x 1
Vitamin E—400 international units (IU) daily with at least 200 mg gamma tocopherol
Vitamin C—2000 mg daily (on an empty stomach to minimize the increased iron absorption caused by vitamin C)
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Peace.
Helpful - 0
144210 tn?1273088782
Thought it might be a good time to re post this info:


HRs' Liver Lover Supplement List


I have added links if additional info wanted.

B12, B6 and Folic acid

a multi vitamin/no iron

1000 mg of Salmon Oil (epa=160 mg / dha=240 mg / omega 3 = 400 mg) x1

1000 mg of ALA
Raw flaxseed/ 1 teaspoon daily

Hepatapro PPC (900 mg) x 2
info:  http://www.medhelp.org/posts/show/346752  ;


Resveratrol (500 mg) x1  and x2 (alternate every other day)
info:   http://www.lef.org/resveratrol/
source:   http://megaresveratrol.com/


SAM-E  (200mg)  x 2


NAC--(n-acetyl-l-cysteine) A sulfur compound that is a precursor of glutathione and protected sulfur-containing amino acid  (600 mg) x2 with Vit C (500 mg) x2
Info:   http://tinyurl.com/9yopf

TMG (750 mg) x 2
http://www.raysahelian.com/trimethylglycine.html

Taurine (500 mg) x 2
In a double-blind, randomized study (3), acute hepatitis patients were given taurine in the amount of 4 grams 3 times a day after meals. The participants in the taurine study experienced significant decreases in bilirubin, and total bile acids.

Super Biocurcumin 800Mg 60 Caps (800 mg) x 2  / Powerful Antioxidant Properties to scavenge free radicals
Anti-Inflammatory Actions
Enhances important detoxification enzymes Curcumin increases the secretion of bile by stimulating the bile duct. It also protects the liver by detoxification, stimulating the gall bladder and scavenging free radicals. With the help of the adrenal glands, it inhibits both platelet aggregation and the enzymes which induce inflammatory prostaglandins. Curcumin may also help break down fats and reduce cholesterol. Large doses not recommended in cases of acute bilious colic, obstructive jaundice, painful gallstones, and extremely toxic liver disorders



Sylmarin (425 mg) x 2 / Milk thistle provides hepatocellular protection by stabilizing hepatic cell membranes.

Green Tea Extract (300 mg) x 2 /
info:  http://tinyurl.com/ypdp9q

Coq10 (200 mg) x 1 / http://tinyurl.com/29em8c

Inulin 1 teaspoon daily
Lactobacillus GG (culterelle) 1 tab x 2


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What to take while on tox per HR

The supplements while on tx question is difficult, because the ones having antifibrotic promise are almost all antiinflammatory, somewhat reducing the initiating events at the dendritic cell/lymphocyte interface.I know this sounds technical. Most of them also have, paradoxically an improving effect on some aspects of lymphocyte function, as the spectracell test clearly shows.

Bottom line, NO CLEAR ANSWER possible  regarding  use during tx.

But a moderate use of NAC/VitC, TMG, ALA ( those are quite cheap and possibly  PPC (since it was actually shown to help the SVR rate) is probably a good idea even during tx. Vit D3 is good, but it would be best to know ones serum level.
Also some Inulin is inexpensive (http://www.raysahelian.com/inulin.html) and a very good well researched prebiotic.   Cannot get Lactulose here in the US  without script.  Available w/o script in Canada. Inulin is the alternative.
-------------------------------------------------------------------------------------There is no fundamental difference between pre tx and post tx antifibrotic measures, except that once you are SVR you can hope/expect the profibrotic inflammatory process in the liver to slow down or in the balance with the constant removal of some fibrosis to tilt towards reduction by itself.

The diet principles of small volume, high fiber meals to reduce the metabolic stress on the liver, removal of adipositas and the principle of prebiosis/probiosis/eubiosis apply always before any "supplements" should be taken.
The glutathione replenishing Sulfur containing NAC, ALA, Taurine and SAMe, possibly if affordable combined with actual glutathione  ( some will be absorbed and the rest will supply building blocks) are good starters for liver protection. TMG also tends to improve liver metabolic performance, since it supplies the Methylgroups needed in numerous biochemical reactions.  What you already take is fine too, many of these "supplements ' work in concert and while there are many studies on cells and animals, there are few human trials, since nobody will want to pay for these.

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Addendum: by gauf

B12, B6 and Folic acid

"Protecting against ribavirin-induced anemia. Hemolytic anemia can result from the use of ribavirin in about 10 percent of cases. Folic acid and vitamin B12 (as methylcobalamin) may protect against ribavirin-induced anemia. The methylation-enhancing effects of both folic acid and vitamin B12 will also improve the liver-protecting effectiveness of S-adenosyl-L-methionine (SAMe) (Bottiglieri T et al 1994; Swain RA et al 1997). Serum ferritin levels are closely monitored during interferon and ribavirin therapy to ensure that iron levels stay within the normal range. Iron supplements are to be taken only under direction of a healthcare provider."
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Boosting Liver Glutathione Levels

Glutathione is the most important antioxidant used and manufactured by the liver. It kills bacterial invaders, acts as a cellular detoxifier, and helps prevent damage from free radicals. In patients with hepatitis C, particularly those who are HIV positive, a systemic depletion of glutathione is observed, especially in the liver. This depletion may be a factor underlying the resistance to interferon therapy and a biological basis for supplementing with the following nutrients that raise glutathione levels (Moriya K et al 2001):

N-acetyl-cysteine. N-acetyl-cysteine (NAC) is derived from L-cysteine, a conditionally essential amino acid. NAC is more efficiently absorbed and also acts as an antioxidant.
S-adenosyl-L-methionine. S-adenosyl-L-methionine (SAMe) is an effective antidepressant that also helps regenerate normal liver function by increasing glutathione levels and decreasing the activity of free radicals. It is one of the most important liver-protecting substances in the body.
Lipoic acid. This acid is used by almost every tissue in the body as a free-radical fighter. It also helps regenerate other essential antioxidants and acts as a metal chelator.

Whey protein isolate. This protein boosts glutathione levels and improves the functioning of the immune system. The fact that hepatitis C often becomes active in people after they reach the age of 40 indicates that age-associated immune decline plays an important role in the progression of the disease.

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While on tox, I omit some anti inflammatories, i.e. milk thistle, resveratrol, green tea, curcumin.
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Helpful - 0
476246 tn?1418870914
Magnum, thanks for posting this.

Here is a good link Abbas posted not too long ago. It talks about dosage of some of these supplements.

http://www.hepcchallenge.org/choices/supplements.htm

Just wanted to mention, that it is also very important to find the right ALA. It should contain only the R+ kind and not the R-
I found a good one called RalaPure. Also wanted to add that ppl on diabetic medication or insulin dependant should consult with their docs first!

Marcia
Helpful - 0
29837 tn?1414534648
Good question. I will investigate with both my Hepatologist and Gastroenterologist and report my findings. Might be a good idea if others follow suit. Nothing was ever mentioned that these treatments caused any damage, so....???

The ever optimistic, searching, illuminating and exploring...Magnum
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29837 tn?1414534648
More here

http://www.umm.edu/altmed/articles/alpha-lipoic-000285.htm

Magnum
Helpful - 0
374652 tn?1494811435
There is a doctor here in NM that works w/ HCV peops and Alpha Lipoic Acid, I may make an appointment He also does IV Alpha Lipoic Acid.  I may make an appointment for a consultation... M4mow
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Avatar universal
Tell me something i dont already know.
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Avatar universal
So what do you think, it wouldn't hurt to try if I'm not gonna get treated with Interferon and antivirals
Helpful - 0
232778 tn?1217447111
I don't understand this comment:

"There are no remarkably effective treatments for chronic hepatitis C in general use. Interferon and antivirals have less than a 30% response rate and liver transplantation is uncertain and tentative."

That's quite the statement to make. I thought for many genotypes, the success rate was well over 70%, and even for the dreaded Geno 1 it is close to 50%.
Helpful - 0
408795 tn?1324935675
Good article there, it got a little wordy in the middle of this page where it says all the talk about neuropathy.  It's an interesting read for sure.  later
Helpful - 0
Avatar universal
wonder what the dosage was?

                                                                             Ron
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