The ABCs of Hepatitis

Hepatitis is an inflammation of the liver. It can be caused by many different things, most commonly a virus, and of the viral causes of hepatitis, Hepatitis B is probably the most common. However, Hepatitis A and now C are likely to be close seconds.

Hepatitis A is typically spread through infected water and food that has been contaminated with feces. The symptoms that occur with the various types of hepatitis are similar, but the severity of them varies. These include: nausea, vomiting, fever, loss of appetite, fatigue, jaundice and changes in the color of the stool, sometimes becoming darker. Additionally, the stools can be become lighter as is seen with gallstones. It’s estimated that up to a third of the US population may contract hepatitis A over the course of their lifetime. Recovery is routine and usually occurs in about six months or so.

Hepatitis B is spread via the blood, infected needles, from mother to baby, and through sexual intercourse. While it is a little more difficult to contract than hepatitis A, it is more serious and may lead more often to chronic symptoms about 1-3% of the time. Interestingly, it is considered one of the more common causes of Hepatitis.

Hepatitis C is spread in a fashion similar to Hepatitis B. It is less common than Hepatitis B, but causes chronic hepatitis in 50 to 80% of those infected according to the CDC. This unfortunately, can be difficult for the person struggling with this disease. Of the three, this type of hepatitis is the most insidious and destructive. Interferon is often used to treat this infection, sometimes with success, but often with many side effects that mimic severe flu. Treatment with interferon is typically six months or more. Imagine having the flu for six months. However, if it is successful than you may have spared your liver. The success rate with interferon however is limited. In my practice, I’ve seen hepatitis C patients go on to develop autoimmune type reactions in addition to cirrhosis of the liver. This can take 20 years, but is a real potential end result of the infection.

Hepatitis C inflicts its damage by latching on to iron in your liver and initiating a huge free radical shower effectively blowing holes in your liver cells allowing them to leak out their liver enzymes. It would make sense then that if we could lower iron levels we could benefit this illness. High doses of green tea polyphenols (300 to 600mg/day) and garlic (2000mg daily) may help reduce serum and liver iron levels and possibly lessen the severity of this illness.

Other Virally-induced causes of hepatitis include Hepatitis D, E, Cytomegalovirus, Epstein Barr Virus, Herpes Simplex Virus, and Varicella (the chicken pox virus). These are much rarer than the former three, but do exist as causes of Hepatitis.

In addition to viruses, some bacteria and parasites are associated with hepatitis including Leptospirosis, Rocky Mountain Spotted Fever, Syphilis, Typhoid Fever, Liver trematodes, and Toxocariasis.

Even autoimmune diseases like lupus can cause hepatitis.

Lastly, chemicals: including acetaminophen (Tylenol), Oral Contraceptives, sulfa drugs, Alcohol, anti-seizure medications, and medications used to treat tuberculosis can cause hepatitis.

Drug Therapies

The FDA approved treatment for Hepatitis B is alpha-interferon. Hepatitis A is generally self-limited and those infected will recover within six months. Hepatitis C is also treated with alpha-interferon. Additionally, Ribavirin has been used for Heaptitis B and C. Consult your gastroenterologist for the most up to date treatments in this case.

So what can you do about it?

Hepatitis A is generally self-limited. Hepatitis B and C are not necessarily self-limited and in fact often aren’t. The treatment varies depending on the cause; however there are some general recommendations that one could follow to make the risk of long-term damage less likely. I encourage you to follow the instructions of your gastroenterologist, but nutritional support for this illness would include the following:

1) Silymarin from milk thistle. This is a very powerful antioxidant and will go to the liver to protect it from oxidative stress. In fact, that is the general approach in protecting the liver in the case of all hepatitis: lessen oxidative stress. The German Commission E monographs support the use of Silymarin as a supportive agent in the treatment of inflammatory liver disease.

200 micrograms twice daily is reasonable to protect the liver from oxidative stress.

2) Phosphatidyl Choline 4 capsules twice daily. Phosphatidyl Choline or PC for short, is a great rejuvenator of the liver, especially in the case of alcoholic hepatitis and has been used in Europe for years in the treatment of cirrhosis. This is a special type of fatty acid complex and remember the liver is full of fats in its membranes. There is a lot of repair work to do and PC helps accomplish that.

3) Selenium, a potent antioxidant may be helpful in protecting the liver as well. In one study published in the Journal of Biological Trace Element Research (1997), the rates of hepatitis B and primarily liver cancer were lower in areas with the highest levels of dietary selenium. In a 4-year study on over 130,000 Chinese who were given selenium in their table salt, there was a 35% reduction in primary liver cancer compared with the group given salt with no selenium. In animal studies selenium supplementation reduced hepatitis B infection by 88% and precancerous liver lesions by nearly 76%.

200 micrograms twice daily is reasonable

4) Licorice root extract 500mg three times daily may provide benefit as well. In Japan this herb has been shown to lower the liver enzymes aspartate aminotransferase (AST) and alanine aminotransfersase (ALT).

5) Vitamin E 400 to 800 ius daily seems reasonable in the short term for this illness, however long term (more than six months) 200 units is probably prudent.

6) Another key antioxidant for the liver is glutathione. Products that help the body make its own glutathione include N-acetyl cysteine (NAC) 600mg twice daily is reasonable. Glutathione can also be generated from highly refined whey protein, which generally comes in packets of 10 to 30 grams. They have to gently be worked into yogurt or water. High powered blending will compromise its integrity and ability to help you make glutathione. There is also now a micellized version of liquid glutathione available from Wellness. Traditionally, straight glutathione has not been well absorbed. This version has been enrobed in special fat globules and seems to be better absorbed. In my practice we have seen about a 25% increase in serum glutathione levels using this product once daily (one tsp).

7) Reportedly alpha-lipoic acid 250mg twice a day will also help boost glutathione levels.

In summary the following nutrients may be of benefit in the nutritional support of hepatitis:

  • Green tea polyphenols 300 to 600mg twice daily
  • Garlic 2000mg daily
  • Silymarin 200mg twice daily
  • Phosphatidyl Choline 900mg capsules four twice daily
  • Selenium 200 micrograms twice daily
  • Licorice Root 500mg three times daily
  • Vitamin E 400 units once to twice daily for 3-6 months, then 200 ius daily
  • Glutathione 500mg three times daily or N-Acetyl Cysteine 600mg twice daily or highly refined whey protein one packet twice daily
  • Alpha-Lipoic Acid 250mg twice daily

As always, consult your doctor and for those of you fighting any form of Hepatitis, I hope this information will be helpful.

To Your Health!!

Dr. Neal


  • Brundage SC, et al, Hepatitis A, American Family Physician pp. 2162- 2168. June 15, 2006.
  • Hepatitis B and C, Life Extension Disease Prevention and Treatment. Third Edition pp321-331.
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