When to treat/what to eat - articles from HC advocate

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rom the HepC Advocate

> **********************

> " HealthWise: Choosing Not to Treat Hepatitis C

> —Lucinda K.Porter, RN

> Imagine this scene. Your medical provider recommends treatment for chronic

> hepatitis C virus infection (HCV). You've had HCV for 30 years and your liver

> is moderately scarred. You have genotype 1 so treatment will likely last for

> 48 weeks. You have read about the side effects of the medications and, after

> careful consideration, you'd rather take your chances with hepatitis C than

> with the treatment.

> Regular Healthwise readers probably think I am going to try to persuade this

> fictitious patient to reconsider. After all, if I didn't believe in treatment

> I would not have tried it once, let alone twice. However, the decision to

> undergo treatment is a complicated one, and what worked for me might not work

> for others.

> So, this month, I am headed in a different direction. I explore the other

> path—making the choice to not treat. I recommend ways to support your liver

> and general health. This advice applies to nearly everyone, but particularly

> those with liver disease.

> There are many reasons for rejecting HCV treatment. Here are some:

>

> You are concerned that you might not be able to work.

> You are troubled by the potential side effects, particularly depression.

> You are bothered by the fact that the medication is given by self-injection

> and concerned it may trigger a relapse from drug recovery.

> You distrust the pharmaceutical industry and their products.

> You are committed to natural or alternative medicine.

> You are afraid that treatment will be unendurable.

> You are paralyzed by indecision.

> You are scared that the medication will harm, maim or kill.

> You favor waiting for better HCV medications.

> You are unwilling to go through treatment without better odds of success.

> You feel well and don't want to give that up for a year.

> Your liver has little or no fibrosis and waiting makes sense.

> You think a sharp stick in the eye sounds like a better alternative.

> Let's assume you discussed all of this with your medical provider and your

> mind is made up. Now what?

> First and foremost, minimize stress to your liver. Abstain from alcohol use.

> If you aren't willing to quit, limit your drinking to no more than one

> standard size drink a day. One standard drink is 12 ounces of regular beer, 8

> to 9 ounces of malt liquor, 5 ounces of table wine, or 1.5 ounces of 80–proof

> spirits. If drugs or alcohol are a problem, get help.

> Keep your weight under control. Nonalcoholic fatty liver disease (NAFLD) is

> quickly becoming a serious health problem in this country. NAFLD is the most

> common cause of elevated liver enzymes. Tragically, NAFLD is striking

> children as well as adults. Complications from NAFLD include liver cancer and

> death.

> Fortunately, NAFLD is treatable and potentially reversible. Weight loss is an

> effective treatment for NAFLD. Exercise may help. Patients with NAFLD showed

> improvement with as little as 60 minutes a week of low-to-moderate intensity

> exercise. Patients who exercised but did not lose weight also had significant

> improvements in fasting blood glucose, insulin resistance, and cholesterol and

> triglyceride levels.

> Eat a low fat, high-fiber diet. Include fresh fruit, vegetables, and whole

> grains. Avoid trans-fatty acids, saturated fats, corn syrup and excess salt.

> Eat real food—rather than stuff out of a box.

> Practice safe food habits. Avoid raw or undercooked shellfish. Raw or

> undercooked oysters and clams may carry Vibrio vulnificus—bacteria that cause

> a number of serious clinical conditions. Uncooked shellfish may also harbor

> hepatitis A.

> Beware of poisonous mushrooms. They contain toxins that can destroy even the

> healthiest liver.

> Do not eat wild mushrooms unless you are 100% sure of what you consume.

> Aim for 30 or more minutes of exercise every day. If you are confused about

> exercise, here is a simple place to start. Put on comfortable walking shoes

> and sunscreen. Step outside and walk 15 minutes or more. Then turn around.

> Make this a daily goal. If 30 minutes is too much, start with something you

> can do. A walk to the mailbox is better than no walk.

> Protect your liver from other viruses. If you aren't already immune to

> hepatitis A and B, get vaccinated. Make sure all immunizations are up to

> date, including an annual flu shot.

> Get regular check-ups. Your medical provider will recommend how often you

> should be seen and what labs and other diagnostic tests need to be performed.

> This all depends on the condition of your liver. Blood tests are usually done

> every six or twelve months, more frequently if you have cirrhosis. Medical

> appointments are usually scheduled annually, more often for patients with

> advanced liver disease. If you have cirrhosis, your provider may order an

> abdominal ultrasound every 6 months. Liver biopsies are usually recommended

> every 3 to 5 years. If you already have cirrhosis, there is no need to biopsy

> the liver.

> If you use herbs or dietary supplements, learn how to do this safely. Some

> herbs are toxic to the liver. Large doses of any supplement are strongly

> discouraged. More is not better. Vitamin A in high doses can cause liver

> injury. Iron supplementation should only be taken under medical supervision.

> Herbs should never be used by people with decompensated cirrhosis. For more

> information about dietary supplements, visit www.hcvadvocate.org.

> Act responsibly around blood and bodily fluids. This means not infecting

> others, and avoiding infections from others. Wash your hands. Practice safer

> sex. Cover all cuts or wounds. Do not share personal hygiene instruments,

> such as razors, cuticle scissors, nail clippers, toothbrushes or other items

> that might be exposed to blood. Properly discard all feminine hygiene

> products. Use good judgment when getting tattoos or body piercings.

> Strive for the best health possible. If you smoke, try to quit. If you don't

> floss your teeth, make this a daily goal. Wear your seat belts. Look for

> every opportunity for improvement. If you hear yourself groaning about this,

> consider an attitude adjustment. We don't have to improve our health—we can

> take chances. Alternatively, we can take our future into our own hands and

> start feeling better now.

> Keep abreast of medical news. Science is making giant leaps. The Hepatitis C

> Support Project provides the latest news on liver disease. You can subscribe

> to regular updates or go to www.hcvadvocate.org. At this website, there is an

> extensive list of HCV and other liver-related drugs that are in various stages

> of development.

> Finally, think about others. Although you cannot donate blood to a blood

> bank, you may donate your organs and tissues after death. To register, visit

> www.donatelife.net The Harvard Brain Bank would love your brain.

> www.brainbank.mclean.org 1-800-BRAIN BANK (1-800-272-4622) Consider giving

> this ultimate gift. "

>

> ************

> " Blueberries, Asparagus and HCV

> —C.D. Mazoff, PhD

> Being a lover of blueberries and asparagus, the recent news articles about

> research done on blueberries and HCV and asparagus and liver toxicity not only

> got my interest but also perked up my appetite!

> I'll eat as many blueberries as I can when they are in season – in smoothies,

> with ice cream, on my morning granola or cornflakes, or whatever. I always

> knew that blueberries were good antioxidants, but I didn't know that an

> extract from the leaves has been shown to be a powerful agent against HCV.

> Findings published in a recent article in the Journal of Biological Chemistry,

> by Masahiko Takeshita et al. of the University of Miyazaki " suggest that

> proanthocyanidin isolated from blueberry leaves may have potential usefulness

> as an anti-HCV compound by inhibiting viral replication, " thus slowing or

> stopping disease progression.1

> The researchers screened nearly 300 different agricultural products for

> potential compounds that suppress HCV replication and found one in the leaves

> of blueberries. The researchers purified the compound and identified it as

> proanthocyanidin, a polyphenol similar to the beneficial chemicals found in

> grapes. Okay, I eat grapes too. Double yum.

> Apparently the blueberry extract found to be most effective comes from a type

> of blueberry found in the South eastern USA: Rabbit eye blueberries (Vaccinium

> ashei).

> A quick look on the internet showed me that Rabbit eye blueberries have been

> used in Food research for some time, but they are not the type used in

> blueberry extracts found in most health food stores – I checked. Hmmmm???

> I did find this, however: " The common blueberry is an abundant source of

> several potent antioxidants, particularly Anthocyanin and related compounds.

> Clinical studies have shown that Anthocyanin neutralizes free radicals which

> are specific to age-related mental clarity and memory capacity. This

> particular family of antioxidants has also been proven effective in fighting

> the free radicals responsible for macular degeneration and other age-related

> eye disorders. A 2001 study at Tufts University rated blueberries as the most

> potent antioxidant of over 60 foods tested (Tufts University. Researching a

> Blueberry/Brain Power Connection. TuftsUniversity Health and Nutrition Letter,

> March 2001, Vol. 19. Number 1) " .2

> Further investigation showed me that what blueberries do is lower cholesterol

> and other lipids, like triglycerides.

> In fact research done at Saga University in Japan and published in 2008,

> showed that Vaccinium ashei had a startling efficacy in lowering hepatic

> lipids in rats.3

> But nowhere could I find out where to get this extract, or how the extract is

> made, or if eating more blueberries would produce a similar effect. Bummer.

> Asparagus

> Just when I thought things couldn't get better, along comes this news item

> about an article on Asparagus published in the Journal of Food Science saying

> that " an extract from asparagus may increase the function of enzymes in the

> liver and boost the metabolism of alcohol. " The researchers from Korea

> concluded that " the leaves of A. officinalis, which are normally discarded,

> have the potential for use in therapy designed to protect the liver from

> various harmful insults. " Sadly, again, no extract recipe.

> Asparagus has long been used as an herbal medicine in Asia thanks to its

> anticancer effects. It also has antifungal, anti-inflammatory and diuretic

> properties, and its health properties probably result from its high levels of

> folate and potassium, and Vitamin C. Green asparagus contains approximately

> six times the levels of Vitamin C than citrus fruits.

> (http://food-facts.suite101.com)

> Okay…but where do I find this stuff, and how do I make sure that it's what it

> says it is, and how much do I take, and what are the side effects if any. All

> this worry is making me hungry.

> I've got an idea. While I'm waiting for more information, I think I'll make

> myself some grilled wild salmon with blueberry sauce, have lots of asparagus

> on the side, and worry about it tomorrow. Because the way it seems to me is

> that lowering serum lipids and boosting glucose tolerance is the best thing I

> can do for my liver in the meantime, and that I can control my health for now

> with my diet.

> Notes:

> 1 " Proanthocyanidin from Blueberry Leaves Suppresses Expression of Subgenomic

> Hepatitis C Virus RNA, " J. Biol. Chem., Vol. 284, Issue 32, 21165-21176,

> August 7, 2009

> 2www.blueberryextract.com

> 3Effect of Vaccinium ashei reade Leaves on Lipid Metabolism in Otsuka

> Long- Tokushima Fatty Rats. Koji NAGAO1, et al. Saga University.

> Bioscience, Biotechnology, and Biochemistry Vol. 72 (2008) , No. 6

> pp.1619-1622. "