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Ask the Naturopathic Doctor

Healing Hepatitis C

A trio of nutrients can help reverse liver damage, whether or not drug therapy is used.

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Hepatitis C is a blood disease acquired by blood-to-blood contact with an infected person. Risk factors include blood transfusion history (the blood supply has been tested since 1990), IV drug use, having sex with someone who has used IV drugs, and tattoos (make sure the artist opens a new bottle of ink).

More than 3 million people in the U.S. are infected with hepatitis C; most of them are “baby boomers” born between 1945 and 1965. Of those infected with the virus, the majority develop chronic hepatitis C, which can result in severe liver damage, long-term health problems, and even death.

Liver Health Basics

The liver is the major organ of detoxification. Everything that goes into your digestive system is processed into micro-units and absorbed into the bloodstream through the villi of the small intestine. The network of blood vessels outside the small intestine leads into the portal vein, which brings all the newly absorbed nutrients through a “first pass” in the liver.

Liver damage begins with “fatty liver.” Fat builds up around the liver cells in an attempt to wall off toxins. Fatty liver can progress to cirrhosis, which means scarring of the liver tissue, rendering it incapable of performing various jobs such as producing bile and sorting out hormone recycling. After cirrhosis, the damage can worsen further to necrosis, or tissue death.

Until a decade ago, the only way to diagnosis hepatitis C and other liver diseases was with a long-needle biopsy. Recent advances in ultrasound technology have made the process less invasive, especially a software known as elastography. It allows the ultrasound image to be manipulated, which provides a more detailed look at tissue changes in the liver. If you’re considering a liver biopsy, see if a hospital or clinic near you has this noninvasive ultrasound option instead.

Drug Treatment Options

Until recently, the drugs for the subtype of hepatitis C most prevalent in North America (subtype 1b) were not particularly effective, and also had serious side effects. Many hepatitis C patients in the past two decades have died from the effects of interferon (first given in 1991) and ribavirin (first given in 1998, often in combination with interferon) on their immune systems.

Interferon typically causes flu-like symptoms, muscle and joint pain, anxiety, and intense irritability. The New England Journal of Medicine published a trial of about 1,000 hepatitis C patients who took interferon and had no improvement compared to control groups. Ribavirin also has its problems: it can destroy red blood cells and increase the risk of heart attacks.

In 2011 a new class of drugs called “direct acting antivirals” (DAAs) were introduced, and the latest one, Harvoni, shows great promise. Harvoni is taken orally, one pill daily, usually for about 12 weeks. So far, Harvoni has produced a 97-99 percent cure rate for patients with subtype 1b. The patients I know who completed the course of Harvoni have reported zero to very-low-level side effects (mild nausea and headache). “Cure” means no viral load detected in a blood test. This is unprecedented in the world of hepatitis C treatment. When the viral load goes to zero, the risk factors for liver problems virtually disappear as well.

All-Natural “Berkson” Protocol

You might think it’s odd for a naturopathic physician to praise a drug. In general, naturopaths are less impressed with pharmaceutical therapy because drugs often produce damaging side effects, and they don’t necessarily cure the problem. Changing lifestyle habits (drinking more water, eating more vegetables, getting enough sleep and exercise) is much more likely to produce lasting “cures” for whatever ails you. And herbal and physical medicine are often very effective in moving patients along a continuum toward optimal health without unwanted side effects.

But Harvoni seems to hold the potential for a real cure for a major strain of hepatitis C, which could save countless lives. Unfortunately, the drug is so expensive that few people can afford it unless they have very good insurance.

There are, however, many ways to live better with hepatitis C if you can’t get the drug. All of my hepatitis C patients have been on the “Berkson” protocol for as long as 20 years-since it first became widely known. Burton Berkson, MD,* was initially motivated by the poor efficacy and side effects of drugs available for hepatitis C. Through extensive research, he found that a combination of 900 mg of silymarin (from milk thistle), 600 mg of alpha-lipoic acid (ALA), and 400 mcg of selenium, taken daily, ideally in 2-3 divided doses, can be effective for hepatitis C.

All thistle plants, including artichokes, are healing to the liver, and milk thistle is no exception-it is one of the most highly researched herbal remedies in the world. A lot of the early literature on milk thistle came out of Russia, where alcoholic hepatitis is rampant. Selenium is a trace mineral involved in at least 75 percent of all enzymatic reactions in the body. Detox is basically driven through biochemical enzyme pathways in the liver.

ALA is a short-chain fatty acid that helps increase insulin sensitivity, and is useful in treating metabolic syndrome, which often features the early phases of fatty liver. ALA also helps neutralize free radicals and reduce cellular damage. Research has confirmed the usefulness of ALA in treating a variety of liver ailments.

I’m convinced that one of the reasons my patients who took Harvoni got a complete cure with minimal side effects is that they had been following Berkson’s protocol for years, as well as abstaining from all alcohol and other drugs, including

OTC products such as Tylenol, most of which are toxic to the liver.

[Editors’ note: For more information on Burton Berkson, visit]