The rate of complementary medicine use by hepatitis C patients dissatisfied with conventional medications is estimated to be as high as 60%. Various types of agents and approaches are used in this setting, including milk thistle, vitamin therapies, Chinese herbal therapies, acupuncture, and lifestyle-modification techniques. Despite the widespread use of these modalities, few -- if any -- well-designed clinical trials evaluating the efficacy of these therapies in hepatitis C have been published.
Silymarin or milk thistle is the most common alternative medication used by patients with hepatitis. Silymarin, which exhibits certain antioxidant properties and may function as a free-radical scavenger, has been used to treat all forms of liver disease for more than 2000 years. It appears to be safe for use in this setting. The effects of this agent on HCV, however, have never been formally evaluated in controlled trials. Recently, results of a controlled trial showed no benefit of silymarin use in patients with primary biliary cirrhosis.
The widespread use of these products does present some serious health risks. Many patients who take alternative therapies either do not seek, or delay the use of, conventional therapies, which may have been effective. In addition, many alternative therapies are associated with significant liver toxicity. Common examples of hepatotoxic agents include chaparral leaf, valerian, skullcap, mistletoe, germander, Jin Bu Huan, and pyrrolizidine alkaloids. These products are available over the counter. Therefore, alternative medicines should be used with caution.
The increasing use of alternative medicines in hepatology has been fueled by patient dissatisfaction with conventional therapies. Physicians must keep an open mind and familiarize themselves with the purported efficacy and potential toxicities of alternative medications in order to provide effective counsel to their patients. Patients must inform their physicians of all their medications, alternative or conventional. Together, patients, pharmacists, and physicians must ensure that hepatotoxic agents are not ingested.
Silymarin or milk thistle is the most common alternative medication used by patients with hepatitis. Silymarin, which exhibits certain antioxidant properties and may function as a free-radical scavenger, has been used to treat all forms of liver disease for more than 2000 years. It appears to be safe for use in this setting. The effects of this agent on HCV, however, have never been formally evaluated in controlled trials. Recently, results of a controlled trial showed no benefit of silymarin use in patients with primary biliary cirrhosis.
The widespread use of these products does present some serious health risks. Many patients who take alternative therapies either do not seek, or delay the use of, conventional therapies, which may have been effective. In addition, many alternative therapies are associated with significant liver toxicity. Common examples of hepatotoxic agents include chaparral leaf, valerian, skullcap, mistletoe, germander, Jin Bu Huan, and pyrrolizidine alkaloids. These products are available over the counter. Therefore, alternative medicines should be used with caution.
The increasing use of alternative medicines in hepatology has been fueled by patient dissatisfaction with conventional therapies. Physicians must keep an open mind and familiarize themselves with the purported efficacy and potential toxicities of alternative medications in order to provide effective counsel to their patients. Patients must inform their physicians of all their medications, alternative or conventional. Together, patients, pharmacists, and physicians must ensure that hepatotoxic agents are not ingested.
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
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