Hepatitis

Viral Hepatitis – Symptoms, Causes & Treatment

Hepatitis refers to inflammation of the liver with viral, toxic, pharmacologic, and immune-mediated causes. Viral infection is the most common cause of hepatitis.  Hepatitis B affects around 1% of the population while it is estimated that more than 250,000 people are suffering from Hepatitis C.

Recent pharmaceutical medications have been able to able to eradicate the Hepatitis C virus, something only achievable in the past few years.

Types of viral hepatitis

• Hepatitis A (infectious hepatitis): transmitted by faecal-oral contamination and ingestion of contaminated water and food (especially salads). Usually mild and self-limiting (1-2 weeks) with sudden onset of fever, malaise, nausea, anorexia and abdominal discomfort. Does not cause lasting liver damage but symptoms can last up to 6 weeks.
• Hepatitis B: spread primarily by infected blood and blood products, saliva and sexual contact. Major risk groups are IV drugs users and homosexual men. 30% are asymptomatic. It can produce cirrhosis and possibly cancer of the liver. Vaccines are available to prevent hepatitis B infection
• Hepatitis C: the most serious type of hepatitis; clinically similar to hepatitis B; spread by blood and blood products (IV drug use, transfusions, tattoos); 50% progress to chronic hepatitis, 20% develop cirrhosis and some can develop liver cancer. Hepatitis C is the leading cause of liver transplantation in Australia.

Signs & symptoms of Hepatitis

• Flu-like symptoms initially: fatigue, fever, headache etc.
• Abdominal discomfort, nausea, vomiting and loss of appetite
• Intolerance to fat, alcohol and caffeine
• Enlarged tender liver
• Jaundice
• Light stools and excess fat in stools
• Dark, foamy urine
• Pruritus (Itchy skin)

Differential diagnosis

• Chronic fatigue syndrome
• Fibromyalgia
• NAFLD
• Autoimmune hepatitis

Investigations

• Liver Function Test (LFT): shows elevated liver enzymes (especially ALT) –need to return level to normal asap to reduce liver damage
• Hepatitis C antibodies

TREATMENT STRATEGY FOR HEPATITIS

• Reduce hepatic inflammation and oxidative stress
• Assess underlying body system dysfunction that contribute to over burdening of the liver.  Intestinal permeability, SIBO, bacterial overgrowth of colon and poor methylation are all systems that affect the liver negatively when not optimized.
• Support immune system / provide anti-viral
• Protect /promote healing of liver

Diet plan guidelines for Hepatitis

• Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
• Encourage antioxidant-rich foods to promote tissue repair: berries, green tea, turmeric, fruits and vegetables
• Include immune-enhancing and antimicrobial foods: garlic, mushrooms
• Include foods to support liver function: bitter foods, cruciferous vegetables, garlic, onions, eggs, protein foods, lemon juice in warm water
• Avoid hydrogenated and trans-fats, alcohol, sugar and refined carbohydrates, junk food, fried foods, processed and refined foods, excessive saturated fats

Supplements that support Hepatitis

• Immune / antioxidant support
• Vitamin C 500mg/hr in acute hepatitis; 500-3000 mg/day in chronic hepatitis
• Zinc- immune support
• Vitamin E: decreases ALT and AST levels in hepatitis C
• L-carnitine: assists with fatty liver and fibrosis
• Vitamin D: (depending on status): supports immune response and protects against fibrosis
• Mushroom extract: reishi, shitake, maitake, cordyceps
• Garlic – 2-3 times daily
• CoQ10
• Alpha-lipoic acid
• Probiotics
• Promote healing of liver / support liver function
• B-complex
• Folinic acid or methyl folate
• Methyl or Hydroxo B12
• Choline, methionine, cysteine
• S-Adenysl Methionine (SAMe)
•  

Herbal medicine treatment that supports Hepatitis

• Immune support: echinacea, astragalus, andrographis, reishi/shitake, cat’s claw
• Anti-viral: picrorrhiza (esp hepatitis C), phyllanthus, licorice, goldenseal, reishi/shitake
• Anti-inflammatory: turmeric, bupleurum
• Liver protective: milk thistle, green tea, schisandra

FUNCTIONAL MEDICINE TREATMENT OF HEPATITIS

Supporting the body to recover from viral hepatitis is important to ensure long term liver damage is not sustained.  Addressing underlying body systems that burden the liver is crucial while supporting and maintain detoxification pathways and promoting liver repair.  A multi system approach that incorporates diet and lifestyle, methylation, bile production and the gut microbiome are a must.

At our Perth clinic of Advanced Functional Medicine we have successfully supported patients with various types of hepatitis with great results.  

If you or a family member are require assistance with hepatitis, other liver conditions or if your liver function blood test has come back with high markers we would love to hear from you, please write a comment below.

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