I have developed a protocol based on a multifaceted program to repair the liver and improve its function. I feel that an integrative approach is best.
Prior to treatment, I perform a blood test looking at the nutritional levels of my patients, as well as the evidence of free radicals, mutation, toxicities and infections. The most important is the immunity of the patient. I have treated various types of hepatitis, including alcoholic hepatitis, hepatitis C, autoimmune hepatitis, cirrhosis, and others.
LIFESTYLE, ORAL AND INTRAVENOUS SUPPLEMENTS:
I routinely do a hepatitis profile in all my patients and evaluate whether they have an acute or chronic infection. Exposure to the virus and development of antibodies in hepatitis C, only ensures immune response to the virus. Approximately 15%-45% of those exposed are able to fight off the infection, but will remain antibody-positive. All positive anti-HCV tests needs to be followed by a quantitative test to detect the presence or absence of the virus, using an RNA polymerase chain reaction. At times, I obtain an HIV status and look at the routine liver blood tests.
Nutrient supplementation can be extremely useful for those undergoing standard treatments, and those who do not qualify or do not wish to undergo standard treatments. Nutrient and botanical medicine is helpful as well for those who have failed or do not qualify for standard treatments.
Evidence shows that they both help slow fibrosis and prevent development of hepatic encephalopathies. It is important in addressing the oxidative damage inherent in these chronic viral infections and of nutrients used in conjunction with the standard treatments–that is, peginterferon, ribavirin, and the newly-approved, direct-acting antivirals.
The body utilizes antioxidants such as E, C, A, selenium, glutathione, zinc, keratin, Q-10, methionines, and cystines to prevent cellular damage, and the possible progression of damaged genetic cellular material to the formation of cancer cells. There is evidence that this oxidative stress and free radical damage that follows, is one of the main mechanisms in both hepatitis B and C that leads to development of cirrhosis and primary liver cancer.
Many hepatology researchers have proposed that the progression of liver cell damage to fibrosis is actually controlled by antioxidants.
Levels of specific antioxidants–glutathione, selenium, A, C, E, have been found to be significantly lower in the blood of those with chronic hepatitis C. Even patients in early stages with minimal disease, were found to have significantly lower levels than controls. There has also been a direct relationship between low levels of antioxidants and advanced fibrosis and cirrhosis.
In China, where hepatitis is epidemic, there has been found to be a significant relationship between low blood selenium levels and increased risk for liver cancer. Smoking, low vitamin A, and low keratin levels in those with hepatitis C infection appear to be at increased risk the most. Selenium levels in people co-infected with HIV and hepatitis C, have been shown to have even lower levels than those only infected with HIV.
CYSTEINE, NAC, AND GLUTATHIONE:
Glutathione is a filter-based peptide and a crucial activator of cytoxic T-cells, which kill virus and cancer. Depletion of glutathione causes liver and kidney failure, and ultimately death. Low glutathione levels are found in people with cataracts, HIV, hepatitis C, and cirrhosis. People with cirrhosis of the liver appear to have difficulty manufacturing glutathione, and levels have been shown to be 30% below normals. Levels of the active form of glutathione, which is called reduced glutathione, are significantly below normal
in people with alcoholic hepatitis or hepatitis C. Studies show that those with the lowest glutathione levels have the highest viral loads and more evidence of liver damage.
NAC has been shown to increase blood glutathione levels in HIV, and in one study with hepatitis C, treatment with interferon with NAC led to a normalization of glutathione and liver enzymes, along with a significant decrease in viral load.
Having low levels of glutathione decreased the chance of responding to standard therapy, and improve both transmethylation and trans-sulfuration. These may improve interferon signaling in the presence of hepatitis C. In a major study in hepatitis C patients with genotype Type 1 who had advanced cirrhosis and had already failed treatment, these patients had the lowest glutathione levels and the lowest response rates. Glutathione is imperative in their treatment.
ALPHA LIPOIC ACID:
This is depleted when the liver is under stress. Alpha lipoic acid has a history of use in Europe, where it is used to treat liver disorders to help the liver repair itself. It raises cellular levels of glutathione and can be administered orally or intravenously.
Other supplements, such as vitamin A, zinc, and omega 3′s as well as vitamin D and milk thistle, are important.
New data using direct-acting antivirals such as (boceprevir, telaprevir) in conjunction with peginterferons and riboflavin in genotype Type 1 patients, showed that viral clearance occurred in 67%-75%. This is quite significant. However, the side effect profile is great: Increased anemia, nausea, diarrhea, chills, irritability, metallic taste in mouth, vomiting, fatigue, hair loss, neutropenia, low platelet count, itching and hives.
I have used a combination of intravenous.GLUTATHIONE, intravenous PHOSPHYTIDYCHOLINE, NAC, SILYMARIN, ALPHA LIPOIC ACID AND OTHERS TO REAIR YOUR LIVER AND PANCREASE
Naltrexone works by increasing the levels of endogenous opiates in the bloodstream. This “fools the brain” and the nervous system by creating the impression that the level of endogenous opiates in the blood stream is low. As a result, in the morning, there is a cascade of endogenous opiates and endomorphins. Naltrexone is administered only at night, at bedtime, and in low dose. The administration of naltrexone correlates with reductions of autoimmunity reactivity. In addition, the met-enkephalin produced appears to bind to cancer cell receptors, resulting in apoptosis. I institute these therapies in autoimmune disorders such as lupus, rheumatoid arthritis, scleroderma, etc., and I have been taking it myself for 13 years to raise my immunity.
Treatment therapies include liver detoxification to help boost Phase 1 and Phase 2 liver detox. Along with this, I use both oral and intravenous nutritionals. I find intravenous alpha lipoic acid, as well as glutathione, to be useful.
Other additional therapies are indicated on a case-by-case basis.
If you or a loved one is suffering from LIVER OR PANCREATIC disease, and you wish to follow an integrative approach, I will work along with your gastroenterologist or separately to help optimize your liver function. If you are interested in this approach, please contact my office for a consultation.
Best in Health,
Dean Silver, M.D.