Nutritional Needs for Hepatitis C Patients Who Don't Have
Cirrhosis
Caloric Requirements
In general, the noncirrhotic patient with hepatitis C has
caloric needs similar to those of noninfected people of the same
age and gender. For this reason we recommend the following:
- no salt restriction
- no protein restriction
- 30 to 40 calories per kilogram intake per day
- one multivitamin per day
Patients who drink excessive amounts of alcohol should stop
drinking altogether. They may also need supplementation with
thiamine and folate.
Vitamin Supplements
In general, noncirrhotic patients with hepatitis C do not
require any additional vitamin supplementation other than that
noted above. One concern is that if bile production drops, the
patient may become deficient in fat-soluble vitamins during the
course of hepatitis C infection. This deficiency rarely develops
during the early stages of hepatitis C, but it may be fairly
prevalent at later, cirrhotic stages of the disease. When detected,
deficiencies of fat-soluble vitamins should be corrected by
administering proper doses of the compounds.
Nutritional Therapies
Americans spend some $6 billion annually on nutritional
supplements. Patients with viral hepatitis have used a number of
such "nutritional supplements," such as echinaceae, pycnogenol,
dandelion root, silymarin (milk thistle), and a wide array of
herbal remedies. None of these have been studied in controlled
trials and, thus, are unproved therapies.
Despite the lack of supporting data, the use of these therapies
has gained widespread acceptance among patients with hepatitis C.
Several factors seem to account for this phenomenon: a history of
lack of effective therapies for liver disease in general;
incompletely effective treatment for hepatitis C; a general
attitude that, "It can't hurt me, and maybe it'll help"; and the
relatively mild and slowly progressive nature of hepatitis C.
However, because proof of their effectiveness is lacking, we cannot
endorse or recommend that patients undergo nutritional therapies.
You should, however, inform your doctor if you are considering
taking any of these nutritional supplements.
"I went to a health food store and asked them to give me
anything that would help my liver. I got coltsfoot, comfrey,
petasites, chaparral, and yohimbe.
"My enzymes shot up to 800. When the doctor asked me if I was
taking anything new, I brought in the bottles and learned that
these herbs were best avoided because they may be toxic for the
liver. I stopped taking them, and my enzymes went back down. I
never thought anything 'natural' could harm me." Harold
Source: "Living with Hepatitis C: A Survivor's Guide" by
Gregory T. Everson, M.D., and Hedy Weinberg. 1997, Hatherleigh
Press.
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