Hep C Primer

Silybin Phytosome® to Prevent Fibrosis
April 10, 2006
Liversupport.com
Nicole Cutler, L.Ac.

Regardless of its cause, the progression of liver disease is typically measured by the suppleness, and in turn, the functionality of the liver. Recent studies demonstrate the ability of the milk thistle extract, Silybin Phytosome®, to inhibit the hardening of liver tissue.

Some types of liver disease respond well to prescribed therapy, while others take on a chronic status. In addition to addressing the underlying cause of dysfunction, these chronic liver diseases require vigilance to support liver tissue health. While each disease has a preferred conventional treatment standard, an increasing number of clinicians are predominantly concerned with fibrosis prevention.

According to the Merck Manual, Fibrosis is an accumulation of fibrous tissue in the liver resulting from an imbalance between production and degradation of the extracellular matrix, and accentuated by the collapse and condensation of preexisting fibers. In more general terms, fibrosis is the hardening of liver tissue, occurring when the liver is impaired and thus, unable to break down fibrous material.

The liver is touted as the most dynamic organ in the body. This title is not only a result of the numerous functions for which it is responsible, but also for its self-restorative capability. The liver is the only organ capable of regenerating parts of itself to repair any sustained damage.

Helping maintain the liver’s texture is akin to supporting this organ’s health. To prevent or inhibit fibrosis, all individuals with liver disease would benefit from an accelerated regeneration of damaged liver tissue.

In Europe, silymarin, the purified extract of the fruits of S. marianum, and its main constituent, silybin, are used to maintain liver health. Worldwide, milk thistle is, deservedly, one of the most commonly prescribed medicinal plants.

S. marianum is a medicinal plant which has been widely used in traditional European medicine for centuries. Commonly known as milk thistle, St. Mary’s thistle and lady’s thistle, it is native to southern Europe, southern Russia, Asia Minor and North Africa. It has been naturalized to North and South America.

Literally hundreds of research studies, mostly conducted in Europe, have confirmed the remarkable ability of milk thistle to protect the liver against virtually all types of damage: from accidental exposure to chemical pollutants, toxic side effects of medications and even the self-inflicted damage from overindulgence of rich food and alcohol.

The United States National Library of Medicine has catalogued more than 300 scientific studies of milk thistle and its active compounds in their medicine database.

The active ingredients of milk thistle are not very bioavailable, especially in their purified or standardized forms. This means one would need to ingest large amounts to experience beneficial effects. Not only impractical, it could be quite expensive.

A recent study published in Digestive and Liver Disease, clearly demonstrates the ability of Silybin Phytosome® to inhibit liver fibrosis. This study confirmed Silybin Phytosome’s® hepatoprotective abilities by proving it counteracts the progression of liver fibrosis typically seen in chronic liver diseases.

On a molecular level, fibrosis is marked by excessive accumulation of extracellular matrix with collagen. The hepatic stellate cells activate this cumulus. In the referenced study, Silybin Phytosome® reduced hepatic stellate cell activation and proliferation. It also significantly reduced the synthesis and deposition of collagen in liver tissue. The authors of this study concluded that Silybin Phytosome® could inhibit liver fibrosis by reducing the synthesis of collagen and by interfering with excessive accumulation of extracellular material.

Additional evidence of silybin’s value in preventing fibrosis is garnered from a 1984 study demonstrating that silybin accelerates the rate of protein synthesis in the liver, leading to faster cell regeneration. A 1997 German study also reported results where silybin reduced the proliferation of hepatic stellate cells by 50 to 75 percent, which again, is highly indicative of its anti-fibrotic effect.

By their very nature, chronic liver diseases are persistent and stubborn to known modern treatments. Chronic liver disease summons our attention to provide every bit of hepatic support possible, until our medical expertise can catch up with us and ameliorate the offending disease. Years of research point to the ability of Silybin Phytosome® to meet this demand, by preventing the damage that liver diseases typically cause.

For more information on supplements containing Silybin Phytosome®, visit LiverSupport.com.

Whites fare poorly with HIV and hepatitis C

Will Boggs, MD
Reuters
April 18, 2006

NEW YORK (Reuters Health) - Liver disease and death rates are worse with hepatitis C virus (HCV) infection on top of HIV infection than with just HIV or HCV, especially among white patients, according to a new report.

“We need to better understand why the co-infected patients do so poorly and the underlying mechanism for apparent racial disparity in their outcome,” Dr. Kyong-Mi Chang, told Reuters Health.
“We also need better drugs that directly target HCV,” added Chang, from the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center.

Chang’s team examined the impact of dual infection and race in 265 veterans with HCV/HIV co-infection, 251 infected with HCV only, and 227 others with HIV only.

Over a three-year period, mortality was significantly greater among HCV/HIV-co-infected patients than among patients mono-infected with either HCV or HIV, the researchers report in the American Journal of Gastroenterology.

Specifically, after taking into account a variety of factors, mono-infected patients were only about one-third as likely to die as dual-infected patients.

During the study period, twice as many white patients died compared to black patients, the report indicates.

Also, the average age at death in white patients (46 years) was significantly younger than that in black patients (52 years).

Since dual-infected patients fare so poorly, Chang said, the team aims to treat them “as much as possible and monitor them closely for liver dysfunction.” He said specialists in liver disease and infectious diseases “as well as pharmacists (also social work and mental health support), is needed to optimize therapy for these complex patients.”

SOURCE: American Journal of Gastroenterology, April 2006.

by Nicole Cutler, L.Ac.

During the winter, we withdraw from the world to reflect, rejuvenate and rest. When the season shifts into spring, energy bursts forth, like bulbs long dormant in the colder months. As daylight lengthens, the inwardly contained energy begins to flow instead of being stored. Nature’s flurry of activity associated with spring is found everywhere, from newly composed avian harmonies to animal mating rituals. Projects sitting on hold jump to life and bodies that have been curled up on the couch itch to move. Spring is representative of transformation and growth, bringing renewed optimism, hope and life.

According to Chinese culture, humans are microcosms of the environment, and are equally affected by the change in season. The cyclical character of energy flow creates a predominance of energy in each body system during a particular season. According to Chinese medical theory, the liver and gallbladder systems are partners, and their energy is most active in the spring. It is logical then, that for individuals living with liver disease, Chinese medical practitioners put extra emphasis on initiating change after the vernal equinox.

Other holistic practitioners also recognize this time of year as pertinent to liver health. Nutritionists typically target spring as ideal for a liver flush, or liver cleanse. Eating vegetables that grow in the spring are recommended by dieticians to aid in moving winter’s sludge out of the liver. No matter what angle taken, the liver is most accessible for transformation during this season.

In addition to viewing humans as a mirror of nature, Chinese medical theory emphasizes the interplay of physical, emotional and spiritual aspects governed by each body system. Encompassing much more than the western medical model’s understanding of organ structure and function, each body system also governs emotion, cognition and spirit.

The cognitive responsibility of the liver is planning and the gallbladder oversees decision-making. When the energy in these two organ systems mounts, as it naturally does each spring, there can be two possible outcomes:

· The desired outcome is an active outpouring of creativity, productivity and release of negative patterns.
· The undesired outcome is energetic stagnation, or resistance to allowing this energy to flow.

Restricted liver energy manifests as anger, frustration, depression and irritability. Liver disease occurs or worsens when this restriction is not expressed or freed. When energy remains stuck, it coagulates, which hampers optimal body functioning. In nature, this is just like a heavy storm’s debris clogging a creek’s thoroughfare, preventing water flow downstream of the obstruction. If the obstruction is not cleared, more debris will accumulate, further preventing the creek’s inclination to flow. The inability to express spring’s active energy can lead to all sorts of illnesses including migraines, cystic breasts, digestive problems and even a progression of liver disease.

Because the energy in the liver and gallbladder systems increase in the spring, people often experience an increase in stress, anger and anxiety during this season. When an outlet for this energy is found, these emotions can be transformed into creativity, opportunity and change. Springtime is ideal to convert these difficult emotions through focusing on their movement and release. Nature provides us with this perfect time of year to spring clean our emotional accumulation. Feeling these intense emotions is the healthy first step, and indicates readiness, or near-readiness for the second spring cleaning step: release.

Emotional release can be achieved in many different ways, and each person needs to find the method that works best for them. Some methods that may be useful include:

· Engaging in physical activity
· Receiving bodywork
· Verbalizing emotions to a friend or professional
· Journaling or writing about one’s feelings
· Crying and/or laughing
· Meditation and/or visualization
· Using creativity as an emotional outlet

Regardless of the method used, finding the path to emotional release keeps the body, mind and spirit healthy. The natural instinct to spring clean our homes and environment answers our yearning to clear away the cobwebs (stagnation) left over from winter. When spring cleaning is applied to emotional health, our ability to plan and make decisions blossoms and we experience renewed optimism, creativity, hope and transformation.

From the Chinese perspective, the free flow of liver and gallbladder energy is the number one disease preventative, and the best way to guarantee health and happiness. Take advantage of spring’s manifestation in your body, and for liver’s sake, decide to do some emotional spring cleaning.

by Nicole Cutler, L.Ac

Everything we eat, breathe and otherwise absorb is processed by the liver. By purifying and transforming our food into substances fueling our body, the liver is dependant on what we feed ourselves. In the face of liver disease, where liver function is impaired, proper nutrition takes on increasing importance. A balanced diet containing sufficient calories and an appropriate ratio of carbohydrates, proteins and fats can assist a damaged or struggling liver to regenerate new, healthy liver cells.The common liver disease, cirrhosis, refers to the replacement of damaged liver cells by fibrous scar tissue. Fibrous scar tissue inhibits the liver from performing its many varied, critical functions. Individuals with cirrhosis typically experience weight loss, which is associated with either a decreased intake of food, or a decreased ability to process food.

Protein and the Liver

Protein in our diet comes from foods such as meat, fish, eggs, cheese, nuts and dairy. Proteins typically provide the building blocks for the body to repair damaged tissue. However, in the case of a severely damaged liver, ingested proteins may not be properly processed, leaving excessive toxic waste circulating in the body. With any type of liver disease, it is paramount to work closely with a healthcare physician to design a customized nutritional plan.

According to the American Liver Foundation, adults with cirrhosis require a balanced diet rich in protein, allowing liver cells to regenerate. However, too much protein can have the opposite effect. According to Melissa Palmer, MD, author of Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease, “If too much protein is consumed and not enough carbohydrates, the liver will be forced to use protein as an energy source. This is an unwise and inefficient use of protein, as protein will be diverted from its primary job of building cells and tissues. Furthermore, this will put undo stress on the liver, as it is more taxing for the liver to convert protein into energy than it is to convert carbohydrates into energy.”

The Atkins diet is a popular weight-loss plan encouraging consumption of very high amounts of protein and very low amounts of carbohydrates. Critics of the Atkins diet emphasize the danger that a diet centered on protein can have on the body. High protein intake can change the pH of the blood, making it very acidic. When the blood is too acidic, the body goes into a state of ketosis, a life-threatening metabolic condition that can seriously damage the liver. Because of the possible repercussions, a knowledgeable physician must determine the amount of protein consumed by someone with impaired liver function. Whether concerned with helping the liver regenerate healthy cells, or preventing the dangerous condition of ketosis, those with liver disease should not leave their protein consumption to chance.

Carbohydrates and the Liver

Carbohydrates come from starch and sugar and are found in food such as bread, potatoes, rice, pasta, cereals, fruit and sweets.The body breaks down carbohydrates into glucose, and stores it in the liver as glycogen. Glycogen is essential for a steady supply of energy, as it is released between meals when blood sugar levels drop. Therefore, glycogen is the link connecting the liver with blood sugar regulation. According to Palmer, “People with liver disease should strive for a diet consisting of approximately 60 to 70 percent carbohydrates, with complex carbohydrates predominating. For such people, a well-balanced diet will include at least 400 grams of carbohydrates.” Most experts agree that for optimal nutritional value, carbohydrates should be the main source of calories for individuals with liver disease.

Fats and the Liver

Fats in our diet come from many sources including butter, lard, cream, cooking oils, cheese, animal fats and many prepared foods.According to Palmer, “Ideally, a person should aim for something in the neighborhood of 10 to 20 percent. People who are overweight should aim for 10 percent. While it is important to eat as little fat as possible, eating a small amount of the more healthy fats does have some benefit … essential fatty acids, perform (as the name suggests) a variety of duties that are essential to the proper functioning of the body.”Some people with liver disease have problems digesting and absorbing fat. Individuals with this issue likely need to decrease their fat intake and will be instructed by their physician to consume a certain type of fat more easily absorbed by the body.

Conclusion

Although liver disease is so prevalent in today’s society, most people are unaware of how influential food can be to our liver’s health. While most authorities agree that carbohydrates should be the most predominant part of a liver supportive diet, balanced amounts of protein and fat are also crucial. Choosing the right balance of foods with your physician will take your specific metabolism needs and liver health status into consideration. When individuals with liver disease follow their advised nutritional program, the support offered to their liver is unmatched by any modern medical intervention.

References:

Ganong, William F., MD, Review of Medical Physiology, Prentice Hall, 1991.
Palmer, Melissa, MD, Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease, Penguin Putnam, 2004.
http://www.liverfoundation.org/, Diet and Your Liver, American Liver Foundation, 2003.
http://www.newsday.com/, Weighing the risks of Atkins diet, Delthia Ricks, 3/18/06.
http://www.nlm.nih.gov/, Diet – liver disease, Medline Plus, 9/22/05.

The efficacy of Liv.52 on liver cirrhotic patients: A randomized, double-blind, placebo-controlled first approach.
15 September 2005

Cirrhosis is the irreversible sequel of various disorders that damage liver cells permanently over time. Presently, the use of herbal medicines for prevention and control of chronic liver diseases is in the focus of attention for both the physicians and the patients; the reasons for such shift toward the use of herbals include the expensive cost of conventional drugs, adverse drug reactions, and their inefficacy. In the present study, the efficacy of herbal medicine Liv-52 (consisting of Mandur basma, Tamarix gallica and herbal extracts of Capparis spinosa, Cichorium intybus, Solanum nigrum, Terminalia arjuna and Achillea millefolium) on liver cirrhosis outcomes was compared with the placebo for 6 months in 36 cirrhotic patients referred to Tehran Hepatic Center. The outcome measures included child-pugh score, ascites, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total billirubin, albumin, prothrombin time, platelet and white blood cells counts. The indices were recorded in all patients before and after 6 months of drug or placebo treatment. The results demonstrated that the patients treated with Liv-52 for 6 months had significantly better child-pugh score, decreased ascites, decreased serum ALT and AST. In placebo administered patients all the clinical parameters recorded at beginning of the study were not significantly different than after 6 months. We conclude that Liv-52 possess hepatoprotective effect in cirrhotic patients. This protective effect of Liv-52 can be attributed to the diuretic, anti-inflammatory, anti-oxidative, and immunomodulating properties of the component herbs.

More information about Liv.52 can be found at http://www.liversupport.com.

Abstract: “The efficacy of Liv.52 on liver cirrhotic patients: A randomized, double-blind, placebo-controlled first approach,” H. Fallah Huseini, S.M. Alavian, R. Heshmat, M.R. Heydari and K. Abolmaali, Phytomedicine; 12:9; September 2005 (DOI:10.1016/j.phymed.2004.10.003)

Biologists at Florida State University have recently produced a study illuminating the replication and mutation of the Hepatitis C virus. This kind of progress represents a giant leap forward in tracking this persistent virus, which likely means more accurate and efficient therapy will be coming soon.

A Japanese research study demonstrates benefits of Vitamin E and C supplementation during combination therapy. These vitamins appear to protect cells from damage typically incurred from conventional Hepatitis C therapy.