By Dr. Krysten DeSouza, ND, Canada

Every organ in the body has a unique and essential role in maintaining balance in the body. The harmony that is created when they all work well together can really energize us—but can equally deplete us when offset. The liver is an integral part of health and serves as a crossroads between many systems of the body. We know the liver best for its filtration and detoxification of the blood, production of certain hormones, and creation of key proteins, but there are several smaller functions that we don’t always notice until things start to go awry. Despite all the stresses we put our bodies through, the liver is capable of withstanding tremendous trauma from alcohol, drugs, foods, or infections, and it can even regenerate when part of it is lost!

Hepatitis is the term used to describe inflammation of the liver, usually caused by a viral infection of the liver that creates a significant amount of inflammation, and that can drastically alter the function of the liver in a permanent way. There are many types of hepatitis, and they are often distinguished in terms of their mode of transmission, their severity of infection, and their likelihood to result in liver damage. Hepatitis C in an infection of an RNA virus that is contracted through contaminated blood and the use of shared needles. It targets the specialized liver cells, or hepatocytes, and decreases their ability to detoxify and carry out their functions. The virus replicates very quickly and in a short period of time can spread to a large part of the organ.Many people don’t notice symptoms in the first stages of infection, but as the virus continues to spread, it can cause jaundice (yellowing of the eyes and skin), stomach pain, loss of appetite, nausea, and extreme fatigue. Hepatitis C is a long-term infection, and in most people, it can move on to cause liver cirrhosis, liver cancer, and permanent scarring of the liver. Some people may be eligible for a liver transplant, but ultimately, the management of hepatitis C involves a series of antivirals and experimental treatments as there is no cure for this disease. [1]

As naturopathic doctors, we see the management of hepatitis as much more than reducing a viral infection, and we put a large emphasis on optimizing liver health. The first place to begin is always with the things we have the most control over, including diet. To maintain a healthy liver, it is important to reduce the toxic load or burden on the system, by eating foods that are detoxifying and anti-inflammatory. This can involve an elimination diet, a food sensitivity test, or just following these basic guidelines of healthy eating:

- Increase the intake of healthy fats, including the powerfully anti-inflammatory omegas from fish oil. Omega-3 and omega-6 essential fatty acids come from a variety of food sources and are most important in their specific balances. Increase the levels of omega-3s and lower the levels of omega-6s to encourage the antiinflammatory action of omega-3s. This means adding more salmon, flaxseed, and walnuts to the diet, while minimizing the use of corn oil, safflower oil, and sunflower oil. Hydrogenated oils and trans fats should be avoided and should be replaced with olive oil, coconut oil, and avocado oil.

- Add foods with natural antimicrobial and immune-strengthening properties.These include onions, ginger, garlic, cayenne pepper, and Chinese mushrooms. Other than their ability to fight off viruses, they improve circulation through the body, move lymphatic fluid, and open the sinuses.

- One of the best herbs to support the liver in its second phase of detoxification is cilantro. Some people are very sensitive to cilantro in food and others don’t even notice it, but adding cilantro to sauces, soups, curries, and dips can stimulate the liver and support the detoxification process. Cilantro is also a well-researched natural “chelator,” which means it has the ability to bind heavy metals like cadmium and mercury and carry them out of the body. [2]

- Antioxidants are powerful nutrients that protect the body from injury and promote healing.The most common antioxidants to include in the diet are turmeric, green tea, cranberries, blueberries, and goji berries. Their effects take place all over the body, including reducing injury to blood vessels, promoting clear skin, and slowing the aging process.

- Balancing out the gut microbiome is an essential part of any treatment plan. It is well known that most of the immune system lives within the gastrointestinal tract, and that a large part of immunebuilding is actually promoting healthy bacterial colonization. Food sources of probiotics can include fermented foods, such as miso soup, yogurt, sauerkraut, and kombucha; however, to see clinical benefits of probiotics, the high doses found in capsules are more effective and difficult to replicate with just food.

- All leafy green vegetables are high in B vitamins and fibre.Dark-green vegetables have tremendous implications in health, but are often ignored because of their bitter flavour. However, this bitter quality is one of the important aspects of why these vegetables are such key players in terms of liver health. Bitter things often contain essential nutrients for the liver and promote the production of bile for fat digestion. The fibre that comes along with all the nutrients is important for regulating bowel movements and supporting the elimination process.

- Adequate water helps to move detoxified products out of the liver and eliminate regularly. This one goes without saying: Water is key to every physiologic process in the body. We have all experienced dehydration at some point, and most of us continue to consume inadequate amounts of water on a regular basis. But anyone who has ever made it up to eight glasses per day consistently has experienced the benefits of hydrated skin, increased energy, and bowel regularity. Like any other infectious process, drinking lots of water can help to flush out any liver viruses as well.

- It is also important to consider foods and beverages that should be avoided to support liver health. These include alcoholic beverages, dairy products, refined sugars and carbohydrates, high-mercury seafood, hydrogenated oils, and preservatives found in all processed foods. As expected, these items all place an extra burden on the liver and can impair the liver if consumed in large quantities.

Overall when discussing diet for hepatic health, the optimal balance of proteins, carbs, and fats can go a long way. Diets higher in protein content may be better for the liver to prevent protein malnutrition and fatty liver disease. This is a common concern for vegans and vegetarians, because protein consumption is often lower than required and sources are often plant-based, which is harder for the body to digest and absorb. However, all of these dietary suggestions will play a key role in management of hepatitis or any other liver dysfunction. [3]

In addition to these dietary changes, additional benefit can come from vitamin and nutritional supplementation in higher doses.

Fish Oil: High doses of at least 1500 mg EPA should be taken every day with a heavy meal. This will help to stabilize mood and reduce inflammation in the body.

Vitamin C at least up to bowel tolerance for the initial stages of infection. Higher doses of vitamin C will help to stimulate the immune system, act as an antioxidant, and help in the healing and repair of the liver.

Phosphatidylcholine: This lipid molecule is found in the outer layer of every cell in the body. It has been researched for its ability to improve liver function, memory, and mood, all three areas of health that are often affected by individuals with hepatitis C. Because it is a large component of the phospholipid bilayer of all cells, it is important in cell signaling, which can speed up communication and create noticeable changes in attention and memory. It has also been shown to delay the progression of liver damage and improve the effectiveness of conventional interferon therapy in patients with chronic hepatitis C.

Silymarin is the active component of milk thistle, a plant with protective and regenerative effects on liver cells. This herb, in combination with curcumin and alpha-lipoic acid, can reduce inflammation and decrease oxidative stress within the liver. In addition to the other dietary antioxidants discussed above, this herb has a powerful antioxidant action specific to liver cells and can be used in all stages of liver dysfunction.

B12 Intramuscular Injection: Vitamin B12 is important in maintaining brain function and reducing cognitive impairment in individuals suffering from depression. It can help increase energy, stimulate immune function, improve memory, and elevate mood. Additionally, vitamin B12 has implications for cholesterol metabolism, and it is often deficient in individuals with symptoms of indigestion, inadequate stomach acid production, or gastrointestinal inflammation.

Vitamin D is indicated for people in the Northern Hemisphere who have reduced exposure to sunlight. Vitamin D deficiencies are linked to depression, low energy, osteoporosis, and multiple sclerosis. Even with great exposure to the sun, the body’s ability to create vitamin D through the skin requires the function of hormones from the kidney and liver. If the liver is already functioning suboptimally, additional vitamin D should be added to the treatment plan for preventative purposes.

Patients with hepatitis C who are being managed conventionally will often feel the side effects of their medications. Naturopathic medicine offers a wide range of natural therapies and options to support the effectiveness of medication, reduce side effects, and promote the strength and function of the liver for the long term.

References: 1. WebMD. What Is Hepatitis C?     2. Sears, M. “Chelation: Harnessing and enhancing heavy metal detoxification - A review.” The Scientific World Journal, Vol. 2013, Article ID 219840, 13 pages.    3. Naturopath Connect. Liver dysfunction: Overview, symptoms, causes, natural treatments and medicines.

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Studies indicate that milk thistle, dandelion, artichoke, curcumin and schisandra help maintain liver health.