Herbs and Hepatitis C
Herbs and Hep C (Also Hep viruses A-E)
What is hepatitis C?
Hepatitis C is an infection with the hepatitis C virus. Although there is no vaccine to protect against infection, there is effective treatment available.
Estimates suggest over 250,000 people in the UK have been infected with hepatitis C, but eight out of ten don’t know that they have it because they have no symptoms. Worryingly, about 75% of these people go on to develop a chronic hepatitis. But because it can take years, even decades, for symptoms to appear, many people (possibly 100,000 or more) remain unaware that they have the problem. By the time they become ill and seek help, considerable damage has been done to the liver. This might have been prevented if the person had been diagnosed earlier.
Elsewhere in the world, hepatitis C is even more common – the World Health Organisation estimate that three per cent of the world’s population (about 170 million people) have chronic Hepatitis C, and up to four million people are newly infected each year.
In most cases, the initial infection doesn't cause any symptoms. When it does, they tend to be vague and non-specific.
Possible symptoms of hepatitis C infection include:
* Weight loss
* Loss of appetite
* Joint pains
* Flu-like symptoms (fever, headaches, sweats)
* Difficulty concentrating
* Alcohol intolerance and pain in the liver area
The most common symptom experienced is fatigue, which may be mild but is sometimes extreme. Many people initially diagnosed with chronic fatigue syndrome are later found to have hepatitis C.
Unlike hepatitis A and B, hepatitis C doesn't usually cause people to develop jaundice.
About 20-30% of people clear the virus from their bodies - but in about 75% of cases, the infection lasts for more than six months (chronic hepatitis C). In these cases the immune system has been unable to clear the virus and it will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all.
About one in five people with chronic hepatitis C develops cirrhosis of the liver within 20 years (some experts believe that, with time, everyone with chronic hepatitis C would develop cirrhosis but this could take many decades).
Causes and risk factors
Hepatitis C virus is usually transmitted through blood-to-blood contact. One common route is through sharing needles when injecting recreational drugs - nearly 40% of intravenous drug users have the infection and around 35% of people with the virus will have contracted it this way.
Similarly, having a tattoo or body piercing with equipment that has not been properly sterilised can lead to infection.
Before 1991, blood transfusions were a common route of infection. However, since then all blood used in the UK has been screened for the virus and is only used if not present.
Hepatitis C can be sexually transmitted, but this is thought to be uncommon. It can be passed on through sharing toothbrushes and razors. It is not passed on by everyday contact such as kissing, hugging, and holding hands - you can't catch hepatitis C from toilet seats either.If someone needs a blood transfusion or medical treatment while staying in a country where blood screening for hepatitis C is not routine, or where medical equipment is reused but not adequately sterilised, the virus may be transmitted.
Most people diagnosed with hepatitis C can identify at least one possible factor which may have put them at risk but for some, the likely origin of the infection isn't clear. Because it can remain hidden and symptomless for so many years, it may be very difficult to think back through the decades to how it might have begun.
There are a number of ways to reduce the risk of the infection being transmitted. Those most at risk of contracting the infection are injecting drug users, who should never share needles or other equipment.
Practising safe sex by using condoms is also important.
People with hepatitis C infection aren't allowed to register as an organ or blood donor.
Treatment and recovery
People with chronic hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy.
Whether treatment is needed, and if so which type, depends on a number of factors. These include blood tests to identify which strain of hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.
Hepatitis C can be treated with pegylated interferon alpha and ribavirin. These drugs offer the best chance to clear the virus from the body, and are often used together as dual or combination therapy which has been shown to be effective in 55% of cases. Some strains or genotypes of the Hepatitis C virus are more likely to respond than others. Even if the virus isn’t completely cleared, the treatments can reduce inflammation and scarring of the liver. They may, however, cause side effects that some people find difficult to tolerate.
Many people also find that complementary and lifestyle approaches help – there is little evidence that these can reduce levels of the virus but they may help to deal with symptoms and improve quality of life.
If you think you could have been in contact with the hepatitis C virus at any point in the past, you can have a test to find out if you've been infected. You should ask you GP. Local drug agencies and sexual health clinics (sometimes called genito-urinary medicine or GUM clinics) may also offer testing.*
Herbactive Herbalist has a specialist herbal health tonic for Hepatitis C. Our herbal tonic contains specific liver herbs for the condition, anti-viral herbs specifically recommended for Hep C, and supportive herbs for the many symptoms common to the condition, along with herbs to improve the immune function.
We consider it important to take our ABC Daily Herbal Powder with your treatment.
Hepatitis A, B, C, D and E are very different viruses. Hepatitis A is genetically closer to the common cold than it is to hepatitis B. Hepatitis C is closer to the virus that causes dengue fever.
Hepatitis means inflammation of the liver. While we usually think of hepatitis A to E viruses, anything that causes inflammation or damage to the liver can be considered as a form of hepatitis.
Hepatitis A, B, C, D and E are very different viruses. Hepatitis A is genetically closer to the common cold than it is to hepatitis B, for example. Hepatitis C is closer to the virus that causes dengue fever.
The thing all five have in common is they can cause mild to very severe liver damage.
Viral hepatitis caused around 1.45 million deaths in 2013, making it the seventh leading cause of death world-wide; 96% of these were due to hepatitis B and C.
Hepatitis A is spread by contaminated food and water, and from person to person via faecal transmission, particularly in household settings.
Hippocrates first described epidemics of diarrhoea and jaundice as far back as the fifth century BCE.
Although hepatitis A can cause significant illness, the body usually recovers without treatment and becomes immune to future infections.
Vaccines can prevent hepatitis A; these are recommended for travellers and other groups at particular risk of infection. Vaccination given early after exposure can also prevent hepatitis A from developing.
This is the most prevalent form of viral hepatitis worldwide. It’s also the leading cause of liver cancer.
An estimated 250 million people live with hepatitis B worldwide. Around 220,000 Australians are thought to be living with chronic hepatitis B.
Hepatitis B can be transmitted from person to person through sex or blood-to-blood contact. But most people living with chronic (long-term) hepatitis B acquired it at birth from their mother, or early in life. Following infection, the chance of developing chronic hepatitis B in infancy is around 90%, but falls to 5% among adults.
A safe and highly effective vaccine has been available for hepatitis B since the 1980s. It has been provided for all infants born in Australia since May 2000.
In China, the proportion of children aged under five who had chronic hepatitis B fell from 9.7% in 1992 to 1% in 2006 after a vaccination program was introduced. The program has prevented millions of deaths from liver cancer and liver cirrhosis in China alone.
Effective antiviral treatments are also available for chronic hepatitis B. These can prevent liver damage and liver cancer from occurring. But even in a well-resourced country such as Australia, only a minority of people needing treatment and care for hepatitis B are receiving it.
This is the most common cause of viral hepatitis in Australia; an estimated 230,000 people live with chronic infection.
Hepatitis C is the leading cause of liver cancer and liver transplants nationally.
Most hepatitis C infections in Australia were acquired through unsafe injecting drug use. But in some low-resource countries, ongoing transmission of hepatitis C in health care settings is a major problem.
Around 80% of people infected with hepatitis C develop chronic infection; those who do clear the infection naturally remain susceptible to future infections.
No vaccine for hepatitis C is available.
On March 1, new treatments were listed on the Pharmaceutical Benefits Scheme (PBS). Although expensive, these treatments represent a huge advance and are a cost-effective way to prevent both new infections and deaths due to existing hepatitis C infections. With cure rates of the order of 90% with 8-24 weeks of tablets, and minimal side effects, these agents have the potential to drastically reduce the impact of hepatitis C.
The real key to unlocking this potential is the very liberal access criteria the Commonwealth government has applied to these treatments. As a result, uptake of treatment for hepatitis C in Australia has risen more than 20-fold.
Hepatitis D is a satellite virus that can only infect people who also have hepatitis B.
It is estimated that approximately 5% of people living with hepatitis B globally also have hepatitis D, which can lead to more severe liver disease.
Hepatitis E, like hepatitis A, is spread through contaminated food and water.
The first outbreak of hepatitis E infection acquired in Australia was reported earlier this year.
While hepatitis E is usually relatively mild, it can cause serious illness late in pregnancy, with a death rate of up to 20% among pregnant women in their third trimester.
A vaccine against hepatitis E has been developed but is currently licensed only in China.
While viral hepatitis remains a substantial public health challenge in Australia and world-wide, with political will, adequate investment and global partnerships, the world can eliminate viral hepatitis by 2030.
Acknowledgement to The Cosmos Magazine 2016, Australia.
Benjamin Cowie, Director, WHO Collaborating Centre for Viral Hepatitis, The Peter Doherty Institute for Infection and Immunity
This article was originally published on The Conversation.
*information from BBC Health
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General advice to consumers on the use of herbal remedies from the Medicines Healthcare products Regulatory Agency
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.
Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.
Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.
A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.
A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.
Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.
The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
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