Hepatitis
C is a liver disease caused by a virus. It’s usually chronic (long
-lasting), but
most people don’t have any symptoms until the virus causes liver damage, which can
take 10 or more years to happen. Without medical treatment, chronic hepatitis
C can
eventually cause liver cancer or liver failure. Conventional medical treatments are
available for chronic hepatitis
C. Some people with hepatitis
C also try complementary
health approaches, especially dietary supplements. This fact sheet provides basic
information on hepatitis
C, summarizes scientific research on selected supplements,
and suggests sources for additional information.
Key Facts
Are Dietary Supplements for Hepatitis
C Safe?
—
Colloidal silver is
not
safe; it can cause irreversible side effects
.
—
Data on the safety of other supplements is limited. However, some can have side
effects or may interact in harmful ways with medications, and some may be
unsafe for people with certain health problems.
—
If you have hepatitis
C, check with your health care
provider before using any
dietary supplement to make sure that it is safe for you and compatible with any
medical treatment that you’re receiving for hepatitis
C or any other health problem.
Are Dietary Supplements for Hepatitis
C Effective?
—
No dietary supplement has been shown to be effective for hepatitis
C or
its complications.
—
The results of research supported by the National Center for Complementary and
Integrative Health
( NCCIH) and National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) have shown that silymarin, the active extract of milk
thistle and the most popular complementary health product taken by people with
liver disease, was no more effective than placebo in people with hepatitis
C.
—
Research on other dietary supplements for hepatitis
C, such as zinc, licorice root
(or its extract glycyrrhizin), S
-adenosyl
-L-
methionine (SAMe), and lactoferrin, is in
nccih.nih.gov
National Center for Complementary and Integrative Health
2
Hepatitis C: A Focus on Dietary Supplements
its early stages, and no firm conclusions can be reached about the potential
effectiveness of these supplements.
Keep in Mind
—
It’s important
not
to replace conventional medical therapy for hepatitis
C with
dietary supplements or other approaches that haven’t been shown to be effective.
—
Tell all your health care providers about any complementary health approaches
you use. Give them a full picture of what you do to manage your health. This will
help ensure coordinated and safe care.
What Is Hepatitis
C?
Hepat
itis
C is a contagious liver disease. It’s caused by the hepatitis
C virus. People
can get hepatitis
C through contact with blood from a person who’s already infected
or, less commonly, through having sex with an infected person. The infection usually
beco
mes chronic. Chronic hepatitis
C often is treated with drugs that can eliminate
the virus. This may slow or stop liver damage, but the drugs may cause side effects,
and for some people, treatment is ineffective. An estimated 3.2 million Americans
have chro
nic hepatitis
C. To learn more about hepatitis
C, visit t
he NIDDK Web site
at
http://d
igestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/index.aspx
.
Use of Herbal Supplements and O
ther Complementary
Approaches for Hepatitis
C
Several herbal supplements have been studied for hepatitis
C, and substantial
numbers of people with hepatitis
C have tried herbal supplements. For example, a
survey of 1,145 participants in the HALT
-C (Hepatit
is C Antiviral Long-
Term
Treatment Against Cirrhosis) trial, a study supported by the National Institutes of
Health (NIH), found that 23 percent of the participants were using herbal products.
Although participants reported using many different herbal prod
ucts, silymarin (milk
thistle) was by far the most common. Another study, which surveyed 120 adults with
hepatitis
C, found that many used a variety of complementary health approaches,
including multivitamins, herbal remedies, massage, deep breathing exerc
ises,
meditation, progressive relaxation, and yoga.
What the Science Says
No dietary supplement has been shown to be effective for hepatitis
C. This section
summarizes what’s known about the safety and effectiveness of milk thistle and
some of the other di
etary supplements studied for hepatitis
C.
—
Milk thistle
(scientific name
Silybum marianum
) is a plant from the aster family.
Silymarin is an active component of milk thistle believed to be responsible for the
herb’s health
-related properties. Milk thistle has been used in Europe for treating
liver disease and jaundice since the 16th century. In the United States, silymarin
is the most popular dietary supplement taken by people with liver disease.
However, two rigorously designed studies of silymarin in peop
le with hepatitis
C
didn’t show any benefit.
•
A 2012 controlled clinical trial, cofunded by NCCIH
and NIDDK, showed that two
higher
-than
-usual doses of silymarin were no better than placebo in reducing the
high blood levels of an enzyme that indicates liver
damage. In the study, 154
people who hadn’t responded to standard antiviral treatment for chronic
National Center for Complementary and Integrative Health
3
Hepatitis C: A Focus on Dietary Supplements
hepatitis
C were randomly assigned to receive 420 mg of silymarin, 700 mg of
silymarin, or placebo three times per day for 24 weeks. At the end of the
treatm
ent period, blood levels of the enzyme were similar in all three groups.
•
Results of the HALT
-C study mentioned above suggested that silymarin use by
hepatitis
C patients was associated with fewer and milder symptoms of liver
disease and somewhat better quality of life, but there was no change in virus
activity or liver inflammation. The researchers emphasized that this was a
retrospective study (one that examined the medical and lifestyle histories of the
participants). Its finding of improved quality of life in patients taking silymarin
wasn’t confirmed in the more rigorous 2012 study described above.
—
Safety.
Available evidence from clinical trials in people with liver disease suggests
that milk thistle is generally well-
tolerated. Side effects can include a laxative effect,
nausea, diarrhea, abdominal bloating and pain, and occasional allergic reactions.
In
NIH
-funded studies of silymarin in people with hepatitis
C that were completed in
2010 and 2012, the frequency of side effects was similar in people tak
ing silymarin
and those taking placebos. However, these studies were not large enough to show
with certainty that silymarin is safe for people with chronic hepatitis
C.
Other supplements have been studied for hepatitis
C, but overall, no benefits have
been
clearly demonstrated. These supplements include the following:
—
Probiotics
are live microorganisms that are intended to have a health benefit
when consumed. Research hasn’t produced any clear evidence that probiotics
are helpful in people with hepatitis
C. Most people can use probiotics without
experiencing any side effects
—or with only mild gastrointestinal side effects such
as intestinal gas
—but there have been some case reports of serious adverse
effects in people with underlying serious health condition
s.
—
Preliminary studies, most of which were conducted outside the United States,
have examined the use of
zinc
for hepatitis
C. Zinc supplements might help to
correct zinc deficiencies associated with hepatitis
C or reduce some symptoms,
but the evidence for these possible benefits is limited. Zinc is generally
considered to be safe when used appropriately, but it can be toxic if taken in
excessive amounts.
—
A few preliminary studies have looked at the effects of combining supplements
such as
lactoferrin, SAM
e,
or zinc with conventional drug therapy for hepatitis
C.
The evidence isn’t sufficient to draw clear conclusions about benefit or safety.
—
Glycyrrhizin
—a compound found in licorice root
—has been tested in a few
clinical trials in hepatitis
C patients, but
there’s currently not enough evidence to
determine if it’s helpful. In large amounts, glycyrrhizin or licorice can be
dangerous in people with a history of hypertension (high blood pressure), kidney
failure, or cardiovascular diseases.
—
Preliminary studies
have examined the potential of the following products for
treating chronic hepatitis
C:
TJ
-108
(a mixture of herbs used in Japanese Kampo
medicine),
schisandra
,
oxymatrine
(an extract from the sophora root), and
thymus extract
. The limited research on these products hasn’t produced
convincing evidence that they’re helpful for hepatitis
C.
—
Colloidal silver
has been suggested as a treatment for hepatitis
C, but there’s
currently no research to support its use for this purpose. Colloidal silver is known to
cause serious side effects, including a permanent bluish discoloration of the skin
called argyria (for more information, see the NCCIH
fact sheet
Colloidal Silver
.)
C is a liver disease caused by a virus. It’s usually chronic (long
-lasting), but
most people don’t have any symptoms until the virus causes liver damage, which can
take 10 or more years to happen. Without medical treatment, chronic hepatitis
C can
eventually cause liver cancer or liver failure. Conventional medical treatments are
available for chronic hepatitis
C. Some people with hepatitis
C also try complementary
health approaches, especially dietary supplements. This fact sheet provides basic
information on hepatitis
C, summarizes scientific research on selected supplements,
and suggests sources for additional information.
Key Facts
Are Dietary Supplements for Hepatitis
C Safe?
—
Colloidal silver is
not
safe; it can cause irreversible side effects
.
—
Data on the safety of other supplements is limited. However, some can have side
effects or may interact in harmful ways with medications, and some may be
unsafe for people with certain health problems.
—
If you have hepatitis
C, check with your health care
provider before using any
dietary supplement to make sure that it is safe for you and compatible with any
medical treatment that you’re receiving for hepatitis
C or any other health problem.
Are Dietary Supplements for Hepatitis
C Effective?
—
No dietary supplement has been shown to be effective for hepatitis
C or
its complications.
—
The results of research supported by the National Center for Complementary and
Integrative Health
( NCCIH) and National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) have shown that silymarin, the active extract of milk
thistle and the most popular complementary health product taken by people with
liver disease, was no more effective than placebo in people with hepatitis
C.
—
Research on other dietary supplements for hepatitis
C, such as zinc, licorice root
(or its extract glycyrrhizin), S
-adenosyl
-L-
methionine (SAMe), and lactoferrin, is in
nccih.nih.gov
National Center for Complementary and Integrative Health
2
Hepatitis C: A Focus on Dietary Supplements
its early stages, and no firm conclusions can be reached about the potential
effectiveness of these supplements.
Keep in Mind
—
It’s important
not
to replace conventional medical therapy for hepatitis
C with
dietary supplements or other approaches that haven’t been shown to be effective.
—
Tell all your health care providers about any complementary health approaches
you use. Give them a full picture of what you do to manage your health. This will
help ensure coordinated and safe care.
What Is Hepatitis
C?
Hepat
itis
C is a contagious liver disease. It’s caused by the hepatitis
C virus. People
can get hepatitis
C through contact with blood from a person who’s already infected
or, less commonly, through having sex with an infected person. The infection usually
beco
mes chronic. Chronic hepatitis
C often is treated with drugs that can eliminate
the virus. This may slow or stop liver damage, but the drugs may cause side effects,
and for some people, treatment is ineffective. An estimated 3.2 million Americans
have chro
nic hepatitis
C. To learn more about hepatitis
C, visit t
he NIDDK Web site
at
http://d
igestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/index.aspx
.
Use of Herbal Supplements and O
ther Complementary
Approaches for Hepatitis
C
Several herbal supplements have been studied for hepatitis
C, and substantial
numbers of people with hepatitis
C have tried herbal supplements. For example, a
survey of 1,145 participants in the HALT
-C (Hepatit
is C Antiviral Long-
Term
Treatment Against Cirrhosis) trial, a study supported by the National Institutes of
Health (NIH), found that 23 percent of the participants were using herbal products.
Although participants reported using many different herbal prod
ucts, silymarin (milk
thistle) was by far the most common. Another study, which surveyed 120 adults with
hepatitis
C, found that many used a variety of complementary health approaches,
including multivitamins, herbal remedies, massage, deep breathing exerc
ises,
meditation, progressive relaxation, and yoga.
What the Science Says
No dietary supplement has been shown to be effective for hepatitis
C. This section
summarizes what’s known about the safety and effectiveness of milk thistle and
some of the other di
etary supplements studied for hepatitis
C.
—
Milk thistle
(scientific name
Silybum marianum
) is a plant from the aster family.
Silymarin is an active component of milk thistle believed to be responsible for the
herb’s health
-related properties. Milk thistle has been used in Europe for treating
liver disease and jaundice since the 16th century. In the United States, silymarin
is the most popular dietary supplement taken by people with liver disease.
However, two rigorously designed studies of silymarin in peop
le with hepatitis
C
didn’t show any benefit.
•
A 2012 controlled clinical trial, cofunded by NCCIH
and NIDDK, showed that two
higher
-than
-usual doses of silymarin were no better than placebo in reducing the
high blood levels of an enzyme that indicates liver
damage. In the study, 154
people who hadn’t responded to standard antiviral treatment for chronic
National Center for Complementary and Integrative Health
3
Hepatitis C: A Focus on Dietary Supplements
hepatitis
C were randomly assigned to receive 420 mg of silymarin, 700 mg of
silymarin, or placebo three times per day for 24 weeks. At the end of the
treatm
ent period, blood levels of the enzyme were similar in all three groups.
•
Results of the HALT
-C study mentioned above suggested that silymarin use by
hepatitis
C patients was associated with fewer and milder symptoms of liver
disease and somewhat better quality of life, but there was no change in virus
activity or liver inflammation. The researchers emphasized that this was a
retrospective study (one that examined the medical and lifestyle histories of the
participants). Its finding of improved quality of life in patients taking silymarin
wasn’t confirmed in the more rigorous 2012 study described above.
—
Safety.
Available evidence from clinical trials in people with liver disease suggests
that milk thistle is generally well-
tolerated. Side effects can include a laxative effect,
nausea, diarrhea, abdominal bloating and pain, and occasional allergic reactions.
In
NIH
-funded studies of silymarin in people with hepatitis
C that were completed in
2010 and 2012, the frequency of side effects was similar in people tak
ing silymarin
and those taking placebos. However, these studies were not large enough to show
with certainty that silymarin is safe for people with chronic hepatitis
C.
Other supplements have been studied for hepatitis
C, but overall, no benefits have
been
clearly demonstrated. These supplements include the following:
—
Probiotics
are live microorganisms that are intended to have a health benefit
when consumed. Research hasn’t produced any clear evidence that probiotics
are helpful in people with hepatitis
C. Most people can use probiotics without
experiencing any side effects
—or with only mild gastrointestinal side effects such
as intestinal gas
—but there have been some case reports of serious adverse
effects in people with underlying serious health condition
s.
—
Preliminary studies, most of which were conducted outside the United States,
have examined the use of
zinc
for hepatitis
C. Zinc supplements might help to
correct zinc deficiencies associated with hepatitis
C or reduce some symptoms,
but the evidence for these possible benefits is limited. Zinc is generally
considered to be safe when used appropriately, but it can be toxic if taken in
excessive amounts.
—
A few preliminary studies have looked at the effects of combining supplements
such as
lactoferrin, SAM
e,
or zinc with conventional drug therapy for hepatitis
C.
The evidence isn’t sufficient to draw clear conclusions about benefit or safety.
—
Glycyrrhizin
—a compound found in licorice root
—has been tested in a few
clinical trials in hepatitis
C patients, but
there’s currently not enough evidence to
determine if it’s helpful. In large amounts, glycyrrhizin or licorice can be
dangerous in people with a history of hypertension (high blood pressure), kidney
failure, or cardiovascular diseases.
—
Preliminary studies
have examined the potential of the following products for
treating chronic hepatitis
C:
TJ
-108
(a mixture of herbs used in Japanese Kampo
medicine),
schisandra
,
oxymatrine
(an extract from the sophora root), and
thymus extract
. The limited research on these products hasn’t produced
convincing evidence that they’re helpful for hepatitis
C.
—
Colloidal silver
has been suggested as a treatment for hepatitis
C, but there’s
currently no research to support its use for this purpose. Colloidal silver is known to
cause serious side effects, including a permanent bluish discoloration of the skin
called argyria (for more information, see the NCCIH
fact sheet
Colloidal Silver
.)
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