Hepatitis A, B and C supplements, herbs, vitamins - Natural and alternative treatment for viral hepatitis C, B, and A
April 5 2018 by Ray Sahelian, M.D.

Hepatitis is inflammation of the liver, which can be caused by viruses, medications, or toxic agents. This page focuses mostly on viral hepatitis B and C. Hepatitis A symptoms are usually temporary and go away after a few weeks.
   Chronic hepatitis B and C are similar kinds of liver infection that are caused by viruses. These infections are named after the viruses that cause them. A virus called hepatitis B causes chronic hepatitis B infection. A virus called hepatitis C causes chronic C infection. Chronic B and chronic C infections of the liver develop after a bout of acute hepatitis. The hepatitis C virus was first identified in 1989. It causes chronic liver inflammation, cirrhosis and liver cancer.

Natural therapies
There's very little research available regarding the natural or herbal therapy for viral liver infections.. I have listed a few possibilities but much more research needs to be done before making any firm recommendations. Please discuss with your health care provider before making any changes to your treatment. I will update this page regularly as more information becomes available. For more details, see the studies at the bottom of this page and also try the individual links to the pages of the nutrients and herbs.

Carnitine decreases the severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C. The carnitine dose would be about 100 to 250 mg daily in the morning shortly before breakfast.
Silymarin is a derivative from the milk thistle plant that has been used for centuries to treat liver ailments. Research results of some small studies suggest silymarin protects liver cells, and has anti-inflammatory and regenerative properties producing a beneficial effect for some types of hepatitis. There is little research regarding the role of silymarin in the therapy of chronic viral hepatitis.
Carotenoids, the yellow, pink, and other pigments found in vegetables, have been found helpful in one study.
Cordyceps, a mushroom, may be helpful in Hepatitis B.
Licorice may be helpful in Hepatitis C.
Aceytylcysteine helps in preventing or reducing liver damage from acetaminophen toxicity, I am not sure if it is helpful in viral hepatitis.
Fish oils may be helpful in reducing inflammation in hepatitis C patients and perhaps B patients.
Propolis from bees has been studied.
Vitamin D deficiency may be linked to hepatitis B infection. More than half of hepatitis B patients were vitamin D deficient, and deficiency was associated with worse outcomes, in a 2016 Vietnamese study.

Amino acids
Mol Med Rep. 2015. Effects of branched-chain amino acids and zinc-enriched nutrients on prognosticators in HCV-infected patients: A multicenter randomized controlled trial. BCAA and zinc‑enriched supplementation may prolong the survival of hepatitis C virus infected patients by improving amino acid imbalance and zinc deficiency.

Antioxidants
Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase I clinical trial.
Oxidative stress and lipid peroxidation play major roles in the fatty liver accumulation (steatosis) that leads to necro-inflammation and necrosis of hepatic cells. Previous trials suggested that antioxidative therapy may have a beneficial effect on patients with chronic hepatitis C virus infection. Fifty chronic HCV patients were treated orally on a daily basis for 20 weeks with seven antioxidative oral preparations (glycyrrhizin (found in licorice), schisandra, silymarin, ascorbic acid, L-glutathione, alpha lipoic acid, and alpha-tocopherol), along with four different intravenous preparations (glycyrrhizin, ascorbic acid, L-glutathione, B-complex) twice weekly for the first 10 weeks, and followed up for an additional 20 weeks. Patients were monitored for HCV-RNA levels, liver enzymes, and liver histology. Assessment of quality of life was performed using the SF-36 questionnaire. In one of the tested parameters (eg, liver enzymes, HCV RNA levels, or liver biopsy score), a combination of antioxidants induced a favorable response in 48% of the patients (24). Normalization of liver enzymes occurred in 44% of patients who had elevated pretreatment ALT levels (15 of 34). ALT levels remained normal throughout follow-up period in 72%. A decrease in viral load (one log or more) was observed in 25% of the patients (12). Histologic improvement (2-point reduction in the HAI score) was noted in 36% of the patients. The SF-36 score improved in 26 of 45 patients throughout the course of the trial . No major adverse reactions were noted. These data suggest that multi antioxidative treatment in chronic HCV patients is well tolerated and may have a beneficial effect on necro-inflammatory variables. A combination of antiviral and antioxidative therapies may enhance the overall response rate of these patients. J Clin Gastroenterol. 2005.

Fish oils and phospholipids
Effects of eicosapentaenoic acid supplementation in the treatment of chronic hepatitis C patients.
Eicosapentaenoic acid (EPA found in fish oil) has been shown to exert anti-inflammatory actions. To evaluate the effects of EPA on chronic hepatitis C, we administered EPA ethyl ester capsules to patients receiving the combination therapy of interferon alpha-2b and ribavirin. EPA (1,800 mg/d) was supplemented in combination with vitamin E (300 mg/d) and C (600 mg/d) to 5 chronic hepatitis C patients (EPA group). Five patients were administered vitamin E and C but not EPA (control group). These observations may suggest the beneficial effect of EPA supplementation in the treatment of chronic hepatitis C patients. J Nutr Sci Vitaminol (Tokyo). 2005 Dec. Graduate School of Health and Welfare, Faculty of Health and Welfare Science, Okayama Prefectural University, Soja, Japan.

Beneficial effect of salmon roe phosphatidylcholine in chronic liver disease.
Phosphatidylcholine, especially dilinoleoyl-PC, has been reported to be effective in preventing hepatic fibrosis in chronically alcohol-fed baboons. Salmon roe phospholipids, 90% of which are PC, were extracted and encapsulated. Although this was a small trial, n-3 PUFA phosphatidylcholine may be beneficial in the treatment of chronic liver diseases. Curr Med Res Opin. 1999. Department of Internal Medicine, Yokohama Red Cross Hospital, Japan.

Proanthrocyandins
World J Hepatol. 2014. Functional foods effective for hepatitis C: Identification of oligomeric proanthocyanidin and its action mechanism. We found a potent inhibitor of HCV RNA expression in the extracts of blueberry leaves and then identified oligomeric proanthocyanidin as the active ingredient.

Email received
I have cut my viral load of hepatitis-c, geno type -1 in half with natural things like milk thistle, liv-52, primrose oil, b-complex, selenium, garlic oil every day, I was on Peg intron and ribavirin and it didn't come close to what the natural remedies do, with no side affects!

Subscribe to a FREE Supplement Research Update newsletter at Physician Formulas. We will mention natural ways to treat hepatitis as more research becomes available.

Causes of hepatitis
Contaminated blood products or body fluids, dirty needles and instruments, and injection drug use are the main routes of transmission. Cultural practices, such as acupuncture, tattoo, body piercing and scarring, also play a role.  A person can get hepatitis B and hepatitis C by having sex with an infected person. Recent research indicates that hepatitis C may be transmitted by common household items such as toothbrushes. Hepatitis B can be secreted through sweat, and if this sweat comes in contact with skin that is damaged, for instance through a wrestling match, hepatitis B may be transmitted from one wrestler to another.

Alcoholic hepatitis
This is the most common precursor of cirrhosis in the U.S. While alcoholic hepatitis may not develop in many patients until several decades of alcohol abuse, it appears in a few individuals within a year after onset of excessive drinking.

Medical treatment for viral hepatitis
Interferon alfa-2b is a new drug for the treatment of chronic hepatitis B or chronic hepatitis C. This drug, given as a shot, helps the immune system fight the hepatitis virus. Treatment with interferon alfa-2b is successful in some patients with chronic hepatitis B or chronic hepatitis C. The shots may be given every day or every other day. Treatment may last for a number of months. Zinc supplementation enhances the response to interferon therapy in patients with intractable chronic hepatitis C.
   Total abstinence from alcohol should be recommended to patients infected with hepatitis C virus as even at moderate levels, alcohol use appears to increase fibrosis progression in these patients.

Chronic Hepatitis
After a person has recovered from acute hepatitis, chronic hepatitis can set in. This occurs when the liver has been damaged from the acute illness and doesn't recover from the damage. Chronic hepatitis develops in 10 to 20 percent of people who have hepatitis B and in 30 to 50 percent of people who have hepatitis C. People with chronic hepatitis B or chronic hepatitis C may not have any symptoms at all. But in some people, chronic hepatitis can lead to cirrhosis of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The liver stops working and can't cleanse the body of wastes. People in the early stages of cirrhosis may not have symptoms. When cirrhosis gets worse, symptoms begin. They may include weight loss, fatigue, jaundice, nausea, vomiting and loss of appetite . Cirrhosis can lead to liver failure (the liver stops working) and liver cancer.
   Individuals who are infected with the hepatitis C virus have an increased risk of developing non-Hodgkin's lymphoma and other diseases of the lymph system.

Hepatitis A
Formerly called infectious hepatitis, hepatitis A is most common in children in developing countries, but is being seen more frequently in people of all ages and in the developed world. Hepatitis A is thought to be spread by a virus from an infected person's feces directly or indirectly contaminating food, raw shellfish, drinking water, cooking utensils or someone else's fingers. The incubation period is two to six weeks after infection. Hepatitis A is considered an acute condition.

Symptoms of Hepatitis
There is an initial acute phase, often with few if any symptoms. If there are hepatitis symptoms, they tend to mimic "flu-like" symptoms such as mild fever, muscle or joint aches, nausea, vomiting, loss of appetite, diarrhea and fatigue. Abdominal pain, often mild, could be another symptom of Hepatitis.
    As the condition worsens, the person also may experience these additional hepatitis symptoms: jaundice (yellowed skin, mucous membranes and eye-whites), dark urine, light colored stools that may contain pus, and itching. Another symptom of hepatitis is hives. The course of the hepatitis and the different outcomes after the acute phase are the factors that distinguish the various types.

Symptom
The acute phase is rarely serious or fatal, although occasionally a so-called fulminant or rapidly progressing form leads to death. As the condition worsens, the person also may experience these additional hepatitis symptoms: jaundice (yellowed skin, mucous membranes and eye-whites), dark urine, light colored stools that may contain pus, itching, hives.

Routinely testing people for hepatitis A virus -- when they don't have clinical symptoms of infection or a history of exposure -- raises the likelihood of false-positive results. Hepatitis A is most often caught when sanitation is poor, or when carriers are not careful about personal hygiene. A false-positive test result may mean that a person's contacts undergo unnecessary treatment to prevent infection. Most false-positives came from older adults without typical risk factors for infection. In fact, most who underwent retesting had negative results. To improve the value of the hepatitis A virus test, clinicians should limit laboratory testing for acute hepatitis A virus infection to persons with clinical findings typical of hepatitis A or to persons who have been exposed to settings where hepatitis A virus transmission is suspected.

Hepatitis B research
Immunization with the synthetic hepatitis B vaccine may be associated with an increased risk of developing multiple sclerosis.

Pediatric doses of hepatitis B vaccine can provide long-term protection against hepatitis B up to 15-16 years.

Inhibition of hepatitis B virus by an aqueous extract of Agrimonia eupatoria - Agrimony.
Phytother Res. 2005.
Cell Biology Laboratory, Korea Research Institute of Bioscience and Biotechnology, Daejon 305-333, Republic of Korea.
Our results suggest that some plants of the genus agrimony contain potential antiviral activity against hepatitis B virus.

Clinical and experimental study on yi-gan-ning granule in treating chronic hepatitis B
Zhongguo Zhong Xi Yi Jie He Za Zhi. 1993.
This paper reports that 320 patients with chronic hepatitis B were treated with Yi-ganning Granule (YGNG) and the pharmacodynamics of YGNG in the animal study. As control, another 70 patients with chronic hepatitis B receiving oleanolic acid granule (OAG) were compared to 68 patients in YGNG group. YGNG is consisted of Astragalus membranaceus , Artemisia capillaris, Codonopsis pilosula, et al. Each patient has taken YGNG or OAG for 3 months. The result showed YGNG was effective on recovering the liver function and OAG had similar effect. The sero-negative conversion rates of HBsAg, HBeAg, HBcAb and positive conversion rate of HBeAb in the YGNG group were 33.1%, 40.5%, 10.5% and 15.5% respectively, which were much better than that in OAG group. The result of 6 months follow up showed that 60 of 62 patients receiving YGNG were in stabilized state. The result in the animal study demonstrated that YGNG had significant protection from the liver damage caused by CCl4. YGNG could decrease serum ALT level and protect the liver function of carbohydrate, fat, protein metabolism and detoxication. YGNG could induce interferon in vivo and play an important role in seroconversion of negative DHBV-DNA and improvement of pathological morphology in chronic viral hepatitis B.

Clinical study of 96 cases with chronic hepatitis B treated with jiedu yanggan gao by a double-blind method
Zhong Xi Yi Jie He Za Zhi. 1990.
This paper reported 96 cases with chronic hepatitis B treated by a double-blind method. There were 51 cases of observation group (OG) and 45 cases of control group (CG). OG was treated with Jiedu Yanggan Gao consisting of Artemisia capillaris, Taraxacum mongolicum, Plantago seed, Cephalanoplos segetum, Hedyotis diffusa, Flos Chrysanthemi Indici, Smilax glabra - Sarsaparilla , Astragalus membranaceus, Salviae miltiorrhizae, Fructus Polygonii Orientalis, Radix Paeoniae Alba - White Peony root , Polygonatum sibiricum). CG was prescribed with three charred medicinal herbs (charred Fructus Crataegi, charred Fructrus Hordei Germinatus, charred fermented mixture of several medical herbs and wheat bran). The average duration of treatment was five months. All 96 cases belong to the virus-duplication-type with positive HBsAg for over one year. Among them 65% of cases HBeAg, DNAP and HBV-DNA were positive. 20% of cases were positive in two out of the above tests. 13 data were compared statistically between two groups, and proved to be comparable before treatment. 27% and 66% of cases' ALT, AST returned to normal respectively in OG after treatment. However, in CG they were 9% and 22%. TTT returned to normal in 52% cases of OG and 44% in CG. 20% cases HBeAg shifted to negative in OG, but 6% in CG. After comprehensive judgement, the total effective rate was 74% in OG and 24% in CG respectively. Eight cases were basically cured in OG and one case in CG. After one year's follow-up, one recurred in eight patients of OG, however the only one cured in CG still relapsed.

Hepatitis C virus treatment
The hepatitis C virus is spread through contact with infected blood, having sex with an infected person and from mother to baby during childbirth. Hepatitis C can lead to scarring of the liver or liver cancer. Some patients require a liver transplant. There is no vaccine for the disease. People chronically infected with hepatitis C virus have a significantly increased rate of thyroid abnormalities. Infection with HCV nearly doubles the risk of developing non-Hodgkin's lymphoma, a cancer involving the lymph nodes. Olysio (simeprevir) was approved by the U.S. Food and Drug Administration in November 2013 to treat chronic hepatitis C infection in adults.

Individuals with hepatitis C infection are three times more likely to develop cirrhosis than are those who are hepatitis C negative, and fibrosis progression is pronounced within the first 5 years after infection.

Prevalence and predictors of herbal medication use in veterans with chronic hepatitis C.
J Clin Gastroenterol. 2004.
Herbal therapies are used by a substantial proportion of persons in the United States, and use of these supplements may be even higher in those with chronic liver disease. The aims of this study were to prospectively determine the proportion of US veterans with chronic hepatitis C that are currently taking vitamins and herbal medications and to evaluate factors associated with use of herbal preparations. Patients with hepatitis C who were seen in the gastroenterology, infectious disease, and primary care clinics at the VA New York Harbor Healthcare System were invited to participate in this prospective study. For comparison, healthy patients without hepatitis C were enrolled from the primary care clinics at the same medical center. Patients were interviewed by trained research coordinators who obtained detailed demographic and clinical data, as well as information on the use of antioxidants (vitamin C and E), multivitamins, and herbal medications. Use of vitamin C, vitamin E, multivitamins, and herbal therapies was significantly higher in the 500 patients with hepatitis C compared with the 250 healthy controls. The most common herbal medications taken by hepatitis C patients were milk thistle, ginseng, and echinacea. The use of herbal preparations is prevalent among veterans with chronic hepatitis C, especially those with higher levels of education and higher incomes. Obtaining a detailed medical history and documentation of the use of these supplements is critical to determine the potential for herbal-drug interactions and hepatotoxicity.

Tomato-based functional food as interferon adjuvant in Hepatitis C virus eradication therapy.
J Clin Gastroenterol. 2004.
The authors conducted a study to verify whether supplementation with an antioxidant-rich tomato-based functional food reduces anemia during pegylated interferon and ribavirin therapy for chronic hepatitis C. Oxidative stress plays a major role in the physiopathology of hemolytic anemia during ribavirin therapy. The efficacy of antioxidant supplementation with vitamins C and E as pure compounds, is still controversial. A functional food with a high content of natural antioxidants and with high carotenoid bioavailability was developed. The authors enrolled 92 patients with chronic hepatitis C, treated with standard combination therapy. Forty-six of them received a daily dose (100 g) of functional food (group 1), and 46 did not (group 2). The effect of antioxidant activity was assessed comparing compliance with the full dose of ribavirin and hemoglobin levels during the first 3 months of treatment. Only 8.7% of patients in group 1 had to reduce their daily ribavirin dose, whereas ribavirin reduction was necessary for 30.4% of patients in group 2. Hemoglobin levels showed significant differences at 15, 30, and 90 days during the observation time. Results demonstrated that the authors' functional food reduces the severity of ribavirin-related anemia and improves the tolerance to the full dose of ribavirin in patients with chronic hepatitis C.

Complementary and alternative therapies in the treatment of chronic hepatitis C: a systematic review.
J Hepatol. 2004.
Systematic searches were conducted in six databases, reference lists of all papers were checked for further relevant publications and information was requested from experts. No language restrictions were imposed. Twenty-seven eligible randomised clinical trials were located involving herbal products and supplements. No randomised clinical trials were identified for any other complementary therapy. In 14 of the hepatitis C trials, patients received interferon-alpha in combination with the complementary therapy. Less than half the trials (11/27) were of good methodological quality. Compared with the control group, significant improvements in virological and/or biochemical response were seen in trials of vitamin E, thymic extract, zinc, traditional Chinese medicine, Glycyrrhiza glabra (licorice) and oxymatrine. We identified several promising complementary therapies, although extrapolation of the results is difficult due to methodological limitations.

Hepatoprotective and free radical scavenging activities of phenolic petrosins and flavonoids isolated from Equisetum arvense - Horsetail.
J Ethnopharmacol. 2004.
Hepatoprotective activity-guided fractionation of the MeOH extract of Equisetum arvense resulted in the isolation of two phenolic petrosins, onitin (1) and onitin-9-O-glucoside (2), along with four flavonoids, apigenin (3), luteolin (4), kaempferol-3-O-glucoside (5), and quercetin-3-O-glucoside. Among these, compounds 1 and 4 exhibited hepatoprotective activities on tacrine-induced cytotoxicity in human liver-derived Hep G2 cells These results support the use of this plant for the treatment of hepatitis in oriental traditional medicine.

Q. I am 47 years old with Hepatitis C for over 15 years normal liver, I am using an  mushroom Immune Assist 24/7 Aloha Medicinals (schisandra for liver) ( ginkgo biloba 120 mg for circulation) (whitania tribulus brahmi formula ayurveda for stress) (red maca for prostate enleargment) broken down during the day breakfast, lunch and dinner. I'm using these supplements for more than a year every day, I would like to continue with complex of 1920 mg of mushrooms and combine Passion Rx.
   A. No major safety issues have been found with Passion Rx after 14 years on the market, however when people start a new supplement it is best to do so by itself for a few days to determine how well it works without interference from other herbs or supplements.

Hepatitis E information
Curr Opin Virol. 2014. Food and environmental routes of Hepatitis E virus transmission. Hepatitis E virus (HEV), genus Hepevirus, family hepeviridae is a main cause of epidemic hepatitis in developing countries and single cases of hepatitis in higher income countries. There are at least four HEV genotypes which have different epidemiologic and clinical features. E viruses are often transmitted via food and environmental routes.

Additional Hepatitis Herbs
The Chinese herbal compound Baicao Rougan Capsule has been tested in the treatment of hepatits B with some improvement of liver fibrosis and early cirrhosis.
Phyllanthus amarus may have positive effect on antiviral activity and liver biochemistry in chronic HBV infection.
Wogonin isolated from Scutellaria baicalensis - scullcap - can suppress HBV surface antigen production in vitro.
St. John's wort has not been found to be helpful in hepatitis C.

Hepatitis natural treatment questions and emails
Is frequent urination a symptom of hepatitis?
   Unlikely. Frequent urination is much more likely to be due to a urogenital condition.

I have chronic hepatitis B and have been taking Hepsera and Epivir for the past two years . My doctor said that i might have to take these medications for the rest of my life. i am very scared of the long term side effects of these medications such as liver and kidney dammage, i cant stop taking Hepsera until my doctor tell me so because my Hepatitis could get worse if stop taking it. i dont want my Hepatitis to get worse and i also want to protect my liver. can you tell me if it is safe for me to take both Hepsera and milk thistle. Hepsera is to supress the Hepatitis B virus in my body but in the same time i take milk thistle to clean the toxin from my liver caused from these medications?
   It is difficult to predict the interaction of herbs and medicines, in this case milk thistle and hepatitis drugs. If your doctor approves, you can take milk thistle and perhaps acetylcysteine and some of the other supplements listed at the top of the page.

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