Hep C and Supplements: Help or Hurt?

From the WebMD Archives

Dietary and herbal supplements can't cure hepatitis C, but many people take them to try to ease their symptoms or get relief from the side effects of treatment. Do they work? For most of these products, scientists don’t have a firm answer.

But even though powerful new drugs can cure hep C, there still may be a role for supplements, says Arti Prasad, MD, executive director of the University of New Mexico Center for Life.

"People will still be looking for other things because it's very hard treatment," she says. "There's a sense of empowerment when [people] get something for themselves versus something prescribed by a physician. [Supplements] may help in many ways."

You should always talk to your doctor before you take any vitamins or supplements. In some cases, these products can be harmful.

Milk Thistle

This is one of the hep C supplements that scientists have studied the most. The thought is that its active ingredient, silymarin, protects liver cells and lowers inflammation that can damage the liver. Studies on it have been mixed, though. One showed that silymarin did not lower the levels of an enzyme, called ALT, that spike when the liver is damaged. But another reported that people’s symptoms and quality of life got better when they took milk thistle.

Researchers haven’t done any large clinical trials to test the compound, but "there is some good evidence for milk thistle," Prasad says. "In multiple smaller studies, it has been shown to improve liver function." Check with your doctor first, though, before you start taking any.

Curcumin

This is a chemical in turmeric, the spice that gives many curries their flavor and yellow hue. It can help the body fight inflammation, viruses, and bacteria, which can be helpful to people with hepatitis C, Prasad says. It’s generally safe, but it can act as a blood thinner, so you shouldn’t use it if you're also taking anti-clotting drugs like warfarin.

Probiotics

"These are beneficial bacteria, like friendly germs, that help maintain the health of the gut and aid in digestion," Prasad says. If you have scar tissue and other damage to your liver, called cirrhosis, which is one of the more serious hep C complications, probiotics may help prevent infections and other problems. How? By restoring the balance of bacteria in your intestine.

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Licorice Root

The findings from early studies in mice suggest that licorice root, part of many Chinese herbal remedies, can slow the growth of liver cancer, which can happen to people with hep C. No studies have shown clear benefits for people, though. Also, the active ingredient in licorice root, glycyrrhizin, can raise blood pressure, among other harmful effects.

Colloidal Silver

Not only is this compound unhelpful if you have hepatitis C, it can actually be harmful. It's made of small particles of silver floating in liquid. It can cause lasting side effects, including a skin condition called argyria (when your skin turns blue). It can also keep some medicines from working and cause kidney, liver, and nerve problems.

St. John’s Wort

Better known as a treatment for depression, this herb can make some hepatitis C medications stop working, says Douglas Dieterich, MD, professor at Mt. Sinai's Icahn School of Medicine in New York City. There’s no firm evidence that the supplement harms the liver, but Dieterich says it’s best to avoid it, especially when you’re trying new hep C drugs.

Vitamins

It's best to get your vitamins and minerals from your diet, one that includes plenty of fruits, vegetables, whole grains, and healthy fats, Prasad says. Still, some new evidence shows that certain vitamins may help people with hep C. Vitamins B12 and D, for example, may make some standard hepatitis drugs work better.

When you’re thinking of taking a dietary or herbal supplement, remember that the government doesn’t regulate them in the same way as drugs and food. Ingredients and dosing can be misleading. Make sure any products you buy have "GMP" or "Good Manufacturing Practice" on the label.

WebMD Feature Reviewed by David Kiefer, MD on March 18, 2015

Sources

SOURCES:

Arti Prasad, MD, professor of medicine, University of New Mexico School of Medicine and executive director, University of New Mexico Center for Life.

Douglas Dieterich, MD, professor of medicine in liver diseases, Icahn School of Medicine, Mt Sinai School of Medicine, New York City.

Seeff, L.B. Hepatology, February 2008.

U.S. Department of Veterans Affairs: "Viral Hepatitis."

National Center for Complementary and Integrative Health: "Hepatitis C and Dietary Supplements: What the Science Says."

National Center for Complementary and Integrative Health: "Effects of Milk Thistle Extract on Chronic Hepatitis C."

University of Maryland Medical Center: "Turmeric."

Oregon State University Linus Pauling Institute Micronutrient Information Center: "Curcumin."

Prasad, A. et al. Biotechnology Advances. November 1, 2014.

MD Anderson Cancer Center: "Turmeric Adds Spice to Your Health."

American Gastroenterological Association: "Probiotics: What They Are and What They Can Do For You."

American Cancer Society: "Licorice."

National Center for Complementary and Integrative Health: "Licorice Root," "Colloidal Silver: What You Need To Know."

University of Maryland Medical Center: "St. John's Wort."

Memorial Sloan Kettering Cancer Center: "St. John's Wort."

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