I once met a nurse who was convinced she had cured her boyfriend of hepatitis C by giving him green tea.  Even after I informed her that 25% of people clear the virus naturally she was still convinced it was the tea that had done it.  Such is the conviction of those who advocate complementary therapies. I am fully expecting an onslaught of rebuttals from this blog.    

Many people worldwide have found an increase in well-being through using complementary therapies, whether they have hepatitis C or not. But while the benefits claimed by proponents often sound impressive, do they stand up to scrutiny?

The list of herbs commonly used by people with hepatitis C includes: St Mary’s thistle (Silybum marianum) also known as milk thistle; licorice (Glycyrrhiza glabra); dandelion (Taraxacum officinale); and CH100. The much longer list of herbs that can damage the liver includes: barberry, black cohosh, chaparral, comfrey, creosote bush, germander, gordolobo, yerba tea, greasewood, greater celandine, false pennyroyal, jamaican bush tea, Jin Bu Huan, kombucha tea, sassafras, senna, and white chameleon. I don’t pretend to know what most of these are but I suspect most other people wouldn’t know a St Marys thistle from a false pennyroyal either, even if it was smacked across their face. Obviously this is a complicated business unless you are an expert.

Of course it is well known that herbs and other organic compounds found in nature are the basis of many of the medicines we are prescribed.  The best known example is probably codeine from opium poppies. But it is not exactly easy to use. I guess you could grow your own and make tea from it, but how do you measure the quantity of active ingredient you are absorbing?  How do you know what is a safe quantity to consume? And how do you know what interactions it has with other drugs? 

For most people the only realistic way is to acquire these herbs is through a retailer.  Most big cities with a Chinatown have Chinese medicine stores that stock these products in rows of glass jars or walls of drawers.  But can you really trust what’s in those drawers when a 2015 toxicology and heavy metal study of 26 widely-available traditional Chinese medicines has found 90% were not safe for human consumption because of undeclared illegal and dangerous substances?  

Of course you can always buy the mass produced tablets from a pharmacy or health food store.  While this is undoubtedly safer, it doesn’t really address the ideological objection to buying mass produced pharmaceuticals produced by multinational corporations with huge profit margins.  Significantly these herbal medicines  don’t need to go through a rigorous development and testing process to ensure they do what they are supposed to do.

Complementary medicine is big business these days with multipronged web based enterprises set up to promote vitamins and other plant based medicine as a cure for practically everything.  If you discount online “”degrees“” from online “”colleges“”, many of the so called therapists or practitioners have no real qualifications and little expertise in specialised fields of medicine such as hepatitis C.  They are mostly unregulated and rely instead on the almost religious fervour of their proponents to promote them.

The history of bogus cures is littered with charlatans and disappointments. But what really grinds my gears is people disregarding medically proven treatments in favour of herbal treatments with no known mechanism of action.  Several of my friends in the early days of HIV chose to pursue vitamin C injections in the spine and other nonsense involving sea slugs, rather than work with doctors to refine the rough, but promising drugs, into an effective treatment.  Those guys are dead now obviously.

Recently I have been bombarded by online posts regarding colloidal silver as a treatment for hep C.  Colloidal silver is a mineral. Despite promoters’ claims, silver has no known function in the body and is not an essential mineral supplement. Colloidal silver products were once available as over-the-counter drug products, but in 1999, the U.S. Food and Drug Administration (FDA) ruled that these colloidal silver products were not considered safe or effective.

Milk thistle is readily available from health food stores. For a couple of years after interferon based treatment hadn’t managed to clear my hep C, I took milk thistle tablets regularly.  An extremely wise woman who recommended them to me said she didn’t know if they worked or not, but they probably didn’t hurt. 

Prior to 2012 some studies had shown good results, although evidence for the clinical effects of milk thistle was inconsistent. Evidence was as not well validated; studies were confounded by a lack of well-defined efficacy, the inclusion of patients with different types of liver disease, and the use of non-standardized silymarin.  But the evidence is now clear from a 2012 study of the effect of milk thistle on liver disease  by Michael W. Fried, MD, Professor of Medicine and Director of Hepatology at the University of North Carolina. 154 patients with hepatitis C virus infection who failed interferon treatment showed no symptom improvement or slowing of disease progression with the popular herbal extract silymarin (milk thistle), compared with placebo, in a randomized trial.

I realise some people will not be convinced even by this evidence. So if you pursue complementary and alternative therapies it is important that you tell your liver specialist and GP of any therapies that you have recently used, are using, or plan to use. Your complementary/alternative practitioner should also be aware of what conventional treatments you are accessing. Every practitioner you see, whether they use conventional or alternative/complementary medicine needs to know of all the therapies you are using. This information will help the practitioner protect your health.

The views expressed above are mine alone and not necessarily those of my employer.