Is There A Natural Way To Improve Liver Fibrosis?  

Page Updated March 24, 2017

On this page the goal is to explore published data on natural alternatives and dietary supplements to fight or curtail liver damage. We begin with research published in International Journal of Molecular Sciences, with an overview of the protective effects of melatonin against various factor-induced liver injuries and diseases. Next we look at whether foods that raise cholesterol levels may affect liver-related mortality in patients with chronic hepatitis C. Followed by diet, exercise and dietary supplements, and foods that may improve liver function and disease progression. Finishing off with recent articles regarding lifestyle interventions and nutrition that could have an impact on HCV patients.

*As a point of reference a study published in Clinical Gastroenterology and Hepatology in 2016 found that curing HCV is linked to long-term reduction in fibrosis and cirrhosis, here is the article; Serum Biomarkers Indicate Long-term Reduction in Liver Fibrosis in Patients With Sustained Virological Response to Treatment for HCV Infection  

News and Research
Fibrosis

Journal Updates
March 24, 2017
Effects of Melatonin on Liver Injuries and Diseases
Liver injuries and diseases are serious health problems worldwide. Various factors, such as chemical pollutants, drugs, and alcohol, could induce liver injuries. Liver diseases involve a wide range of liver pathologies, including hepatic steatosis, fatty liver, hepatitis, fibrosis, cirrhosis, and hepatocarcinoma. Despite all the studies performed up to now, therapy choices for liver injuries and diseases are very few. Therefore, the search for a new treatment that could safely and effectively block or reverse liver injuries and diseases remains a priority. Melatonin is a well-known natural antioxidant, and has many bioactivities. There are numerous studies investigating the effects of melatonin on liver injuries and diseases, and melatonin could regulate various molecular pathways, such as inflammation, proliferation, apoptosis, metastasis, and autophagy in different pathophysiological situations. Melatonin could be used for preventing and treating liver injuries and diseases. Herein, we conduct a review summarizing the potential roles of melatonin in liver injuries and diseases, paying special attention to the mechanisms of action.

Diet And Cholesterol
In a 2016 study research into whether dietary cholesterol consumption affects liver-related mortality in patients with chronic hepatitis C is investigated. The study​ compared women who consumed dietary cholesterol within recommended guidelines to women who consumed high cholesterol amounts in their diet. Those with high dietary cholesterol intake had “significantly increased risk” for liver-related death and transplantation in HCV-infected women with advanced fibrosis or compensated cirrhosis, according to the article published in the British Journal of Nutrition.

2013 - The Mediterranean Diet
Published in the July 2013 issue of the Journal of Hepatology patients with nonalcoholic fatty liver disease who followed the Mediterranean Diet for six weeks significantly improved insulin sensitivity and reduced both liver fat and inflammation. A closer adherence to the Mediterranean diet appears to be protective against HCC (liver cancer). Results point to potential benefits from adhering to a Mediterranean dietary pattern for patients chronically infected with hepatitis viruses, according to this 2013 study; Mediterranean Diet and Hepatocellular Carcinoma.

Diet
2017 - New Book
The Liver Loving Diet - A Must Read For People With HCV Or Liver Disease

March 17, 2017 - Update
HCV Advocate
Nutrition and Hepatitis C
Nutrition is an important part of living well with and without hepatitis C. It is also one of the most important ingredients to help reduce the chances of developing fatty liver disease–the next liver disease epidemic. Our newly revised fact sheet provides a starting place to help people get on the right track.

March 16, 2017
Could maintaining a healthy weight actually improve liver health in a person with HCV?
Studies indicate that obesity and diabetes can accelerate damage caused by the hepatitis C virus, with research pointing to an increased prevalence of diabetes in people with HCV.

2016
Is There a Special Diet for Liver Disease Patients?
Probably the most common question I am asked, is regarding a special diet to follow if you have liver problems.  Here is an updated answer to these questions.

Video
2017 - January
Editorial - Medscape
Detox diets purport to accomplish this through "clean eating." That typically means eating a strict diet of fruits, vegetables, whole grains, and raw nuts and seeds, plus lots of water. ... But there's no evidence detox and cleanse diets actually rid the body of toxins, or that they're necessary.

Of Interest
Published in The Journal of the American College of Nutrition March 2016 issue researchers set out to investigate the prevalence of insulin resistance in HCV genotype 1 patients without obesity or type 2 diabetes. As reported; Our data show the importance of monitoring insulin resistance​, weight, and body composition in patients with chronic hepatitis C. Nutritional management seems to be important in the control of comorbidities related to excess weight and the enhancement of therapeutic responses.

Fatty Liver
2017 - January
HCV - Fatty liver disease and genotype 3
In this post a collection of journal articles and videos reviewing HCV and fatty liver disease is highlighted; with a focus on individuals afflicted with both conditions. In addition given the development of steatosis (abnormal levels of fat in your liver) is higher in people with HCV and genotype 3, links are provided to current therapies in this difficult to cure genotype. Finishing off with several liver healthy tips.

Liver cancer
2017
March 24, 2017
Statin use may lead to: Decreased fibrosis and Reduced risk of developing liver cancer
Statin drugs are widely used to manage high cholesterol and reduce the risk of cardiovascular disease. But in a new review of more than 50 studies, researchers cite reductions in liver inflammation and improvements in other related factors as reasons why statins make good candidates for treating chronic liver disease.

Jan 26, 2017
Dietary factors can protect against liver cancer development
Liver cancer is the third leading cause of cancer mortality worldwide with hepatocellular carcinoma (HCC) representing more than 90% of primary liver cancers. Most HCC patients are also suffering from chronic liver disease (CLD). Evidence is emerging that the composition of diet plays an important role in HCC and CLD development and may also have a chemoprotective role. In contrast to other types of cancer, there are few studies investigating the role of diet in hepatocarcinogenesis. From the available data it is evident that high intakes of red meat and dietary sugar positively correlate with HCC occurrence. On the contrary, high consumption of white meat, fish, vegetables, fruits and cereals are inversely associated with HCC risk. This letter discusses the potential role of dietary interventions in the prevention of hepatocarcinogenesis. The increasing HCC incidence and its high fatality are making HCC prevention an urgent matter. Dietary modifications are found to offer protection against HCC, however, new studies from well-designed and large prospective trials are required to confirm these results.

Vitamins
2017- February
Vitamin D decreases HCV cell replication, aids virologic response
February 27, 2017
Vitamin D decreased hepatitis C cell replication and appeared significantly associated with rapid virologic response in anti-viral therapy, according to study results published in Hepatology Research.

“Liver has long been regarded as the key player manipulating complex biochemical metabolism, which is essential to maintenance of homeostasis,” the researchers wrote. “[Vitamin] D, the secosteroid hormone with pleiotropic effects, is an important physiological regulator contributed into various biological, immunological and metabolic functions in liver diseases. These non-skeletal effects are relevant in the pathogenesis of many causes of chronic liver disease.”
Continue Reading @ Healio

Although several mechanisms for the favorable effects of vitamin D3 (VitD3) supplementation were reported, the total effect of VitD3 supplementation remains unclear. Recently, the main treatment of chronic hepatitis C should be direct acting antivirals (DAAs) without pegylated interferon (Peg-IFN). Peg-IFN is a strong immune-modulator. Therefore, an immunological analysis should be carried out to understand the effect of VitD3 after treatment of DAAs without Peg-IFN. The induction of a favorable immune response by adding VitD3 might be able to suppress the hepatocarcinogenesis after achieving SVR, especially in children and elderly patients with severe fibrosis lacking sufficient amounts of VitD3.

2017 - January
Is there an association between vitamin D and liver fibrosis in patients with chronic hepatitis C?
This study aimed to evaluate the association between serum vitamin D levels and the histopathological findings in patients with chronic hepatitis C virus infection.

Vitamin D Status and Virologic Response to HCV Therapy in the HALT-C and VIRAHEP-C Trials
Published: November 10, 2016
http://dx.doi.org/10.1371/journal.pone.0166036
Higher vitamin D status was not beneficially associated with responses to therapy; if anything, patients with higher vitamin D concentrations were less likely to attain SVR. Our data do not support a role for vitamin D supplementation as an adjuvant therapy for HCV

Dr. Joe Galati - Do You Really Need Daily Vitamins?
The simple answer is no, you do not need a daily “one-a-day” vitamin, despite the billion dollar supplement industry...

2013 - Exercise
Previous research indicates HCV patients who participated in a diet and exercise program lowered their grade of steatosis and remarkably their fibrosis score, according to a study published in Nutrition 2013.

5 Things You Should Know About Dietary Supplements for Hepatitis C
National Center for Complementary and Integrative Health (NCCIH)

Hepatitis C is a liver disease caused by a virus. It is usually chronic (long-lasting), but most people do not 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.If you are considering any dietary supplement for hepatitis C, here are some things you should know.
  1.  No dietary supplement has been shown to be effective for hepatitis C or its complications.
      
  2.  The results of research supported by the National Institutes of Health 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.
      
  3.  Research on other dietary supplements for hepatitis C, such as zinc, licorice root (or its extract glycyrrhizin), SAMe, and lactoferrin, is in its early stages, and no firm conclusions can be reached about the potential effectiveness of these supplements.
      
  4.  Colloidal silver is sometimes promoted for treating hepatitis C, but is not safe. Colloidal silver can cause irreversible side effects, including a permanent bluish discoloration of the skin.
      
  5.  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 are receiving for hepatitis C or any other health problem.  
HERBAL GLOSSARY
Healthcare professionals strongly advised not to take megavitamin therapy or to use nutritional products bought in special stores or by catalogue without consulting your doctor. Some dietary supplements can harm your liver. A few that have caused problems are cascara, chaparral, comfrey, kava, and ephedra.

Learn more by reviewing the following Herbal Glossary available at HCV Advocate: This glossary describes various herbs — the safety concerns, interactions with other medications and potential harms to The goal of the herbal glossary is to help people make an informed decision and stay safe. Note: be sure to inform your medical provider if you are taking any herbs or supplements.

Where to find up-to-date, comprehensive clinical information on Drug-induced liver injury (DILI)
LIVERTOX provides up-to-date, accurate, and easily accessed information on the diagnosis, cause, frequency, patterns, and management of liver injury attributable to prescription and nonprescription medications, herbals and dietary supplements.  LIVERTOX also includes a case registry that will enable scientific analysis and better characterization of the clinical patterns of liver injury.

Where to find up-to-date information on drug-drug interactions with velpatasvir/sofosbuvir (Epclusa) and other hepatitis C medications?
HEP Drug Interaction Checker
Currently 170 million people worldwide are infected with the hepatitis C virus (HCV) and >300 million with hepatitis B (HBV). Although interferon-free combination direct acting antivirals (DAAs) regimens have improved tolerability and efficacy for HCV-infected patients, drug-drug interactions (DDIs) have the potential to cause harm due to liver dysfunction, multiple comorbidities and comedications. This web site was established in 2010 by members of the Department of Pharmacology at the University of Liverpool to offer a resource for healthcare providers, researchers and patients to be able to understand and manage drug-drug interactions.

In The News
2017
Herbal/dietary supplements linked to liver injury requiring transplant
Herbal or dietary supplements are the fourth most common cause of drug-induced acute hepatic necrosis requiring liver transplantation in the United States, according to a study of liver transplant registry data.

Oct 2016
Herbal and dietary supplements tied to liver damage
One in five cases of chemical-induced liver damage come from herbal and dietary supplements, a research review concludes

Research Shows Little Benefit for Dietary Supplements, but Industry Continues to Boom
Dietary supplements are a 32 billion dollar a year industry in the U.S. Although numerous studies have found little evidence of benefit, the supplement industry continues to grow. A new study examined the trends in dietary supplement use among U.S. adults from 1999-2013. Researchers found that the proportion of users stayed consistent throughout the study period at just over 50%.

Milk Thistle
2017
Jan 26, 2017
Review - Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years
The aim of this review is to examine scientific studies concerning the effects derived from silymarin/silybin use in chronic liver diseases, cirrhosis and hepatocellular carcinoma.



2016 ​- Silymarin in the treatment of liver diseases: What is the clinical evidence?
Clinical Liver Disease CDL
Volume 7, Issue 1 January 2016 Pages 8–10
Watch a video presentation of this article
Watch the interview with the author

2016 National Institutes of Health
This updated article provides information on dietary supplements studied for hepatitis C.
Hepatitis C and Dietary Supplements
Several dietary and 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 (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis) trial found that 23 percent of the participants were using herbal products. Although participants reported using many different herbal products, silymarin (milk thistle) was by far the most common. However, no dietary supplement has been shown to be efficacious for hepatitis C.

2016
Questions and Answers About Milk Thistle
From The National Cancer Institute
Updated: September 20, 2016
Healthy You
Support healthy liver function by eating a variety of organic vegetables, fruits, seeds, nuts, beans and whole grains. If you have a long-term hepatitis infection (when infection lasts longer than six months) caused by a virus such as hepatitis B or C, you can eat a normal, well-balanced diet. Try to maintain a body weight appropriate for your height and build. Maintaining a healthy weight is important as studies show that obesity can speed up the damage caused by hepatitis C.

Diet For People With Cirrhosis
If your condition has progressed to cirrhosis there are additional considerations you will need to make in your diet to support your liver, learn more here.  For support visit; I Help C - Your Best Friends Guide to Hepatitis C and Cirrhosis

​​Can Eating Certain Foods Improve Liver Health?
The good news is consuming healthy foods will help you maintain a healthy weight, and reduce cholesterol, that alone can help your liver. Right? Listed below are a few foods that may help improve or reduce liver damage caused from viral hepatitis and other liver disease, we begin with my favorite, blueberries.

Blueberries

A 2016 study conducted in mice investigated the effects of the combination of blueberry juice and probiotics on the apoptosis of alcoholic fatty liver disease. After studying two groups of rats, all with liver fibrosis, the scientists concluded that blueberries could reduce liver indices. The researchers showed a significant difference in the rats who ate blueberries compared to the group that did not. The blueberries helped to decrease levels of malondialdehyde in liver homogenates.

The authors of this study suggest that blueberry consumption may be beneficial for hepatic diseases (including fibrosis). Here is the full text article; ​The combination of blueberry juice and probiotics reduces apoptosis of alcoholic fatty liver of mice by affecting SIRT1 pathway

Mandarin oranges may reduce risk of liver cancer, other diseases
During a meeting of the American Chemical Society "Functional Foods and Health," held in 2006 a pair of studies from Japan suggests that eating mandarin oranges may cut your risk of developing liver cancer as well as other diseases, including atherosclerosis and insulin resistance. In one study, researchers at Kyoto Prefectural University of Medicine found that drinking mandarin orange juice may reduce the risk of developing liver cancer in patients with chronic viral hepatitis. After a one-year study period, no liver cancer was detected among a group of 30 patients with viral hepatitis who were given one cup daily of a specially prepared beverage containing mandarin orange juice, whereas an 8.9 percent rate of liver cancer was found among a group of 45 patients who did not drink the juice supplements, according to Hoyoku Nishino, M.D., Ph.D., a researcher at the university

In an epidemiological study by scientists at the National Institute of Fruit Tree Science in Japan, scientists surveyed 1,073 people in a Japanese town noted for its high consumption of mandarin oranges. The researchers found certain chemical markers in the subjects' blood that are associated with a lower risk of several health problems, including liver disease, atherosclerosis (hardening of the arteries) and insulin resistance (a condition associated with diabetes), according to study leader Minoru Sugiura, Ph.D, here is the article

2016 - National Meeting & Exposition of the American Chemical Society (ACS)

Citrus fruits could help prevent obesity-related heart disease, liver disease, diabetes
​The study was presented in 2016 at 252nd National Meeting & Exposition of the American Chemical Society (ACS). The team, at Universidade Estadual Paulista (UNESP) in Brazil, conducted an experiment with 50 mice, treating them with flavanones found in oranges, limes and lemons. The flavanones they focused on were hesperidin, eriocitrin and eriodictyol. For one month, researchers gave groups either a standard diet, a high-fat diet, a high-fat diet plus hesperidin, a high-fat diet plus eriocitrin or a high-fat diet plus eriodictyol.

​The high-fat diet without the flavanones increased the levels of cell-damage markers called thiobarbituric acid reactive substances (TBARS) by 80 percent in the blood and 57 percent in the liver compared to mice on a standard diet. But hesperidin, eriocitrin and eriodictyol decreased the TBARS levels in the liver by 50 percent, 57 percent and 64 percent, respectively, compared with mice fed a high-fat diet but not given flavanones. Eriocitrin and eriodictyol also reduced TBARS levels in the blood by 48 percent and 47 percent, respectively, in these mice. In addition, mice treated with hesperidin and eriodictyol had reduced fat accumulation and damage in the liver.

"Our studies did not show any weight loss due to the citrus flavanones," says Thais B. Cesar, Ph.D., who leads the team. "However, even without helping the mice lose weight, they made them healthier with lower oxidative stress, less liver damage, lower blood lipids and lower blood glucose."
Read more, here.

Avocados
The avocado contains nutrients that aid in liver functioning and enhance overall liver health.  During the 2000 International Chemical Congress of Pacific Basin Societies  researchers in Japan reported that avocados contain potent chemicals that may reduce liver damage; ​Avocados Contain Potent Liver Protectants.

2016
Review an array of research that suggest avocados support weight management, healthy aging and helps support cardiovascular health at Medical News Today.​

Can curcumin slow liver disease?
Curcumin is in turmeric spice, a common curry ingredient

“Curry favor for your liver,” is the headline in the Daily Mirror. The newspaper said that mice fed curcumin (the chemical in turmeric that gives curry a yellow color) had less liver damage over time than those on a normal diet.
The researchers in this animal study investigated how an extract of the spice protected mice that had been bred to have inflammation in their bile ducts from liver damage.
The results suggest that liver damage, jaundice and scarring were all reduced by the curcumin and that the underlying cellular pathways affected might, in time, become promising targets for new drug development. However, there is no suggestion from this study that eating turmeric will have the same effect or be a useful treatment for humans., read the 2010 article here.

Jan 11, 2017
Deceptive curcumin offers cautionary tale for chemists
Inside the golden-yellow spice turmeric lurks a chemical deceiver: curcumin, a molecule that is widely touted as having medicinal activity, but which also gives false signals in drug screening tests. For years, chemists have urged caution about curcumin and other compounds that can mislead naive drug hunters.

Now, in an attempt to stem a continuing flow of muddled research, scientists have published the most comprehensive critical review yet of curcumin — concluding that there’s no evidence it has any specific therapeutic benefits, despite thousands of research papers and more than 120 clinical trials. The scientists hope that their report will prevent further wasted research and alert the unwary to the possibility that chemicals may often show up as ‘hits’ in drug screens, but be unlikely to yield a drug.
Continue reading.....

Coffee Is Good For The Liver

Patient Friendly Review
The evidence is in - drinking coffee is clearly beneficial for the liver, to learn more read this special report (published June 2016) by The British Liver Trust.

March 14, 2017
Previous studies have shown coffee consumption may significantly reduce the risk of hepatic fibrosis and cirrhosis and drinking more than 3 cups per day may modestly reduced risk to liver cancer.
In the March 2017 issue of Clinical Gastroenterology and Hepatology, researchers examined the relationship between coffee consumption and chronic hepatitis C, non-alcoholic fatty liver disease, and alcoholic liver disease.

Coffee is now good for us—or is it?
Two Part Podcast
Listen to this podcast over at ABC Radio on the many health benefits of drinking coffee, hosted by Dr. Kruszelnicki.
Part One - Listen here
July 12 2016
Yes, it is a drug and so we should remember the words of Paracelsus, 'all drugs are poisons, what matters is the dose.' Based on the fact that coffee has been used widely for over a millennium, we would expect its bad side-effects would be fairly minimal—so long as we don't take too much.
Read the transcript

Part Two - Listen here
July 19,2016
Coffee can play a role in reducing risks of cancer and diabetes?
It seems that beside caffeine, there are other natural chemicals in coffee that can help with medical conditions. With regard to liver cancer, two chemicals, kahweol and cafestrol, have direct cancer protection and anti-inflammatory properties. They seem to 'upregulate biochemical pathways in the liver that protect the body from toxins, including aflatoxin and other carcinogenic compounds'.
Read the transcript

Coffee and Heart Disease
Drink for your heart: Caffeine may counter age-related inflammation, cardiovascular disease
There’s a clear connection between chronological age, chronic inflammation, cardiovascular disease and… coffee consumption. More than 90 percent of all noncommunicable diseases of aging are associated with chronic inflammation. And more than 1,000 papers have provided evidence that chronic inflammation contributes to many cancers, Alzheimer’s disease and other dementias, cardiovascular disease, osteoarthritis and even depression. It’s also well known — well, at least among the scientists who study this kind of thing — that caffeine intake is associated with longevity. Now, Stanford immunologists David Furman, PhD, and Mark Davis, PhD, and their colleagues have revealed a likely reason why this may be so. In a study published in Nature Medicine, the researchers conducted extensive analyses of blood samples, survey data and medical and family histories obtained from more than 100...

Liver Health
Although drinking coffee provides potential health benefits for people living with liver disease, abstaining from alcohol, eating a well balanced diet and avoiding herbs known to be toxic to the liver remain key factors to protect against developing liver disease, and help those who already have some degree of liver damage.

The British Liver Trust
If you have a liver condition, there are some special considerations you may need to make in your diet to stay nutritionally well and to help to manage your condition. Some of these are specific to certain liver diseases, others relate to how advanced your liver disease is. In the following publications we cover how your liver is affected by the food you eat; elements of a well-balanced diet suitable for most people; disease specific dietary considerations and special or therapeutic nutritional diets for those with more advanced liver disease.

A Well-Balanced Diet
Keeping a Healthy Weight
Dietary Advice For Specific Liver Conditions
Cirrhosis and Advanced Liver Disease
Coping With Eating Difficulties
Looking After Yourself
Complementary & Alternative Medicines (CAM)
Your Dietary Needs

Related link - Foods that are Good for Your Liver written by Jenelle Marie Davis online at HepatitisC.Net.

What's Bad For The Liver?
The American Liver Foundation warns; ​Eating raw or undercooked shellfish such as oysters and clams are a definite no-no.​

Alcohol And HCV​
alcohol use is a well known risk factor for progression to advanced forms of liver disease; cirrhosis and liver cancer among people with HCV. A recent study claims that; many people living with hepatitis C report either former or current excessive alcohol use. In addition, hepatitis C-infected adults were three times more likely to drink five or more drinks per day every day at some point in their lives than those without hepatitis C, the article was published in the American Journal of Preventive Medicine. Read a summary of the article, here.

Alcohol use disorder and its impact on chronic hepatitis C virus and human immunodeficiency virus infections
The present review published in World J Hepatol. Nov 8, 2016; 8(31): 1295-1308 is focused on alcohol use disorder and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, as well as HCV/HIV co-infection.

Of Interest
Published 8 March 2017
Perceived health and alcohol use in individuals with HIV and Hepatitis C who use drugs

Acetaminophen
Acetaminophen is a very safe drug when taken as directed, even for people with liver disease. Nevertheless, every drug carries risks. Liver damage from acetaminophen, which can be severe, can result either from an overdose or from regular doses that are taken while drinking alcohol.

January 2017
It’s Flu Season: When You Have Hepatitis B, Too Much Tylenol Can Damage Your Liver
November 30, 2016
Download Full Text Article @ AACN Advanced Critical Care
About 46 percent of persons with acute liver failure in the United States have liver damage associated with acetaminophen, making it the most common cause of DILI. Since acetaminophen is often an ingredient in over-the-counter and prescription pain medications, patients may take higher doses than needed.

Liver disease and acetaminophen: can you take it safely?
June 2016
Doctors often tell patients with liver disease that they shouldn't use acetaminophen, a common over-the-counter pain reliever found in Tylenol and many other cold and flu medications. Acetaminophen is broken down by the liver and can form byproducts that are toxic to the liver, so this warning is not completely without merit. But take it from a hepatologist, acetaminophen is the best option for pain relief for people with liver disease.

Acetaminophen is a “dose-dependent hepatotoxin,” which means that its toxic effects on the liver are related to the amount taken. If anyone takes too much, even those with healthy livers, it will reliably cause an acute injury to the liver. In fact, acetaminophen is the most common cause of acute liver failure in the United States, accounting for almost half of all cases.

The good news is that liver injury can be avoided by limiting the amount of acetaminophen taken each day to 3,000 mg for most people and 2,000 mg for those with chronic liver disease. Staying within these limits will generally prevent liver injury. But the toxic byproducts can accumulate, so it’s best not to take acetaminophen every day.
Continue reading....

Why acetaminophen is the 'most common cause of liver injury' in Canada
Sep 16, 2016
Health Canada's new labelling rules for acetaminophen are not strict enough, and the extra-strength products should be removed from store shelves, some doctors say. Acetaminophen is one of the most widely used pain and fever relievers in Canada and worldwide. It is safe if used properly, but too much can be dangerous, particularly over time.
"It is the most common cause of liver injury. Period. Full stop," said  Dr. Michael Rieder, a pediatric clinical pharmacologist at Western University in London, Ont.

Acetaminophen-induced acute liver injury, acute liver failure occurs more in women
May 23, 2016
​SAN DIEGO —  Despite increased rates of acetaminophen-induced acute liver injury and acute liver failure than male counterparts, women did not experience poorer survival outcomes related to these conditions, according to findings presented at Digestive Disease Week 2016.

2016
Research Articles
Role of Nutrition in the Progression and Treatment of Hepatitis C Virus - Related Chronic Liver Disease: A Review
The aim of this review is to provide an overview of existing evidence regarding nutrient intake and its impact HCV patients, and to present some proposed mechanisms of action of some nutrients on HCV replication and infection

Evidence-Based Complementary and Alternative Medicine Volume 2016 (2016), Article ID 4750163, 26 pages http://dx.doi.org/10.1155/2016/4750163
Preclinical Models for Investigation of Herbal Medicines in Liver Diseases: Update and Perspective
In this review, we aim to systematically review the most commonly used animal models that were employed to screen and study the efficacy of herbal medicines for liver diseases. This may serve as a guiding tool for selecting the appropriate liver disease model for herbal medicine screening as well as facilitating further exploration of studied herbal remedies for clinical applications.

Of Interest
Effect of Quercetin on Hepatitis C Virus Life Cycle: From Viral to Host Targets
Several flavonoids such as naringenin and catechin have shown antiviral properties against HCV17. Quercetin, a flavonoid present in many components of human diet18, has also been reported to have anti-HCV properties by several mechanisms: it has been found to decrease internal ribosomal entry site (IRES) activity19, and to inhibit HCV replication20 and NS5A-driven IRES-mediated translation of the viral genome21,22,23. Quercetin plays a protective role in diseases such as cancer, coronary heart disease and atherosclerosis because it modulates lipid profile and antioxidant status24. Moreover, quercetin modifies eicosanoid biosynthesis, protects LDL from oxidation, prevents platelet aggregation, and promotes relaxation of cardiovascular smooth muscle25. Finally, quercetin has been found to inhibit DGAT activity26,27, an enzyme involved in the assembly step of the HCV life cycle12. The main limitation for use of flavonoids in general and quercetin in particular has been low bioavailability requiring orally high doses. Thus, quercetin is widely available, cheap, and has previously demonstrated antiviral activity against HCV. In a phase I dose escalation study, quercetin demonstrated high safety (up to 5 g per day) and antiviral efficacy in hepatitis C patients28. The main aims of this study were to further elucidate at which steps of the virus life cycle and by which mechanisms quercetin exerts anti-HCV activity.

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