When we get sick, we want to get well quickly. Some of us turn to our doctors first, while others may try home remedies or alternative medicine. Many of us do both.
Natural medicine means that no chemicals, drugs or surgeries are used to help you get well. Alternative medicine is simply an alternative to conventional medicine. For instance, in the U.S., ancient healing practices, such as faith healing, Chinese medicine or seeing a curandero (Spanish for healer) are alternatives. So are naturopathy, homeopathy, and herbal medicine. Integrative medicine uses both. It’s common for people to use more than one healing method.
In the U.S., we have access to many alternatives, and we tend to apply Western medical concepts to natural medicine. This is most evident in our use of supplements. When diagnosed with hepatitis B, we may want to “take something” that will help the liver, such as a supplement or herb. It’s easier to take something than it is to exercise and eat right. However, everything passes through the liver, and just because herbs and supplements are natural, they aren’t necessarily safe.
Despite claims on the Internet, no natural remedy has been proven to cure hepatitis B. There may be remedies that improve symptoms associated with hep B, but none has permanently eradicated the virus. There isn’t a large body of research on natural remedies and hepatitis B; much of what we know is anecdotal, meaning that people tell others about their experiences.
If you are interested in herbs and other dietary supplements, don’t forget to assess your overall health. If you smoke, drink alcohol or have other potentially unhealthy habits, do not expect herbs to offset the potential damage these habits can cause. Adopting healthy habits will provide far more benefits than supplements can.
If you have hepatitis B or another liver disease, here’s important information about supplements:
- If you have decompensated cirrhosis, never take supplements unless recommended by your doctor.
- If you are on medications to manage your hepatitis B, do not take herbs or supplements unless your doctor recommends it.
- Some supplements prolong bleeding times or interfere with anesthetics. Stop all supplement use at least a week prior to any surgery or procedure that uses anesthesia. Tell your medical team and anesthesiologist about any herbs you are using, particularly if the procedure occurs before you have sufficient time to observe this “wash-out” period.
- Report any suspected adverse reactions to an herb or supplement to the FDA’s monitoring program, Medwatch.
If you are interested in supplements, here are tips for safer use:
- Talk to your doctor before using supplements.
- Apply the same commonsense approach and standards to herbs as you would to any drug; ask the same questions about supplements that you would a medicine.
- Before you take an herb or supplement, find out if it is compatible with other drugs or supplements you are taking and not contraindicated for any other condition you may have.
- Be skeptical. Claims made by the product manufacturer or seller may differ from independent research.
- More is not better; do not exceed the recommended dose.
- Supplements may be contaminated, so know your source. In rare cases, people have suffered liver damage as a consequence of taking contaminated substances.
- Choose supplements that are standardized. Buy products that submit to voluntary self-regulation.
- Do not rely on health store staff for medical information. Although they may be helpful, remember that salespeople are usually not licensed to practice medicine.
- Do not be swayed by personal testimonies. Let medical advice and evidence guide your decision to use supplements.
- Do not be influenced by the latest supplement to make headlines. Supplements are like cars; when new models are introduced, sometimes it takes time before problems develop. A product that has value will stand up to the test of time.
Of all the natural remedies used for hep B, milk thistle is the most popular, and the most tested. This herb is a common ingredient in supplement blends that promote liver health. Milk thistle (Silybum marianum) is a plant from the aster family. Silymarin is the active ingredient in milk thistle that is likely responsible for its medicinal qualities. Silymarin is actually a group of flavanoids, with silybin (aka silibinin) being the most powerful. Typically, milk thistle is sold in standardized amounts of 70 to 80 percent silymarin.
Here is a little of what is known about milk thistle:
- Talk to your medical provider before taking milk thistle.
- There is no clear evidence that milk thistle cures HBV infection. Much of the research is unreliable due to poor scientific method, so it’s difficult to sort out the facts. There are no high-quality randomized clinical trials on milk thistle versus placebo.
- All milk thistle is not alike, and what is in the bottle may not match what is promised on the label. It is very difficult to find milk thistle in the U.S. that provides the standardized amount of silymarin that is claimed on the label. Much of what is sold is substandard milk thistle extract, often purchased from Chinese suppliers. Unfortunately, since herbs are not strictly regulated by the FDA, it is virtually impossible to know what is safe and effective.
- Milk thistle is poorly absorbed. After digestion, very little is left for the liver. This is particularly true for older adults. As little as 10 percent of silymarin may be absorbed in the adult over age 60. A couple of small studies suggest that silybin-phosphatidylcholine complexed as a phytosome may be more bioavailable, but it is difficult to find in the U.S.
- Some experts say that milk thistle may interact with other drugs. One strategy is to take milk thistle alone rather than in combination with other drugs, particularly oral contraceptives and coumadin.
- Milk thistle is usually well tolerated and has not been shown to harm the liver, except in people who have hemochromatosis. Those with a history of hormone-related cancers, including breast and uterine cancer and prostate cancer, may need to avoid milk thistle. Milk thistle should not be used by pregnant or breastfeeding women.
The following herbs may be harmful to the liver, so before taking these or any herbs or dietary supplements, talk to your health care provider:
- Atractylis gummifera
- Bush tea
- Callilepsis laureola
- Chapparal leaf (creosote bush, greasewood)
- Comfrey (Symphytum officinale)
- Gordolobo herbal tea
- Kava (Piper methysticum)
- Kombucha mushroom (tea)
- Ma-Huang (Ephedra sinica)
- Margosa oil
- Mate (Paraguay) tea
- Nutmeg (if taken in large doses)
- Pennyroyal (squawmint oil)
- Tansy Ragwort (variation of Ragwort)
- Senecio aureus
- Valerian Root
Last Reviewed: March 4, 2019