for Veterans and the Public
Alternative and Complementary Therapies: Entire Lesson
Many people use alternative (also known as complementary) health treatments to go along with the medical care they get from their doctor.
These therapies are called "complementary" because usually they are used alongside the more standard medical care you receive (such as your VA doctor visits and the hepatitis C antiviral drugs like interferon).
They are sometimes called "alternative" because they don't fit into the more mainstream, Western ways of looking at medicine and health care. These therapies may not fit in with what you usually think of as "health care."
Some common complementary therapies include:
- Physical (body) therapies, such as yoga and massage
- Relaxation techniques, such as meditation and visualization
- Herbal medicine (from plants)
With most complementary therapies, your health is looked at from a holistic (or "whole picture") point of view. Think of your body as working as one big system. From a holistic viewpoint, everything you do--from what you eat and drink to how stressed you are--affects your health and well-being.
Are they safe?
Generally, physical and relaxation therapies are safe. However, some complementary medicines ("mega" vitamins, herbs, and other supplements) can be dangerous for people who have liver disease. Always talk to your VA health care provider before you take any herb, supplement, or megavitamin, even if you think it is safe.
- There is no complementary treatment that has yet been proven safe and effective for treating or curing hepatitis C.
- There are no herbal treatments which have been proven to reduce the hepatitis C viral load.
- Just because something is "natural" (an herb, for example) doesn't mean that it is safe to take. Sometimes these products can hurt your liver instead of help it, or they might interfere with the medicines you are taking for hepatitis C.
- Certain herbs, supplements, and "mega" vitamins can be very dangerous for people with hepatitis C. Your liver plays an important role in breaking down these substances after you take them into your body. If your liver is sick, many herbs, supplements, and megavitamins can hurt it even more.
- Be careful of treatments that claim to be "miracle cures"--ones that claim to cure hepatitis C. Certain people may try to trick you into buying an expensive product that doesn't work.
- Complementary therapies are not substitutes for the treatment and medications you receive from your VA doctor. You shouldn't stop taking your hepatitis C drugs just because you've started another therapy.
- Many herbs and supplements and complementary therapies come from different parts of the world and thus, there are often differences in the regulation and labeling of these products. This might mean that two herbal products may have very different ingredients and quality.
Do they work?
There is not enough research to tell if these treatments really help people with hepatitis C.
Many people who use alternative treatments report positive results, that they feel better or that their liver test results get better. We don't know if those changes are due to their use of alternative treatments or not until better research has been done.
Healthy people use complementary therapies to try to make their immune systems stronger and to make them feel better in general.
People who have diseases or illnesses, such as hepatitis C, use these therapies for the same reasons. They also can use these therapies to help deal with symptoms of the disease or side effects from the medicines that treat the disease.
Avoid any therapy that promises to cure hepatitis C. The only treatments which have been shown to rid patients of the hepatitis C virus are pegylated interferon, ribavirin, and, for certain patients, boceprevir and telaprevir. (Read more on hepatitis C medications.)
Avoid any treatment that promises to cure your hepatitis C. If you are interested in learning whether an alternative treatment is safe enough and worth your paying money for and trying, discuss it directly with your provider.
The federal government is funding studies on how well some alternative therapies work to treat disease, so keep your eyes open for news about these studies.
Physical (body) therapies
Physical, or body, therapies include such activities as yoga, massage, and aromatherapy. These types of therapies focus on using a person's body and senses to promote healing and well-being. Here you can learn about examples of these types of therapies.
Yoga is a set of exercises that people use to improve their fitness, reduce stress, and increase flexibility.
Yoga can involve breathing exercises, certain stretches and positions, and meditation. (See the Meditation section for more information on what this is.) Many people, including people with hepatitis C, use yoga to reduce stress and to become more relaxed and calm. Some people think that yoga helps make them healthier in general, because it can make a person's body stronger.
Some kinds of yoga are gentle enough for people with hepatitis C and other illnesses. If you would like to try yoga, talk to your VA health care provider. Also, if you do try it, be sure to tell your yoga teacher that you have a liver disease. While most yoga is safe, some exercises may be dangerous if your liver is swollen.
Before you begin any kind of exercise program, always talk with your doctor.
Many people believe that massage therapy is an excellent way to deal with the stress and side effects that go along with having an illness, including hepatitis C. During massage therapy, a trained therapist moves and rubs your body tissues (particularly your muscles). There are many kinds of massage therapy.
You can try massage therapy for reducing muscle and back pain, headaches, and soreness. Massages also can improve your blood flow (your circulation) and reduce tension. Some people think that massages might even make your immune system stronger.
If you are interested in learning more about massage, you should ask your VA doctor for information. Your doctor also may have a list of trained massage therapists.
Aromatherapy is based on the idea that certain smells can change the way you feel. The smells used in aromatherapy come from plant oils, and they can be inhaled (breathed in) or used in baths or massages.
People use aromatherapy to help them deal with stress or to help with fatigue. For example, some people report that lavender oil calms them down and helps them sleep better.
You can also ask friends or family if they've tried aromatherapy or know someone who has.
Please remember! The oils used in aromatherapy can be very strong and even harmful. Always talk with an expert before buying and using these oils yourself.
Energy healing is based on the concept that the human body is surrounded by various kinds of energy fields--electrical, magnetic, and subtle. In this healing-based tradition, practitioners are consciously aware of their client's imbalances of energy, and claim they can alter it to improve the overall sense of well being for their clients. The concept that unseen energy flows through and around all living things is a belief that comes from many cultures since ancient times.
Conventional medicine concerns itself with health on a very physical and cellular level. Viewing the body as having other dimensions requires a shift in thought. The concept of subtle energy fields continues to have slow acceptance into our traditional, Western medical approach.
Therapeutic touch is a type of energy healing where the Therapeutic Touch (TT) practitioner "smooths out" the energy field of a client without touching them. The practitioner's hands are a few inches or more away from the physical body. The goal of TT is to help stimulate the recipient's innate healing processes. These are theories, and are not scientifically proven. Case reports indicate that TT is effective in stimulating the relaxation response. TT can be used with other interventions such as guided imagery and visualization.
Reiki is another type of energy healing. The Reiki practitioner's hands are either lightly touching the patient's body or are held slightly over it. Energy is thought to flow through areas most in need of healing. In Reiki, the energy is thought to come from the Universe, and the practitioner helps to transfer this positive, healing energy to the recipient. The concept is bizarre to some, but people who receive Reiki often have positive experiences.
Practitioners claim Reiki can aid in healing at a physical, emotional and mental level. Most recipients of Reiki report a peaceful sense of relaxation, and some people have reported reduction in pain, anxiety, fear and anger. There is no scientific evidence to confirm the effectiveness of Reiki.
The federal National Institutes of Health is funding research on energy healing therapies.
Relaxation therapies, such as meditation and visualization, focus on how a person's mind and imagination can promote overall health and well-being. In this section, you can read about some examples of how you can use relaxation therapies to reduce stress and relax.
Meditation is a certain way of concentrating that allows your mind and body to become very relaxed. Meditation helps people to focus and be quiet.
There are many different forms of meditation. Most involve deep breathing and paying attention to your body and mind.
Sometimes people sit still and close their eyes to meditate. Meditation also can be casual. For instance, you can meditate when you are taking a walk or watching a sunrise.
People with hepatitis C can use meditation to relax. It can help them deal with the stress that comes with any illness. Meditation can help you to calm down and focus if you are feeling overwhelmed.
If you are interested in learning more about meditation, you should ask your VA health care provider for more information. There may be meditation classes you can take.
Visualization is another method people use to feel more relaxed and less anxious. People who use visualization imagine that they are in a safe, relaxing place (such as the beach). Most of us use visualization without realizing it--for example, when we daydream or remember a fun, happy time in our lives.
Focusing on a safe, comfortable place can help you to feel less stress, and sometimes it can lessen the symptoms of hepatitis C or side effects from the medicines you are taking.
You can ask your VA doctor where you can learn more about visualization. There are classes you can take, and there are self-help tapes that you can listen to that lead you through the process.
Herbal medicines are substances that come from plants. They can be taken from all parts of a plant, including the roots, leaves, berries, and flowers. The small amounts of herbs used in cooking do not pose a threat. It's the larger amounts sold as medicines that can be risky.
One of the main problems with herbal medicines is that, unlike medications dispensed from licensed pharmacies in the United States, the amount of medication in a pill or other quantity of the medicine is not regulated. So one preparation can vary in potency by five-, ten-, one hundred-, or one thousand-fold, and the person taking the medicine doesn't know what that factor is. Other things also can be in the preparation that a person doesn't know about. Steroids and other medicines,which can have powerful effects, can be added to herbal preparations. Again, a person doesn't know this when they take the herbal product. This is why Western medical doctors tell their patients to be careful with herbal medications--no one knows what the patient is really getting.
People with hepatitis C sometimes take these medicines to help deal with side effects and symptoms, or because they did not get a response from their hepatitis C medications. Others take them while they are on interferon treatment in order to boost the effects of interferon.
Here is a summary of the research on some of the more popular herbs used for hepatitis C, as reported by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.
Milk thistle, sold as capsules and tablets, belongs to the same family of plants as ragweed, chrysanthemum, marigold, and daisy. It contains a substance called silymarin, found in the fruit, which is believed to be responsible for any medicinal properties.
So far scientific studies have found no clear-cut evidence that milk thistle helps in treating hepatitis C. Some studies found a benefit, other studies didn't. Currently, the National Center for Complementary and Alternative Medicine is sponsoring a clinical trial to look at possible benefits of milk thistle in people with hepatitis C. Until these study results are published, we won't know whether milk thistle offers benefits that we can measure.
Milk thistle is generally considered safe to use, but it can have a laxative effect and cause nausea, diarrhea, and bloating in the abdomen. People who are allergic to plants in the same family as milk thistle, such as ragweed, may experience allergic symptoms to milk thistle as well.
Licorice root, sold as capsules and liquid extracts, comes from the licorice plant. Its active component is called glycyrrhizin.
Glycyrrhizin shows potential for reducing long-term complications from hepatitis C. For example, some evidence suggests that long-term use of glycyrrhizin might prevent liver cancer in patients with hepatitis C. The several clinical trials found that taking glycyrrhizin reduced the levels of liver enzymes, such as ALT, but did not reduce the amount of hepatitis C virus in the blood. These studies, however, gave glycyrrhizin in intravenous (IV) form, not as dietary supplements.
People with hepatitis C should not take licorice without first talking to their doctors. The herb can interact with certain medications. And taking licorice over a long period of time can cause serious side effects, including high blood pressure, headache and sluggishness. Glycyrrhizin can worsen ascites, the buildup of fluid in the abdomen, a condition sometimes caused by cirrhosis.
There are two types of ginseng: American ginseng and Asian ginseng. (A product called Siberian ginseng is not really ginseng.) Ginseng is usually sold as capsules.
Studies on animals and human tissue in the laboratory show some benefits of ginseng on the liver, but ginseng hasn't been studied in people with hepatitis C. So it's not possible to know whether it is worth taking. As for its safety, ginseng has been known to cause insomnia, headache, nosebleed, nervousness, and vomiting.
Dandelion was taken in the past to treat conditions including arthritis, certain cancers, gout, diabetes, and "liver problems." From a modern perspective, some dandelion preparations seem to have weak diuretic and laxative properties.
Dandelion also can have side effects such as causing an upset stomach, lowering blood sugar, and causing skin rash. So patients with a history of stomach problems, stomach ulcers, diabetes, or rashes to plants, especially plants in the daisy family, should probably not take dandelion.
Dandelion is known to have medicinal properties, but it does not have any known effect on hepatitis C specifically.
Echinacea is a wildflower that is reputed to stimulate the immune system. It remains a popular herbal preparation, and has been studied extensively for treatment of "the common cold," although it may or may not have an effect on it. Monitored, medicinal preparations of echinacea have been used by doctors in Europe to treat certain cancers and infections.
Echinacea has been studied for certain cancers and chronic infectious conditions like AIDS. It is not clear whether it is helpful or harmful for these conditions, and the same probably applies to hepatitis C, where it has not been studied extensively.
Taking echinacea can cause problems in some cases. The herb can interfere with common medications, such as those to treat allergies, high cholesterol, fungal infections, and certain cancers. It also may interfere with birth control pills, or immunosuppressant medications used after organ transplants. It should be used only with significant caution in these settings. It should not be used by anyone with an autoimmune disease, such as Crohn's disease, multiple sclerosis, or lupus.
The thymus is a gland that is involved in the regulation of the body's immune response. Thymus extract supplements are made from the thymus glands of cows or calves and are sold as capsules and tablets. Although thymus extract products often carry claims of boosting the immune system to fight diseases such as hepatitis C, few studies have been performed, and there is little evidence to show that they work.
Taking thymus extract does not seem to carry many risks. Because the extracts come from animals, however, there is the possibility of contamination from diseased animal parts. For this reason, people with suppressed immune systems, such as people with HIV/AIDS or those who have had organ transplants, should be careful taking these products.
Herbs to avoid
The following herbs may be toxic (harmful) to your liver and should be avoided:
- 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
- Pennyroyal (squawmint oil)
- Tansy Ragwort (variation of Ragwort)
- Senecio aureus
- Valerian root
Cautions about herbs
- The federal government does not require that herbal remedies and dietary supplements be tested in the same way that standard medicines are tested before they are sold. Many of the treatments out there have not been studied as much as the hepatitis C drugs you are taking. It is always a risk to take something or try something that hasn't been fully studied or researched.
- Remember that just because something is "natural" doesn't mean that it is safe to take. Sometimes herbal products can hurt your liver instead of help it, and they can interact with the hepatitis C drugs you may be taking.
- Finally, remember that herbal medicines come with their own set of side effects, so be sure you know what to expect.
To learn more about herbs, see the links in Resources.
- National Center for Complementary and Alternative Medicine (NCCAM)
The NCCAM is one of the 27 institutes and centers that make up the National Institutes of Health (NIH). This Web site includes information on specific diseases, treatments, and herbal therapies.
- Includes a section on Hepatitis C and Herbal Supplements
- Includes a reference on Things To Know About Evaluating Medical Resources on the Web
- Includes a section on Hepatitis C and Herbal Supplements
- About Aromatherapy from the National Association for Holistic Aromatherapy
Provides basic information on aromatherapy, essential oils, and safety precautions.
DrugDigest offers a library of common herbs and supplements including their uses, cautions, and side effects. It is provided by Express Scripts, Inc. (ESI), an independent pharmacy benefit manager.
HerbMed is an interactive, electronic database that contains scientific information about the use of herbs for health. It is provided by the nonprofit Alternative Medicine Foundation, Inc.
- Hepatitis Neighborhood: Herbs to Avoid
Includes information on herbs known to cause health problems, including liver disease. (Free registration required)
- Stress Management from Mind Tools
A guide to stress management, with information on yoga, visualization, meditation, and more.
- Yoga Site's Frequently Asked Questions about Yoga
Information on the yoga basics.