Liver cirrhosis is a life-threatening condition that requires close supervision by a qualified physician. Because the liver metabolizes many nutrients and drugs, it is important that liver patients not add any substances to their regimen without cooperation and close monitoring by a qualified physician. The goal of therapy is threefold
Eliminate the toxins or conditions that cause liver damage. Among patients with alcoholic liver disease, this means the total elimination of alcohol. Cirrhotic patients should also limit exposure to environmental toxins, decrease consumption of omega-6 fatty acids (corn oil especially), and use monounsaturated fats such as olive oil instead.
Provide the liver with appropriate nutritional and pharmaceutical support so that it may heal itself.
Maintain health sufficient to undergo liver transplantation should other measures fail.
The following supplements have been shown to boost liver health and help manage cirrhosis:
PPC—2 to 4 900-milligram (mg) capsules daily. Each capsule contains phosphatidylcholine 900 mg.
BCAAs:—L-leucine 1200 mg, L-isoleucine 600 mg, and L-valine 600 mg
EPA/docosahexaenoic acid (DHA—fish oil supplement supplying EPA 700 mg and DHA 500 mg, and ideally providing 100 mg of Polyphen-Oil™ Olive Fruit Extract 265 mg along with sesame seed (Sesamum indicum) lignans.
PGX fiber—2 capsules with every meal or snack that includes nonfruit carbohydrates. Two capsules contain 1000 mg proprietary blend of Konjac root extract, sodium alginate, xanthan gum, mulberry powdered extract (leaf) 50 mg
An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include
Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Take fiber supplements with a full 8-ounce glass of water.
Drink eight 8-ounce glasses of water daily while taking fiber.
Consult your doctor before taking milk thistle with tranquilizers such as Haldol, Serentil, Stelazine, and Thorazine. Milk thistle combats the effect of tranquilizers.
Do not combine milk thistle with the blood pressure medication Regitine. Milk thistle combats the effect of Regitine.
Niacin (nicotinic acid)
Do not take high doses of nicotinic acid (1.5 to 5 grams daily or more) if you have liver dysfunction, an unexplained elevation in your serum aminotransferase (transaminase) level, active peptic ulcer disease, arterial bleeding, or if you consume large amounts of alcohol.
Consult your doctor before taking high doses of nicotinic acid if you have a history of jaundice, peptic ulcer disease, gastritis, disease of the liver or bile ducts, gout, kidney dysfunction, or cardiovascular disease (especially acute myocardial infarction or unstable angina).
Consult your doctor before taking high doses of nicotinic acid if you have diabetes. High doses of nicotinic acid can negatively affect glucose tolerance. Monitor your serum glucose level frequently if you take nicotinic acid and have diabetes.
Have your doctor monitor your serum aminotransferase level if you take high-doses of nicotinic acid.
Nicotinic acid may cause flushing, principally of the face, neck, and chest. This flushing is thought to be prostaglandin-prostacyclin mediated. Histamine may also play a role in the flushing.
Nicotinic acid can cause dizziness, palpitations, rapid heartbeat, shortness of breath, sweating, chills, insomnia, nausea, vomiting, abdominal pain, and muscle pain.
High doses of nicotinic acid can cause blurred vision, macular edema, toxic amblyopia, and cystic maculopathy.
PABA (Para-aminobenzoic Acid)
Do not take PABA if you are taking sulfonamides or have a kidney disease.
PABA can cause anorexia, nausea, vomiting, fever, and rash.
Phosphatidylcholine can cause increased salivation, a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea.
Consult your doctor before taking SAMe if you have bipolar disorder. See your doctor frequently if you take SAMe and you have bipolar disorder.
Consult your doctor before taking SAMe if you take antidepressants. See your doctor frequently if you take SAMe in place of or in addition to antidepressants.
Consult your doctor before taking SAMe if you have cancer. Nucleic acid methylation patterns may change in people who have cancer and take SAMe.
Do not take SAMe if you are undergoing gene therapy.
SAMe can cause anxiety, hyperactive muscle movement, insomnia, hypomania, and gastrointestinal symptoms such as nausea and diarrhea.
Vitamin B1 (Thiamin)
Consult your doctor before taking vitamin B1 for a thiamin deficiency, lactic acidosis secondary to thiamin deficiency, Wernicke-Korsakoff syndrome, Wernicke's encephalopathy, or Korsakoff's psychosis.
Vitamin B2 (riboflavin)
High doses of vitamin B2 (riboflavin) may interfere with the Abbott TDx drugs-of-abuse assay.
Riboflavin absorption is increased in hypothyroidism and decreased in hyperthyroidism.
If you are taking nucleoside reverse-transcriptase inhibitors, even a mild riboflavin deficiency can increase your risk of lactic acidosis.
Individuals who are being treated with levodopa without taking carbidopa at the same time should avoid doses of 5 milligrams or greater daily of vitamin B6.
Vitamin B12 (cyanocobalamin)
Do not take cyanocobalamin if you have Leber's optic atrophy.
Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.
Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.