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Natural Isn’t Necessarily Safe: Hepatitis C and Dietary Supplements
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I don’t like taking pills, and whenever possible, I look for healthy alternatives instead of taking drugs. If I have an upset stomach, I drink tea before opening the medicine cabinet. If I have a mild cough, I’d rather sip herbal tea with than slurp down cough syrup. In short, sometimes I use “natural medicine” rather than manufactured medicine.
Living with hepatitis C for more than 25 years taught me to be careful about what I take. Everything goes through the liver, whether I eat it, drink it, inhale it, or put it on my skin. With hepatitis C replicating a trillion times a day, my liver was already working overtime. I didn’t want to add to my liver’s burden by taking something that might not be good for me—and this included herbs and other dietary supplements.
Natural does not mean safe. An herb or vitamin that is generally safe for healthy people, can be risky for someone with hepatitis C or other liver diseases. Here are some dietary supplements that may cause liver injury:
- (oral use)
- Black Cohosh
- Iron – Iron supplementation should be medically supervised. Unless your doctor advises otherwise, men and post-menopausal women taking multi-vitamins should take low-iron versions, aka “senior” multivitamins.
- Vitamin A - The recommended daily allowance (RDA) for vitamin A is 700-900 µg/day (2300-4300 IU) for adults
Of course, always talk to your medical provider before taking supplements. Some healthcare professionals are more educated on the subject than others are, but even if your provider isn’t up on the latest in natural medicine, it is a good idea to talk to him or her before going down that road. I can’t tell you how often people tell me they take something because they heard about it from a friend, read about it, or got advice from someone working at the health food store. When I ask them if they’ve talked to their doctor about such-and-such product, they say “no,” despite the fact that physicians have years of education.
Although liver injury is rare, a bigger risk of taking dietary supplements is that they may interfere with other medications. A “safe” herb may alter the dose of a medication you are taking. The supplement you are taking may not directly cause damage, but the drug you are taking may be ineffective or reach toxic levels. Supplements may lower the effectiveness of birth control drugs, putting you at risk on an unwanted pregnancy.
The bottom line is to get professional advice and use common sense before taking anything. Here are a few general tips:
- Be a diligent researcher, and find out everything you can about a product before you take it.
- Check for potential interactions by using a medication checker and ask your pharmacist if a supplement you are interested in is known to interact with any of the medications you take.
- Do not take supplements if your hepatitis C has progressed to decompensated cirrhosis.
- Find out if you need to stop any of your supplements before undergoing a medical or dental procedure
- More is not better. Do not exceed the supplement’s recommended dose.
If you want to know more about dietary supplements, here are a few of my favorite resources:
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