Alternative Medicines and Treatments

Having had my views on this subject wrongly represented on a forum recently, this, I hope, will set the record straight. It is based on the text of my reply, and goes into more detail.

I have no problem with this in general, provided it is carried out by a competent practicioner. It needs to be someone with an extremely good knowledge of conventional treatment of HCV, and its effects on the body. Carol Metcalfe has my total confidence and admiration, but I would hesitate to recommend anyone else. Some substances frequently used by aromatherapists will cause distorted blood test readings, and are not exactly liver-friendly, and only the absolute best aromatherapists with extensive knowledge of HCV are likely to be aware of this.
General appraisal - Safe and effective in the hands of a good practicioner.

Nutritionists and Supplements
Nutritionists, in general, know an awful lot about nutrition, and next to nothing about HCV or its treatment. Very few are medically qualified and capable of understanding the effects of interferon and ribavirin on the body. Let's face it, if a GP with seven years training is not qualified to treat HCV, what chance has a nutritionist of being able to operate safely in the area? Usually, they have no access to your medical records, and can only guess at how damaged your liver is, and the dose reductions this often entails. They frequently mistake haemolytic anaemia from treatment for conventional iron-depletion anaemia. One frequently has too much iron, and the other too little. This has serious implications. For instance, a diet rich in iron can be seriously damaging in many cases as it increases iron overload problems often associated with treatment and can cause permanent liver damage. Despite this I am aware of professional nutritionists prescribing herbal supplements described as 'a rich source of iron' to HCV patients on treatment. This is the sort of elementary mistake that should never happen, but it does with alarming regularity. Sooner or later a nutritionist will be sued by a patient forced to undergo an avoidable liver transplant caused by supplements.

The whole area of supplements is one of doubt and danger. Even simple vitamins carry their own problems. For instance, vitamin C is a diuretic, and will increase dehydration symptoms from treatment, make you feel worse, and the extra fluid that you take to compensate will reduce your interferon levels and degrade your treatment success chances. Few people realise that vitamin C promotes iron absorbtion, and will double the quantity of iron absorbed from any food taken with it, risking iron overload problems. This is just one simple example. There are many more.

As a general observation, all of the more common vitamins have been trialled during treatment, mostly in the US. None has been found to have any significant benefit. I can throw a further 'spanner into the works' as follows. Suppose 'supplement X' degrades treatment success rates by half. How would this fact come to light? The answer is that it would not, unless it happened to be part of a trial. The bulk of supplements have not been properly tested, and the possibility of treatment degradation exists for most. How can you be certain that the supplement that you are proposing to take will not damage your chances of a cure? There have been classic cases of liver transplant patients nearly loosing their new livers (and their lives) as a supplement that were taking blocked their anti-rejection medication.

If despite all this, you feel that you need the services of a nutritionist, get your treatment centre to recommend one. If they refuse, or say you don't need one, then respect their decision. They, after all, are the experts!

Most people have adequate knowledge of what constitutes a healthy diet, and the best advice is to try to stick to it. This is not always practical during treatment with low appetite and change in taste. It is better to eat something rather than nothing when you feel rough, and dietary considerations are sacrificed in favour of getting some fuel into your system in the form of any food that you can manage. If this means a trip to MacDonalds, then so be it!
General appraisal - Supplements and nutritionists are dangerous and usually unnecessary.

Organic food
This can be extremely dangerous during treatment. It is well known that the immune system is seriously depressed during treatment, and organic food contains higher levels of bacteria due to the nature of the fertilisers employed (i.e. animal shit). A normal healthy person will tolerate these without problems, but during treatment they are dangerous. If you wish to play Russian Roulette with E. Coli or Listeria be my guest, but it is highly inadvisable. In fact even sushi, raw shellfish, non-pasturised cheeses, and products containing raw egg should be off the menu during the later stages of treatment. It is worthwhile taking particular care over food hygene and ensuring that all vegetables and fruit are thoroughly washed, particularly those that are to be eaten uncooked. Note that this is only applies to the later stages of treatment when depressed immune systems are a problem.
There is a story of a golfer who had the habit of licking his thumb and rubbing the marks off his golf ball. When the golf course sprayed the grass with organic fertiliser his habit cost him a week in hospital with a very nasty stomach infection. He survived, but then he was not on HCV treatment. Be warned!
General appraisal - Dangerous and unnecessary.

Homoeopathic remedies
These are a complete waste of money but harmless, and have (at last) been proven to be so. They are slightly less effective than a placebo, according to the BMA. If you wish to take the matter up with them you are welcome to do so! If the modern homeopathic remedies were made to the originally prescribed method rather than the mass production methods used today this might be different. If you insist on flying in the face of science this is one area where you can do so in absolute safety.
General appraisal - Safe but ineffective.

Traditional Chineese Medicine - TCM
Chinese herbs kill hundreds each year. Despite the attempts of regulators, it is virtually impossible to ensure that what is written on the bottle is what is inside. Some of the mistakes are innocent, when the wrong herb is picked, or the wrong label applied, but there is always a temptation for far eastern manufacturers to jazz-up their remedies by including 'extras' such as modern drugs in the formula and not saying so on the label. Then we get to the problems of dose standardisation. Different manufacturers produce different strengths of the same herb, and the active ingredients of some herbs vary according to the time of year that they are harvested. There is also the issue of heavy metal and insecticide contamination. There is no quality control in the system at all. We then reach the issue of the actual prescribing of herbal remedies. Personally, I would like to see the letters MD after the name of anyone prescribing anything for me. At least there would be some chance that the part of the Hippocratic oath that says 'First, do no harm' might apply, and the practicioner would have a reasonable knowledge of medicine, and some chance of understanding the very special circumstances of somebody going through combo treatment which is obviously not taught to Chinese Herbalists. To be fair, is it reasonable to expect a system of medicine that has evolved over hundreds of years to cope with ordinary ailments, to be able to cope with the impact of the very nasty drugs used to treat HCV? At the very best they are groping in the dark. If there is the slightest interaction between the herbal and conventional medicine it will reduce the chances of success, and there is no way of ruling this out. There is no evidence of a single virus particle being destroyed by anything other than conventional medicine. Those considering TCM are advised to take a long hard look here before making a decision.
General appraisal - Extremely dangerous even in the hands of a good practicioner.

Can be particularly useful for pain and tension relief. Generally acknowledged as safe, but effectiveness varies. Do not forget to point out that your blood is infective. It should make no difference, but is worth saying all the same!
General appraisal - Safe and often very effective in the hands of a good practicioner.

Yoga, meditation, psychotherapy, hypnotherapy, reflexology, spiritual healing, Shaitsu etc.
I have no problems with any of these and would encourage those who think they might benefit to try them. Mental health is a vitally important and very neglected aspect of treatment, and essential to treatment success. All of these have been tried with varying degrees of success and it seems fair to say that different treatments work for different people. I have a few reservations about hypnotherapy, as it is technically possible to exploit vulnerable patients under hypnotherapy. It should never happen, but it would be wise to check the credentials of any alternative practicioner thoroughly, and particularly so with hypnotherapy.
General appraisal - Safe and often very effective in the hands of a good practicioner.

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