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Fish Oil Eases Hep C Therapy-Related Anemia

Nicole Cutler L.Ac. December 18, 2013

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Discover why omega 3-fatty acids may be extremely valuable for preventing hemolytic anemia –one of the most challenging, potential side effects of Hepatitis C combination therapy.

To prevent or treat anemia, numerous additional medications frequently accompany Hepatitis C therapy in hopes of elevating the red blood cell count enough to complete treatment. Although requiring additional studies before omega 3-fatty acids are built in to side effect management protocol, fish oil supplementation may prevent ribavirin-related anemia.

Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). EPA and DHA are the two types of omega-3 fatty acids most readily used. Omega 3-fatty acids are known to reduce inflammation throughout the body, including the liver. When battling a chronic illness like Hepatitis C, inflammation in the liver increases liver scarring and necrosis. Thus, this natural anti-inflammatory is highly recommended for keeping liver inflammation at bay.

Today, Hepatitis C therapy typically includes a combination of pegylated interferon and ribavirin – and may also include a protease inhibitor such as Victrelis, Incivek and the recently approved simeprevir. The addition of a protease inhibitor seems to increase the success rate of Hepatitis C therapy, but all of the currently approved protocols include the medication ribavirin.

Because ribavirin causes red blood cell destruction, hemolytic anemia is one of the most frequent side effects of Hepatitis C therapy. Severe anemia develops in about 10 percent of people treated with ribavirin and may lead to dose reduction, which compromises treatment effectiveness. Additional arsenals of medications are currently used to prevent, slow or reduce Hepatitis C treatment related hemolytic anemia; however, these drugs have side effects of their own. Some researchers are finding that omega-3 rich fish oil is a natural supplement capable of preventing hemolytic anemia resulting from ribavirin:

  1. According to a study published in 2007 in the journal Intervirology, Japanese researchers evaluated the effectiveness of EPA against ribavirin-associated hemolytic anemia during the first three months of Hepatitis C antiviral therapy. They found that 17 percent of participants receiving EPA and 29 percent of those not receiving EPA required ribavirin dose reduction due to hemolytic anemia. They concluded that EPA helped prevent anemia in the first three months of therapy.
  2. According to a study published in the August 2012 edition of Pediatrics International, researchers studied the prophylactic effect of EPA supplementation on ribavirin-induced hemolytic anemia in pediatric and young adult Hepatitis C patients. They found that anemia was eliminated after two to four months with EPA supplementation, especially when compared to the control group who did not take EPA. The authors concluded that in pediatric and young adults, supplementing with EPA prevents ribavirin-induced hemolytic anemia during combination therapy with pegylated interferon α-2b and ribavirin.
  3. As published in an April 2008 edition of the journal Lipids, subjects with Hepatitis C who received combination therapy of pegylated interferon and ribavirin for six months had improved hemoglobin levels in half the amount of time in those supplementing with EPA compared to those who did not take EPA. The researchers concluded EPA supplements might be useful during Hepatitis C therapy.

Preventing ribavirin-induced hemolytic anemia is not the only reason someone with Hepatitis C might want to supplement with fish oil. As published in the June 2012 edition of Gastroenterology, researchers investigated the impact of omega 3-fatty acids on developing hepatocellular carcinoma (liver cancer). They found that consumption of n-3 PUFA-rich fish or n-3 PUFAs – particularly EPA, DPA and DHA – appears to protect against the development of liver cancer, even among subjects with Hepatitis C infection.

By taking a fish oil supplement such as Super Omega-3 Fish Oil which contains 300 mg EPA and 200 mg DHA per serving, or Omega Complete which contains 360 mg EPA and 360 DHA per serving, this natural anti-inflammatory could prevent liver cancer and anemia from Hepatitis C antiviral therapy. Since there are several side effects of fish oil supplementation such as thinning of the blood, digestive upset and blood sugar fluctuations, this should only be attempted under a physician’s guidance.

EPA seems to do more than stop inflammation in the body; it also appears to protect red blood cells from abnormally breaking down. More research is needed to verify the capability of the omega-3s in preventing ribavirin-induced hemolytic anemia, but the existing evidence is exciting. If this common supplement can keep people on the full dose of Hepatitis C medications for the duration of treatment, it will significantly increase the overall effectiveness of treatment. Increasing the odds of beating Hepatitis C is the bottom line and, if fish oil can do it, the Hepatitis C community has some major celebrating to do.

References:

http://www.liversupport.com/wordpress/2010/02/omega-3%E2%80%99s-benefits-now-include-liver-protection/, Omega-3’s Benefits Now Include Liver Protection, Nicole Cutler, L.Ac., Retrieved November 24, 2013, Natural Wellness, 2013.

http://www.mayoclinic.com/health/drug-information/DR602577/DSECTION=side-effects, Ribavirin (Oral Route), Retrieved November 24, 2013, Mayo Foundation for Medical Education and Research, 2013.

http://www.nbcnews.com/health/fda-approves-pill-treat-hepatitis-c-2D11645059, FDA Approves Pill to Treat Hepatitis C, Deena Beasley, Retrieved November 24, 2013, NBCNews.com, 2013.

http://www.ncbi.nlm.nih.gov/pubmed/17168855, Ribavirin-induced anemia: mechanisms, risk factors and related targets for future research, Russmann S, et al, Retrieved November 24, 2013, Current Medicinal Chemistry, 2006.

http://www.ncbi.nlm.nih.gov/pubmed/18253048, Eicosapentaenoic acid could permit maintenance of the original ribavirin dose in chronic hepatitis Cvirus patients during the first 12 weeks of combination therapy with pegylated interferon-alpha and ribavirin. A prospective randomized controlled trial, Takaki S, et al, Retrieved November 24, 2013, Intervirology, 2007.

http://www.ncbi.nlm.nih.gov/pubmed/18320252, Eicosapentaenoic acid supplementation for chronic hepatitis C patients during combination therapy of pegylated interferon alpha-2b and ribavirin, Kawashima A, et al, Retrieved November 24, 2013, Lipids, April 2008.

http://www.ncbi.nlm.nih.gov/pubmed/22342990, Consumption of n-3 fatty acids and fish reduces risk of hepatocellular carcinoma, Sawada N, et al, Retrieved November 24, 2013, Gastroenterology, June 2012.

http://www.ncbi.nlm.nih.gov/pubmed/22375604, Prophylaxis for ribavirin-related anemia using eicosapentaenoic acid in chronic hepatitis C patients, Suzuki M, et al, Pediatrics International, August 2012.

http://www.yournaturalhealth.com/health_concerns/hepatitis_treatment.htm, Hepatitis C Treatment, Retrieved November 24, 2013, The Connecticut Center for Health, 2013.

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  • Victoria Grandetta

    I really wish you guys would do some research into soft laser. I spoke with a guy recently who in one treatment no longer tested positive for hep c. As he explained to me it works in a manner that empowers the healing cells in the body that previously were outweighed by the hep cells, but once regaining their strength eliminated the cells. He was very knowledgeable of body chemistry and make up as he had spent years himself researching a way out of the nightmare. Since I started researching, I found that soft laser is used all around the world, except the US, with one small exception. Its used by the military in the field for pain. Now why don’t we know of this approach that the federal government has implemented???? Pls, get us some info on this PLEASE.