Guest guest Posted February 7, 2004 Report Share Posted February 7, 2004 In June of 2003 this patient, male, age 51, came to see me for treatment of Hepatitis C which he was diagnosed with several months earlier. He was and is largely asymptomatic and was diagnosed through routine blood work which showed elevated liver enzymes which led his MD to send him for more tests revealing the HCV. His MD sent him to a liver specialist who wanted to put him on interferon, but the patient refused. Through a friend (a previous Hep C patient of mine) he heard about me and came for a consultation. I told him that I'd be happy to work with him in conjunction with the interferon treatment, but he still didn't want to do interferon. I told him we could try using Chinese medicine alone, but warned him that it would be unlikely I could rid him completely of the virus. I told him we could bring probably bring his liver enzymes down and get the viral load down, but that he would have to continue treatment indefinitely if he didn't want everything to revert back to where it was. He agreed to this as he was strongly opposed to trying interferon. After 3 months of weekly acupuncture and daily taking loose herbs, his blood work showed the following changes: Results of 5/30/2003 (before treatment): AST 53 U/L ALT 92 U/L HCV RNA 2,691,000 IU/mL Results of 9/11/2003 (after 3 months of herbs and acupuncture) AST 42 U/L ALT 79 U/L HCV RNA 238,000 With this he was extremely happy (as was his MD) and he asked if he could stop with the acupuncture and just take herbs. I thought this would be OK, so he came once every other week for three months for loose herbs, then we sent him for another round of blood work: Results of 12/9/2003 AST 48 ALT 86 HCV RNA 1,330,000 This was obviously disappointing and I suggested that he either consider interferon along with acupuncture or if that was unacceptable, herbs and acupuncture. He wanted to continue with herbs alone for a couple months to see what would happen, so we did that. He recently went for another round of blood work which I just received: results of 1/27/2004 AST 44 ALT 65 HCV RNA 2,220,000 He will be coming in next week to discuss what to do next. What I'm mainly asking for in the way of advice is whether or not I should continue to treat him with herbs and acupuncture alone or do I recommend he do the interferon in combination with Chinese medicine treatment to see if the virus can be completely suppressed? Is it ever possible to get the viral load down to undetectable levels with CM alone? Is it acceptable, if the patient desires, to continue treating with CM alone if the viral load is always detectable and treatment would have to be of indeterminate length? If it proves helpful, here is a brief description of tongue, pulse, etc.: tongue body is slightly thin, red, with greasy yellow coating on sides. pulse (i'm not a master, so bear with me): left side: thin, guan is somewhat weak, chi deep. right: moderate, guan slightly slippery. Patient generally feels good. Good energy, appetite, digestion, bowel movements, sleep. Thirst normal. Has kidney stones which occasionally give him some trouble. Emotions are good. He basically has no complaints and is not terribly worried about the HCV, but he would love to avoid interferon if possible! Any and all comments, suggestions, etc, would be greatly appreciated. Thanks in advance. Greg Lake Street Greg A. Livingston, L.Ac. Wang Huiyu, BTCM 121-1/2 11th Avenue San Francisco CA 94118 (415)752-3557 shanren Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2004 Report Share Posted February 8, 2004 , Greg Livingston <shanren@c...> wrote: > > results of 1/27/2004 > AST 44 > ALT 65 > HCV RNA 2,220,000 > > Greg AST and ALT remain lower than at outset as does viral load, so this is positive. It really looks like the first test after tx may have been erroneous. Was it checked for errors? In any event, there are alternatives to using interferon, such as combining naturopathic style treatment. A colleague in Portland, OR who works with the local med school has seen several patients go to no detectable virus with natural therapies alone, but not just with CM.. His name is Keivan Jinnah. the protocol involves individualized herb rx, plus vitamin C, glutathione reductase, silymarin and liver extracts plus whatever else they have developed recently. See also the encyclopedia of natural medicine by michael murray for evidence based naturopathic hepatitis protocols. BTW, can anyone on this list claim to have achieved this result with CM alone? This case certainly raises the issue of the importance of acupuncture if the tests results were all accurate. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2004 Report Share Posted February 8, 2004 Dear Greg, Our company is conducting a clinical phase II trial on hep C using Sho-saiko-to (xiao chai hu tang in Chinese) in collaborating with the Memorial Sloan-Kettering Cancer Ctr in NY since a year ago. Here is the description of the trial: " Sho-Saiko-to for Patients with Chronic Hepatitis C Who Are Intolerant to Or Have Contraindication to Interferon-Based Therapy: A Phase II Study A single arm, single center trial of Sho-saiko-to in patients with chronic hepatitis C who cannot tolerate or who have specific contraindications to interferon therapy. Thirty-one patients will receive 52 weeks therapy with Sho-saiko-to granule extract at 7.5 gram per day. Outcome will be assessed by comparing pre- and post-treatment liver biopsies. Patients will be said to respond if they have an improvement of two points or greater on a standard measure of liver histology. " I have reviewed about 40 research papers published during the past decades by mostly Japanese researchers. The review was published on OMJ last year. You can find the review paper at the following link: http://honsousa.com/download/OMJ%20article_dan%20wen.pdf You can also fine other research information on this herbal formula in our website: http://HonsoUSA.com If the links don't work, please send me an email and I will send a copy to you. Hope this help. Dan Wen Honso USA, Inc. , Greg Livingston <shanren@c...> wrote: > In June of 2003 this patient, male, age 51, came to see me for treatment > of Hepatitis C which he was diagnosed with several months earlier. He > was and is largely asymptomatic and was diagnosed through routine blood > work which showed elevated liver enzymes which led his MD to send him for > more tests revealing the HCV. > > His MD sent him to a liver specialist who wanted to put him on > interferon, but the patient refused. Through a friend (a previous Hep C > patient of mine) he heard about me and came for a consultation. I told > him that I'd be happy to work with him in conjunction with the interferon > treatment, but he still didn't want to do interferon. I told him we > could try using Chinese medicine alone, but warned him that it would be > unlikely I could rid him completely of the virus. I told him we could > bring probably bring his liver enzymes down and get the viral load down, > but that he would have to continue treatment indefinitely if he didn't > want everything to revert back to where it was. He agreed to this as he > was strongly opposed to trying interferon. > > After 3 months of weekly acupuncture and daily taking loose herbs, his > blood work showed the following changes: > > Results of 5/30/2003 (before treatment): > AST 53 U/L > ALT 92 U/L > HCV RNA 2,691,000 IU/mL > > Results of 9/11/2003 (after 3 months of herbs and acupuncture) > AST 42 U/L > ALT 79 U/L > HCV RNA 238,000 > > With this he was extremely happy (as was his MD) and he asked if he could > stop with the acupuncture and just take herbs. I thought this would be > OK, so he came once every other week for three months for loose herbs, > then we sent him for another round of blood work: > > Results of 12/9/2003 > AST 48 > ALT 86 > HCV RNA 1,330,000 > > This was obviously disappointing and I suggested that he either consider > interferon along with acupuncture or if that was unacceptable, herbs and > acupuncture. He wanted to continue with herbs alone for a couple months > to see what would happen, so we did that. He recently went for another > round of blood work which I just received: > > results of 1/27/2004 > AST 44 > ALT 65 > HCV RNA 2,220,000 > > > He will be coming in next week to discuss what to do next. What I'm > mainly asking for in the way of advice is whether or not I should > continue to treat him with herbs and acupuncture alone or do I recommend > he do the interferon in combination with Chinese medicine treatment to > see if the virus can be completely suppressed? Is it ever possible to > get the viral load down to undetectable levels with CM alone? Is it > acceptable, if the patient desires, to continue treating with CM alone if > the viral load is always detectable and treatment would have to be of > indeterminate length? > > If it proves helpful, here is a brief description of tongue, pulse, etc.: > tongue body is slightly thin, red, with greasy yellow coating on sides. > pulse (i'm not a master, so bear with me): left side: thin, guan is > somewhat weak, chi deep. right: moderate, guan slightly slippery. > Patient generally feels good. Good energy, appetite, digestion, bowel > movements, sleep. Thirst normal. Has kidney stones which occasionally > give him some trouble. Emotions are good. He basically has no > complaints and is not terribly worried about the HCV, but he would love > to avoid interferon if possible! > > Any and all comments, suggestions, etc, would be greatly appreciated. > Thanks in advance. > > Greg > > > > > Lake Street > Greg A. Livingston, L.Ac. > Wang Huiyu, BTCM > 121-1/2 11th Avenue > San Francisco CA 94118 > (415)752-3557 > shanren@c... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2004 Report Share Posted February 8, 2004 AST and ALT numbers as well as viral loads are deceptive, whether favorable or not, unless maintained for months or years. I compare it to dipping a bucket in the ocean every 3 months to see how many fish are in the ocean. I have only met 2 people who have had their viral status changed. One was through acupuncture and raw herbs and the other who worked with a naturapath/Aruyvedic doctor for a number of years. I do think that CM herbs can keep the liver healthy for preventative care. One of the best books to read is Dolan's The Hepatitis C Handbook. doug > Greg > > AST and ALT remain lower than at outset as does viral load, so this is > positive. It really looks like the first test after tx may have been erroneous. > Was it checked for errors? In any event, there are alternatives to using > interferon, such as combining naturopathic style treatment. A colleague in > Portland, OR who works with the local med school has seen several patients > go to no detectable virus with natural therapies alone, but not just with CM.. > His name is Keivan Jinnah. the protocol involves individualized herb rx, plus > vitamin C, glutathione reductase, silymarin and liver extracts plus whatever > else they have developed recently. See also the encyclopedia of natural > medicine by michael murray for evidence based naturopathic hepatitis > protocols. BTW, can anyone on this list claim to have achieved this result > with CM alone? This case certainly raises the issue of the importance of > acupuncture if the tests results were all accurate. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2004 Report Share Posted February 9, 2004 I agree with you, Doug on the deception of the ALT/AST and viral loads. I have patients with no symptoms... no fatigue however their viral load is over 21 million. Then there are those with low viral, low liver enzymes... yet have lots of symptoms. Also, it is my understanding that as the liver becomes cirrotic, liver enzymes can go back into normal range and stay there. In my training with Misha Cohen, it was advised that all patients get a liver biopsy. I do not push this with my patients, although I will tell them it is the only way to see what is really going on. However, I am still not convienced that looking at one little, itsy bitsy piece of the liver is going to tell about the entire liver. I have one patient who is from up North and participated in a Hep C study looking at the effects of alcohol. She drinks a bottle of wine a day... apparantly this particular study thinks that there is no correlation between alcohol and Hept C. Again, I would never recommend that my Hept C patients begin to drink. I have about 8 regular Heptatis C patients. Several in their 50's and it seems like the ones who have been alcohol free the longest, are fairing the best. I personally do not advocate to patients the erradication of this virus. It is a slowing growing virus... and allot is unknown. Rather I advocate a healthy lifestyle including regular sleep, eat and exercise... also, teach the importance of well balanced emotions. I am sure with most of my Hept C patients they will die from something else, other then Liver disease. The most important thing is to maintain a good qualtiy of life. As far as herbs, I use Honso's Xiao Chai Hu Tang, also use a Health Concern protocal for Hept C, that is taught by Misha Cohen up in the Bay area.... and for one patient (on a liver transplant list), which happened shortly after I requested an Alpha Feta Protein test, which showed to be out of range. I continue to make raw honey pills, on a regualar basis. My advanced Hept C patient has blood drawn every month whereas the rest get draws every 6 months to 1 year. Happy Monday! Teresa Hall, L.Ac, M.S, Q.M.E. 619-517-1188 - " " Sunday, February 08, 2004 10:24 PM Re: Hep C patient > AST and ALT numbers as well as viral loads are deceptive, whether favorable or not, > unless maintained for months or years. I compare it to dipping a bucket in the ocean > every 3 months to see how many fish are in the ocean. I have only met 2 people who > have had their viral status changed. One was through acupuncture and raw herbs and > the other who worked with a naturapath/Aruyvedic doctor for a number of years. I do > think that CM herbs can keep the liver healthy for preventative care. > One of the best books to read is Dolan's The Hepatitis C Handbook. > > doug > > > > Greg > > > > AST and ALT remain lower than at outset as does viral load, so this is > > positive. It really looks like the first test after tx may have been erroneous. > > Was it checked for errors? In any event, there are alternatives to using > > interferon, such as combining naturopathic style treatment. A colleague in > > Portland, OR who works with the local med school has seen several patients > > go to no detectable virus with natural therapies alone, but not just with CM.. > > His name is Keivan Jinnah. the protocol involves individualized herb rx, plus > > vitamin C, glutathione reductase, silymarin and liver extracts plus whatever > > else they have developed recently. See also the encyclopedia of natural > > medicine by michael murray for evidence based naturopathic hepatitis > > protocols. BTW, can anyone on this list claim to have achieved this result > > with CM alone? This case certainly raises the issue of the importance of > > acupuncture if the tests results were all accurate. > > > > > > > > Chinese Herbal Medicine offers various professional services, including board approved continuing education classes, an annual conference and a free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
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