Saturday, June 03, 2006

Hepatitis C Help

Introduction

Hepatitis C virus (HCV) infection is increasing in the United States and around the world today. HCV infection is the most common chronic blood borne infection in the United States. More than three-quarters of those who are infected will develop chronic liver diseaseand up to 20 percent will develop cirrhosis. It is estimated that there are 8,000 to 10,000 HCV-related deaths each year and the US Centers for Disease Control and the National Institutes of Health expect the rate to triple in the next 10 to 20 years.

The Centers for Disease Control (CDC) estimates that during the 1980s an average of 230,000 new infections occurred each year. The Third National Health and Nutrition Examination Survey conducted during 1988-1994, indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV. Most are chronically infected and might not be aware of their infection because they do not have apparent symptoms. Infected persons may transmit the virus to others and are at risk for chronic liver disease or other HCV-related chronic diseases during the twenty to thirty years following infection.

General symptoms of Hepatitis C virus

Acute symptoms of Hepatitis C virus include flu-like symptoms, dark urine, light stools, jaundice, fever, fatigue, anorexia, nausea, and itching skin.

Chronic HCV symptoms include fatigue, malaise, weakness, mild fevers, liver pain, decreased appetite, and itching skin. However, many persons infected with HCV do not have obvious symptoms, especially in the early stages of chronic infection with HCV.

HCV infection is found within people of all ages. The highest prevalence rates of chronic HCV infection are found among those aged 30-49 years and among males. The highest incidence of acute hepatitis C is among 20-39 year olds with men having a slightly higher rate of acute infections. Because most HCV-infected people range between 30-49 years old, the number of deaths caused by HCV-related chronic liver disease could increase significantly during the next 10-20 years as more likelihood of complications develop.

While African Americans and whites currently have similar occurrence of acute infection, African Americans have a substantially higher prevalence of chronic HCV infection than do whites. Latinos have the highest rate of acute infection.

The CDC identified most risk factors associated with HCV transmission in the US in case-control studies conducted during 1978-1986. These risk factors included: blood transfusion, injection drug use, patient care or clinical laboratory work employment, sex partner or household member who has had a history of hepatitis, multiple sex partners, and low socioeconomic level. These studies reported no association with military service or exposures resulting from medical, surgical, or dental procedures, tattooing, acupuncture, ear piercing, or foreign travel, although it may be that the frequency of infection through these means may be too low too detect.

Currently, the highest rate of acute infection is among injecting drug users. Acute HCV infection is basically undetected in people who have had transfusions and in hemophiliacs since the early 1990s, since the blood supply in the US has been tested for HCV since 1990, with more sensitive tests developed in 1992.

Chinese Traditional Medicine for HCV

Many people with HCV are turning to Chinese traditional medicine, which has a rich history in the treatment of chronic hepatitis. Hepatitis B — and increasingly, Hepatitis C — is prevalent throughout China, accounting for increased risk of hepatocellular carcinoma in the mainland Chinese population. The Chinese medical system has been dedicated to solving the problem for many years, working to eliminate sources of hepatitis as well as developing treatments for hepatitis using both Chinese traditional medicine and Western medicine.

At the International Symposium on Viral Hepatitis and AIDS held in Beijing in April 1991, more than 100 papers on viral hepatitis were presented, several of which documented positive results of studies of Chinese herbal medicine. Studies of herbal antivirals and Xue-cooling and Xue-circulating herbs for repairing liver damage supported the hundreds of years of practical experience with Chinese herbs for the symptoms of hepatitis.

A literature review by Dr. Kevin Ergil in 1995 revealed at least 55 herbal formulas that may be used to treat hepatitis clinically. Recent herbal studies in China and Australia showed positive results in hepatitis C using similar formulas to those used widely in clinics in the US.

In the US, Chinese traditional medicine is a popular complementary or alternative therapy among patients with chronic liver disease. In a late 1990¡s anecdotal report from one of the largest clinical hepatology practices in San Francisco found that at least 20 to 30 percent of patients report use of Chinese herbal interventions for hepatitis. The level of use is probably underestimated because patients often choose not to divulge the use of complementary and alternative medicine therapies to their Western primary care physician.

Chinese medicine uses nutrition, acupuncture, heat therapies such as moxibustion, exercise, massage, meditation, and herbal medicine for the treatment of people with HCV. Protocols have been developed that have successfully helped HCV infected people to decrease symptoms, normalize or lower liver enzyme levels, and slow down the progression of liver disease.

A pilot study conducted among people co-infected with HIV and hepatitis at the Quan Yin Healing Arts Center in 1995 indicates that acupuncture alone may have an effect in lowering and normalizing liver enzyme levels.

The Hepatitis Help section explores the use of TCM treatment for HCV as well as the use of a comprehensive East/West approach to healing the liver. This section also explores the use of traditional Chinese medicine as both adjunctive and as an alternative to current Western treatment.

HIV Wellness: Living Well with HIV

Toxic Heat and the Human Immunodeficiency Virus: Understanding HIV disease from the Chinese Perspective

Through clinical observation and treatment of thousands of people with HIV and AIDS, clinical evaluation of the tongues of over 600 people with HIV infection and/or AIDS, and the use of pulse diagnosis, I have come to understand that HIV infection is triggered by Toxic Heat, and initially attacks the Spleen and Stomach Organ Systems. They are the central organs involved in this complex syndrome and must be supported throughout the entire course of the disease even when the HIV-related disharmonies expand to involve all the other organ systems as well.

The Impact of Toxic Heat

Toxic Heat creates the initial flu-like symptoms that for many people accompany initial exposure to HIV. And as the Toxic Heat moves more deeply into all systems of the body, it triggers a whole variety of common HIV-related symptoms: pruritis (chronic itching), sore throats, increase in body temperature, feeling like you always have a fever even if one is not present, a nagging sensation that something toxic is present in the body.

Toxic Heat is also responsible for the cascade of Organ System disharmonies in the Spleen and Stomach, Kidney and Liver, which contribute to the major complication associated with HIV infection, wasting. (For detailed information on nutritional management and therapy see the Diet Therapy chapter and the three-part “Wasting Program: The Daily Diary;” “The Cleansing Diet;”“ The Anti-Wasting Program” in The HIV Wellness Sourcebook.)

Role of the Spleen and Stomach Systems in the Progression from HIV to AIDS

The Spleen and Stomach Systems govern the digestive process, transforming food energy and fluid into Qi and Xue (blood). As a result the Spleen and Stomach moisten and nurture all the other Organ Systems and channels.

When Toxic Heat disrupts the Spleen and Stomach Systems, it triggers symptoms that are associated with the very early stages of HIV infection. These symptoms include

  • fatigue,
  • inability to gain weight no matter how much is eaten,
  • loose stools,
  • bloating, gas and flatulence and/or dull pain in the abdomen,
  • needing to take naps after meals, and/or
  • frequent infections.

In addition, symptoms of early stage HIV infection, such as dry skin and lips, set in when the flow of fluids and food essence from the Spleen and Stomach to the Lungs, is disrupted. Often dryness in one area, triggers dampness in another: Spleen Qi deficiency with dampness manifests in early neuropathy (a numbness or tingling sensation often in the hands or feet, lymphadenopathy (swelling and inflammation of the lymph nodes), vaginal candidiasis (yeast) infections, more serious loose stools and/or bloating. Spleen-related diarrhea is prevalent with loose stools and abdominal bloating after eating. Skin rashes, commonly associated with early-stage HIV infection, are a result of Spleen Qi deficiency and Lung disharmonies interacting with the essential substances.

Spleen Qi deficiency also causes deficient Xue (blood). Once this sets in, the door is opened to allow Toxic Heat to enter the depleted blood and penetrate ever deeper into the body. The body them moves into more advanced stages of HIV/AIDS. If unchecked, an increasing depletion of the fluids of the Spleen (the Spleen’s Yin aspect) leads to overall Yin deficiency, which in turn can lead to Yang depletion.

Although today the combination of Western and Chinese therapies can arrest (for some period of time) the progression of HIV infection to end-stage AIDS for many people, when the cascade of Spleen-Stomach triggered disorders causes overall Yin deficiency and Yang depletion, wasting becomes severe. Diarrhea stops. The skin becomes drier and drier. Thirst is unquenchable. Fevers spike every afternoon and often in the evenings. The pulse is rapid, thready and superficial. This is a terminal stage of HIV disease. (ED: Yes it is called HIV disease.) Acupuncture and herbs are used to support the Shen (spirit) and the passing over to a new phase of existence.

Associated Disharmonies and Opportunistic Infections

Toxic Heat and the Spleen-Stomach disharmonies weaken the body’s overall resistance to assault from both internal and external disease factors and allow other organ systems to become involved. This leads to the development of HIV-related disorders and opportunistic infections. For example, if Toxic heat assaults the Lungs, PCP (Pneumocystis Carinii pneumonia) may develop. Xue disharmonies are associated with Kaposi’s sarcoma (a proliferative, circulatory cell disease that causes skin lesions); dampness is associated with candidiasis (yeast infections) and fungal invasions; Yin deficiency and Xue deficiency are associated with MAC (Mycobacterium Avian Complex) ; dampness and Spleen and Lung disharmonies may manifest as chronic sinusitis; disturbed Shen that is associated with mental disturbances that accompany HIV/AIDS; and many more.

Each of these syndromes is detailed in the individual treatment programs in the last section of the book. However, I wanted to make the point here that looking at HIV disease as an assault by Toxic Heat that starts with damage to the Spleen and Stomach, and moves on to include other organ systems and Essential Substances, provides a concise method of describing, diagnosing and treating the whole constellation of HIV-related diseases.

Women’s Health: Managing Menopause

In Chinese Medicine, the symptoms of menopause – hot flashes, palpitations, emotionality, depression, vaginal dryness, change in libido, urinary problems and changes in skin texture are associated with Deficient Kidney Yin; Deficient Liver Xue ; Deficient Kidney Yang; and Deficient Yin and Yang of Kidney. But it is important to stress that menopause is not a disease or a disorder – it is part of the natural progress of life. Any physical or emotional discomfort associated with it can be eased or eliminated.

Managing Menopausal Symptoms

  • Pre-menopausal and menopausal women should be vigilant about having regular mammograms, annual Pap smears (even after the period has stopped) and cardiovascular check-ups. For women in high-risk groups such as whites, fair-haired women, those who are very thin, smokers, those with a family history, a bone density scan may be recommended.
  • The smartest approach to menopause is to try the least harsh, most natural treatments first: that means change your diet, increase supplements, particularly vitamin, reduce stress levels, increase aerobic exercise routine, avoid caffeine and stop smoking – this is the single worst trigger of symptoms – use acupuncture, herbs, massage and meditation first.
  • There are a growing number of physicians who are using Estrogen Replacement Therapy (ERT) or Hormone Replacement Therapy (HRT) as the last resort for menopausal symptoms. Evidence is mixed about the increased risk of breast cancer among women who use ERT, although evidence that the risk of osteoporosis and heart disease is decreased appears overwhelming. However, the lifestyle changes suggested in this comprehensive program and throughout the book may also diminish the risk of brittle bones and heart disease sufficiently to make it unnecessary to take ERT.
In order to relieve your symptoms, follow the guidelines in the general gynecologic program plus the suggestions that follow here.

Understanding Chinese Medicine

What is Chinese Medicine?

Traditional Chinese Medicine (TCM) is a 4,000 year-old system of balancing the body’s own health-preserving forces.

Components of Chinese Medicine

Diagnosis

Find out how Chinese medicine practitioners describe the disharmonies of the body and perform a diagnosis. In this package:

Asking the Questions
No one knows your body as well as you do, so help your practitioner learn about your by answering these questions.

Listening and Smelling
Evaluating your voice and smell can help your doctor zero in on the origins of disharmony.

Pulse and Touch
Did you know there are 28 different pulses? And your reaction to pressure along acupuncture meridians can provide important information.

Tongue, Body Language and Face
Your tongue, body language, and facial color offer strong clues to the location of disharmony.

Acupuncture

Acupuncture is the art of inserting fine sterile metal needles into certain body or ear points to control the body’s energy (Qi) flow.

Moxibustion

Moxibustion is the common herb mugwort (called moxa in Chinese) that is burned over certain points or areas.

Herbal Therapy

Herbal Therapy is integral to Chinese medicine. The herbs selected reflect the type of imbalance which has been diagnosed. Herbal medicine may be used alone or in conjunction with other therapies.

Dietary Therapy

Dietary therapy focuses on improving digestion, increasing energy, and balancing body energy. Food therapy often increases the effect of other treatments.

Exercise/Meditation: Qi Gong

Exercise includes martial arts as well as more subtle movement such as T’ai Chi, Qi Gong, and Yoga. Gym work-outs or aerobic exercise are also suggested. Meditation may include traditional Asian forms as well as relaxation exercises, hypnotherapy, and bio-feedback.

Web Links

Other Chinese Traditional Medicine resources on the Web.