Nutritional treatment to prevent liver scarring (fibrosis, cirrhosis) and to support the liver in cases of chronic hepatitis C and hepatitis B.
One of the main treatments (along with chelation therapy, diet, and ozone therapy), that we have been using for cardiovascular disease is intravenous phosphatidyl choline therapy. We call this plaquex or essential lipid therapy for short. This is an essential lipid that has been used to reduce blockages in the arteries by stimulating the exchange of old, friable, fats on the plaque of artery wall with new flexible phosphatidyl choline. It is given intravenously because normally greater than 90% of an oral dose does not enter the general circulation and instead recirculates between the liver and GI system.
What we are finding now is that this treatment also has a large amount of research that focuses on its activity in liver disease. Many studies in Russia and Europe, and a few in the US have shown that adding phosphatidyl choline intravenously and orally decreases liver inflammation and reduces enzyme elevations in the blood. If there are problems with chemical sensitivity and liver detoxification, then the phosphatidyl choline IV and oral treatment may be for you.
Polyenylphosphatidylcholine protects against alcohol but not iron-induced oxidative stress in the liver.Aleynik SI, Leo MA, Aleynik MK, Lieber CS. Alcohol Clin Exp Res. 2000 Feb;24(2):196-206.
Polyenylphosphatidylcholine attenuates alcohol-induced fatty liver and hyperlipemia in rats.Navder KP, Baraona E, Lieber CS. J Nutr. 1997 Sep;127(9):1800-6.
It seems that the greatest use is in cases of naturopathic treatment of chronic hepatitis. It was particularly useful in lowering ALT enzyme levels in patients who were also taking the interferon injections. Overall though, most studies showed a great protective effect. Here are the summaries of the studies; if you are interested in this treatment please call the office to schedule an appointment. At the consultation, you will be examined and some baseline tests will be run. Depending on the results, it may require between 10-20 treatments depending on the severity, but we would redraw blood to follow progress after 6-9 treatments.
In April 2002, a Russian study compared intravenous phosphatidyl choline and milk thistle (both used in our clinic) to oral dosing. Both methods were able to lower elevated liver enzymes in the blood, showing a decrease in liver inflammation and damage. Interestingly enough, intravenous dosing showed a much greater effect than oral dosing, though both had an effect. This implies that stability in the gut is an issue, because remember the oral dose mostly goes straight to the liver for metabolism. We use both oral and intravenous dosing routinely. This study looked at human patients who had either chronic hepatitis B, chronic hepatitis C, or a combination of both.
In the American Journal on Addictions, 2001, the biochemistry of how the liver is affected in chronic alcoholic liver disease and hepatitis C was studied. It was shown that certain enzyme activities were induced (cytochrome P450 2E1) and that this was partly responsible for the liver damage. Furthermore, phosphatidyl choline levels were depressed in these two diseases. This study showed thatphosphatidyl choline corrected the deficiency, helped to block the induction of the enzyme mediated damage, and helped to reduce liver scarring.
In a 1998 Russian study, the combination of phosphatidyl choline and milk thistle intravenously was roughly 1.5 to 2x better than phosphatidyl choline alone at protecting rat livers from acute hepatitis. In humans, we treat mostly chronic hepatitis and have used either the intravenous phosphatidyl choline or the milk thistle; we are happy to combine both but haven't found it necessary yet.
In the North American journal Hepatogastroenterology, 1998, patients withhepatitis B or hepatitis C treated with interferon were studied to see if additional phosphatidyl choline would help. They found roughly a 50% better response in the combination group, compared to interferon alone. This is great evidence for us to use phosphatidyl choline in our hepatitis C patientstaking interferon. This study found that for patients treated with interferon, there was no difference in the hepatitis B group. The hepatitis C group did great.
A negative study in Alimentary Pharmacology and Therapeutics didn't find benefit in acute hepatitis with oral phosphatidyl choline. However, they used half the dose that other studies used, and didn't look at chronic hepatitis. We find great results in acute hepatitis with IV vitamin C - this is the treatment of choice.
A Russian study in July 1987 found that the enzyme LCAT (lecithin cholesterol acyl transferase) activity was decreased in hepatocellular cancer, cirrhosis, and hepatitis. They found that administration of phosphatidyl choline corrected the deficient activity, but only in chronic hepatitis patients. This is an important indication that liver function can be restored with treatment.
This same year and month, another Russian study showed that chemical-induced sensitivity and damage was blocked by phosphatidyl choline administration. Metabolic activity was restored in the cases where injury was from a chemical. This is an important indicator that PC treatment can be useful for chemically sensitive patients, such as chronic fatigue syndrome and fibromyalgia.
In 1983, the North American journal aptly titled Gut showed that phosphatidyl choline protected from immune mediated damage to the liver. This is a very important study as it demonstrated that administered phosphatidyl choline is incorporated into the liver cell membranes. This study was done on patients infected with hepatitis B. Considering the large number of patients who are carriers and some who have chronic active disease, it is perhaps one of the best preventative treatments as it can protect the liver from further damage.
Another Hepatitis B study: the journal Liver in 1992 did a double blind trial in which 3 grams of phosphatidyl choline was administered to patients. All patients were on immunosuppressive therapy. HBsAg negative patients benefitted and had liver protection even when standard immunosuppressive therapy was not working. Based on the study above that showed PC protects from immune mediated injury, this study shouldn't be surprising. The combination of the two give great incentive for Hep B patients who's disease is not well-controlled to have a course of phosphatidyl choline therapy.
In summary, phosphatidyl choline combination oral and IV therapy can be an option for treatment in a variety of liver diseases. While acute hepatitis, which normally can make a patient miss weeks of work, can be relatively easily treated with IV vitamin C (and get better in days), chronic hepatitis C and hepatitis B can be treated with phosphatidyl choline. We tend to use a combination of oxidative therapies such as ultraviolet blood irradiation and ozone, but the addition of phosphatidyl choline, especially if interferon therapy is underway and in hepatis B, is ideal.