Hepatitis C, CFS/CFIDS and Other Viral Concerns

Introducing New Viral Care Formula (VCF), An Interview with Shari Lieberman, PhD, CNS, FACN
By Jim English

The last time we spoke with Dr. Shari Lieberman, PhD, CNS, FACN, we discussed her Auto Immune Formula (AIF) — designed to nutritionally support those with autoimmune and immune system concerns — and her two unique nutritional support formulas, BCF (Breast Care Formula) and PCF (Prostate Care Formula). We recently had the opportunity to catch up with Dr. Lieberman to learn about a new formula she has just made available through Vitamin Research Products.

VRP: Dr. Lieberman, your previous formulas were designed to support healthy immune function in people diagnosed with, or concerned about, cancers of the breast or prostate. Now youve turned your efforts to a new area with the introduction of Viral Care Formula (VCF). What is the rationale behind this new formula and who should consider its use?

Dr. Lieberman: VCF was designed as a nutritional support formula for those with chronic viral-induced illnesses, such as Hepatitis C (Hep C) and Chronic Fatigue Syndrome (CFS). Hep C, for example, is reaching epidemic proportions, with close to four million people infected in the US alone. Thats four times the number of people infected with HIV. Hep C is responsible for some 10,000 deaths each year, and this rate is expected to triple by the end of the decade. Hep C is also the most common cause of chronic liver diseases, such as cirrhosis, and is a leading cause of liver cancer.

Interferon (INF) and ribavarin, the current standard of medical treatment for Hep C, are effective for less than 30 percent of all patients after a year of treatment. And of those patients who do benefit from interferon, up to 70 percent of patients suffer a relapse within a few months of treatment. In total, only about 10 to 15 percent of Hep C patients enjoy a sustained recovery lasting even 6 months following treatment with interferon, and a slightly higher number of patients benefit from treatment with pegylated interferon.


VRP: Interferon also has a reputation for causing severe side effects.

Dr. Lieberman: Absolutely. In fact, the side effects from interferon and ribavarin are so harsh that many patients cant function or work during treatment. The list of side effects includes muscle pains, fatigue, fever, headaches, nausea, hair loss, irritability, depression, thyroid abnormalities, pulmonary complications and retinal damage.

VRP: But put in perspective, arent these side effects a small price to pay for reducing the risk of developing liver cancer?

Dr. Lieberman: Interferon treatment has only been shown to reduce risk of liver cancer in the small portion of patients who were able to maintain a sustained reduction of the Hep C virus. Now, these numbers increase somewhat when interferon is combined with ribavarin, but the side effects of combination treatment are significant and serious, including hemolytic anemia (destruction of blood cells) and birth defects. So you really have to ask, is the treatment worse than the disease?

VRP: So, given the low rate of successful recovery and the long list of serious side effects, what options are available to patients?

Dr. Lieberman: Well, to solve the problem I reviewed the medical literature looking for natural and alternative therapies that have been shown to be effective in supporting the bodys defense against viral agents. One of the most impressive compounds in this regard turned out to be a natural agent called glycyrrhizin. Glycyrrhizin (GL) is an active compound from the licorice plant (Glycyrrhiza glabra) found throughout Europe and Asia. Licorice root is a favored herbal treatment that has been used for centuries in traditional medicine to treat coughs, bronchitis and liver inflammation. This herbal tradition intrigued Japanese researchers — and extensive research led to the development of a formula, known as Stronger Neo-Minophagen C, or SNMC, that combines glycyrrhizin, L-cysteine and glycine. SNMC is used extensively in Japan to treat acute and chronic hepatitis. Over 20 years of clinical research has shown that glycyrrhizin exhibits a number of mechanisms that make it effective against a wide range of human viruses.

First, glycyrrhizin acts directly as an antiviral to inhibit RNA transcription, particularly with the HIV virus. Glycyrrhizin has also been shown to act indirectly against a number of viruses by decreasing cell membrane permeability, making it more difficult for the virus to infect host cells. Additionally, glycyrrhizin has been found to act by inactivating viruses, and by inhibiting viral proliferation. In cases of chronic hepatitis, glycyrrhizin has also been found to lower serum levels of alanine aminotransferase (ALT). ALT is a liver enzyme associated with hepatitis, cirrhosis and cancer of the liver. In fact, normalization of ALT levels turns out to be the most important factor for reducing the risk of long-term complications, such as fibrosis and liver cancer, regardless of the presence of viral markers in the serum.

VRP: You mentioned that glycyrrhizin also has anti-inflammatory effects?

Dr. Lieberman: Yes, glycyrrhizin has been shown to inhibit immune responses that cause inflammation, primarily by inhibiting the production and actions of several important pro-inflammatory compounds produced by cells in response to injury — prostaglandins, eicosanoids, and cytokines. Glycyrrhizin also acts as an antioxidant by promoting two vital antioxidant systems, glutathionine-S-transferase and catalase, and by reducing the formation of cellular oxidative products. Additionally, glycyrrhizin supports the bodys immune responses by increasing the production of antibodies, as well as gamma interferon, T cells, and NK (Natural Killer) cells.

VRP: What about clinical studies with glycyrrhizin and hepatitis?

Dr. Lieberman: Glycyrrhizin has been shown to be effective in a number of human studies. In one paper, Japanese researchers found that ALT levels dropped significantly when 100 patients who had previously not responded to other therapies were treated for three weeks with glycyrrhizin. A second study found similar results when 194 patients suffering from chronic hepatitis B were treated with two different doses of glycyrrhizin. Both groups showed a significant improvement, with 74 percent of those receiving the higher dose, and 79 percent of those receiving the lower dose, showing normalization of ALT levels after only eight weeks of treatment. More recently, Japanese researchers found that glycyrrhizin was effective in both reducing ALT levels in persons infected with Hep C, as well as in reducing progression to liver cirrhosis in a group of 178 patients treated to eradicate Hep C for as long as 15 years. This is an important finding, because controlling Hep C and suppressing the inflammatory processes that lead to cirrhosis may help prevent liver cancer, which kills some 30,000 people each year in Japan.


VRP: So glycyrrhizin is effective in treating Hep C, particularly in cases where patients didnt respond to interferon or combined interferon and ribavarin therapy?

Dr. Lieberman: Yes, and glycyrrhizin has also been shown to improve the response of those taking interferon or combination therapy and to make those treatments more tolerable. But its vital to point out that the benefits of glycyrrhizin go beyond Hep C. Glycyrrhizin has been shown to also be effective for Hepatitis A and B, and against HIV. Glycyrrhizin has actually been shown to be superior to AZT. Other viruses that glycyrrhizin can help control include Herpes I, Herpes II, Herpes zoster (shingles), as well as Lichen Planus, Influenza, and Cytomegalovirus (CMV). And in my personal experience, glycyrrhizin is also effective for chronic fatigue syndrome (CFS) and chronic fatigue immune dysfunction syndrome (CFIDS).

VRP: Lets come back to the CFIDS issue in a bit. What else did you include in the VCF formula, particularly with regard to liver support for Hep C?

Dr. Lieberman: Of course, Ive included the herb silymarin (milk thistle). Silymarin has been used in Europe since the 16th century, and continues to be used today as a treatment for liver disease and jaundice. There are numerous studies supporting its ability to help treat acute viral hepatitis and hepatitis B. Silymarin has also been shown to protect the liver from injury while repairing liver tissue and normalizing liver enzymes. One paper that especially impressed me detailed the effects of eight patients diagnosed with chronic hepatitis, including both hepatitis B and C, who were treated with silymarin and phosphatidylcholine. At the end of the 60-day trial, liver enzymes were significantly improved, as were levels of malondialdehyde, a marker of lipid peroxidation in liver tissues.

VRP: And monolaurin—I see youve included 1,500 mg per serving. What is monolaurin, and why is it included in the formula?

Dr. Lieberman: Monolaurin is a short chain fatty acid (SFA) and an ester of lauric acid. Lauric acid was first identified as the most active antiviral and antibacterial substance found in human breast milk. Monolaurin is more biologically active than lauric acid, and works by a number of mechanisms to disrupt and inactivate viruses. First, lauric acid binds to the lipid-protein envelope that surrounds the virus. This, in turn, inhibits the replication cycle of the viruses by interrupting its ability to bind to the host cells. Lauric acid also prevents the uncoating, or shedding of the viral envelope that is required for replication and infection. Additionally, lauric acid directly disintegrates the viral envelope to make the virus more susceptible to host defenses.

VRP: And monolaurin has been shown to have antiviral effects as well?

Dr. Lieberman: Monolaurin has been shown to be active against influenzavirus, pneumovirus, paramyxovirus (Newcastle), morbillivirus (Rubeola), coronavirus, Herpes simplex I and II, CMV (cytomegalovirus), Epstein-Barr (EPV), and HIV, just to name a few. Some of the viruses monolaurin is not effective against include Polio, Coxsackie, Encephalomyocarditis, Rhinovirus and Rotavirus. In addition to its antiviral effects, monolaurin has also been shown to have antibacterial activity against Staphylococcus aureus, Streptococcus agalactiae, Chlamydia, H. pylori, and against yeast and fungi as well, including Candida and ringworm.

VRP: Youve also included extracts of Phyllanthus amarus and Phyllanthus urinaria. Could you address these and explain their specific actions?

Dr. Lieberman: Phyllanthus species have traditionally been used to treat jaundice and other general conditions of liver disease. Researchers have shown that phyllanthus extracts exhibit significant antiviral activity, primarily by inhibiting viral DNA replication of hepadnaviruses, a viral family including the human hepatitis B virus and several animal hepatitis viruses.

When researchers systematically reviewed 22 randomized trials they found that phyllanthus significantly reduced hepatitis B antigens while normalizing liver enzymes. Phyllanthus extracts were also found to enhance the effects of interferon therapy, while outperforming interferon in normalizing ALT levels.

A recently published German study shows that phyllanthus extracts also act as potent anti-inflammatory agents. When rat cells and whole human blood were treated to simulate liver damage, phyllanthus was shown to suppress production and or secretion of a number of pro-inflammatory chemicals, including endotoxin-induced nitric oxide synthase (NOS), cyclooxygenase (COX-2), and tumor necrosis factor (TNF-alpha) as well as other cytokines. This anti-inflammatory effect is important for aiding the liver in recovery from viral-induced damage and preventing cirrhosis and potential liver cancer.

VRP: I note that youve included R-Lipoic Acid, a potent antioxidant that weve seen a lot of new research on.

Dr. Lieberman: As mentioned earlier, antioxidants play a vital role in protecting liver cells from oxidative damage. Additionally, antioxidants have been shown to be effective in interfering with and disrupting viral proliferation. In one case study researchers treated 3 subjects randomly selected from a group of fifty patients diagnosed with cirrhosis from chronic hepatitis C infection. Each patient was treated with an antioxidant combination that included alpha-lipoic acid and selenium (as selenomethionine), along with silymarin, vitamins C and E and a multi-mineral. All patients recovered, showing a remarkable improvement in liver function and enzyme levels.

Most importantly, the patients avoided undergoing liver transplants. A liver transplant costs over $300,000 and transplanted livers frequently become infected with the virus again. Even more important is the fact that whereas five years ago only 20 percent of Hep C patients required a transplant, today the number has increased to 50 percent!

VRP: Earlier you mentioned that these substances were also effective for Chronic Fatigue Syndrome (CFS). Can you expand on this?

Dr. Lieberman: Yes. Chronic Fatigue Syndrome (CFS), also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), is characterized by incapacitating fatigue, profound exhaustion and an extreme lack of stamina. CFS is also associated with an inability to concentrate and loss of short-term memory. CFS often starts with symptoms that are viral in nature, including joint and muscle pain, poor sleep, swollen glands, sore throat, headache, fatigue and malaise. Recovery from CFS requires lots of rest and very long periods of convalescence. In fact, a hallmark of CFS is that any mental or physical activity leads to a profound fatigue that can require a full day for recovery.

VRP: Is there currently any cure or treatment for CFS or CFIDS?

Dr. Lieberman: Not really. Standard medicine can offer some support by treating individual symptoms, but currently there is no medical treatment or cure for CFS. One has to understand that diagnosing and treating CFS is complicated by the fact that the syndrome is associated with a number of viruses, including Epstein-Barr (EBV), CMV (cytomegalovirus), Human Herpes-virus (HHV)-6 and 7, retroviruses and enteroviruses (including polio and Coxsackie virus).

As mentioned earlier, glycyrrhizin can help to control many of the viruses implicated in CFS, including cytomegalovirus (CMV). In my experience glycyrrhizin is effective in treating CFS when taken in combination with the ingredients found in the VCF formula. For best results I put my clients on a comprehensive program that includes:

-Fish Oil (EPA/DHA): 6-9 caps per day
-Quercetin: 2-4 grams per day
-NAC: 2-4 grams per day
-Glutathione: 1-2 grams per day
-CoQ10: 100-200 mg per day

Other helpful substances include aloe vera, natural antifungals (Citricidal, berberine, oregano), medicinal mushrooms, bromelain, curcumin (turmeric), proanthocyanidins (grape seed extract), ginger, gingko biloba, and proteolytic enzymes. And, of course, I also recommend taking broad-spectrum multi-vitamin and multi-mineral supplements daily. (Additional information and expanded protocols are available online at www.drshari.net.)

VRP: Do you have any other comments to share regarding the VCF formula?

Dr. Lieberman: Just as my other formulas are intended for use with standard medical protocols, Viral Care Formula can be used alone or, concomitantly with current medical antiviral therapies. I believe that the best outcomes occur when VCF is taken in conjunction with medical supervision, particularly given the potential for glycyrrhizin to elevate blood pressure. The potential blood pressure effects are offset by the inclusion of potassium and cysteine in the formula, but I still recommend that patients monitor their blood pressure at least once or twice a week.


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