Many Ways to Love Your Liver

Many Ways to Love Your Liver

(reprinted from the NYBC SUPPLEMENT, Summer 2008)

Liver impairment is a frequent concern for people with HIV. There are many different causes, including co-infection with hepatitis, HIV meds that put added stress on the liver, excessive alcohol or recreational drug use, opportunistic infections, repeated resort to antibiotics, or just consuming big doses of the over-processed, nutrient-poor junk that too often passes for food these days! (By the way, we like the rule of thumb for choosing good stuff at the supermarket: if your grandmother wouldn’t recognize the item as “food”—then it’s probably not very good for you.)

The liver is crucial for processing and breaking down wastes, whether those produced by normal body functioning or those absorbed into the system in the form of drugs, alcohol, or toxins. So keeping it in good repair is essential for health. One specific strategy to support liver function is to maintain levels of the intracellular (= “found within cells”) antioxidant glutathione, which plays a key role in protecting the liver as it performs its detoxification duties. Here is a short list of nutritional supplements that are frequently recommended for this purpose: Vitamin C (2–6 grams per day, in divided doses); N-acetyl-cysteine, or NAC (500 mg, 3 times per day); alpha-lipoic acid (300-600 mg, twice daily). (Note that NAC and Lipoic can be taken in the combination form ThiolNAC, one of the key supplements stocked by NYBC.)

Another worthy option for countering stresses to the liver is an herb called Milk Thistle (Silybum marianum), which has a long tradition of use as a botanical remedy. Modern research has isolated compounds referred to as silymarin within this plant, and many studies have pointed to silymarin’s effectiveness in protecting liver cells from toxic chemicals, and even in stimulating the repair and regeneration of liver cells. In 2007, a federally funded investigation identified one component of milk thistle as a potent anti-cancer agent, and suggested that it held much promise in protecting against or treating liver cancer. Be advised that if you consult sources such as the Canadian AIDS Treatment Information Exchange (CATIE) website, you may encounter concerns about whether silymarin interferes with HIV meds. But here’s what one National Institutes of Health study concluded: “Milk thistle in commonly administered dosages should not interfere with indinavir therapy in patients infected with the human immunodeficiency virus.” This and other research, we believe, suggests that milk thistle-HIV med interference is not actually a very signficant issue.

Now here’s a rather unusual dietary supplement that has been investigated for liver health: S-adenosylmethionine (SAM-e). First isolated by Italian researchers in the 1950s, SAMe is synthesized by living cells from the amino acid methionine and can’t be supplemented from food sources. In several European studies of people living with hepatitis B or C, it has been shown to help reduce jaundice, fatigue, and other symptoms. And it’s also been applied to treating alcohol-related damage to the liver. The unusual aspect of SAMe is that there’s also a great deal of published research on its value as an antidepressant and as a treatment for arthritis—so it’s quite a versatile molecule! (See the NYBC Blog at http://www.nybc.wordpress.com for more details.)

Last, we note that the New York Buyers’ Club, like its predecessor DAAIR, has carefully followed the modern, US-based study and dissemination of traditional Chinese herbal remedies for liver disease. For example, NYBC stocks Pacific Biologic’s Hepato-C and Hepato-Detox, and, more recently, has added Health Concern’s Hepatoplex One and Hepatoplex Two to its product list. Both of these California-based companies have a very good reputation for quality, and both have devised blends based on Traditional Chinese Medicine as well as current clinical experience by licensed practitioners. (Please consult the NYBC website for more information about the specific herbs in these formulas, as well as recommendations for their use.) Of course we’re always interested in hearing about the experience of our members in using these products, and so we welcome your comments and questions—just email us at contact@newyorkbuyersclub.org.

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PharmaNAC (effervescent n-acteylcysteine) and MAC-Pack (K-Pax alternative)

A few words about PharmaNAC, an effervescent NAC (n-acetylcysteine) that the New York Buyers’ Club has been supplying in the past year. This form of NAC has proven especially useful to people with respiratory conditions like chronic bronchitis. And we were interested to read recently of a person with cystic fibrosis reporting on her use of PharmaNAC.

NAC in various forms has been researched and used more widely in Europe than in the US, although some influential work on this supplement for people with HIV was conducted at Stanford back in the 1990s, and helped lead, for example, to the inclusion of NAC in K-Pax, a multivitamin antioxidant combination that showed significant enough benefit to be added to state government-financed formularies for people with HIV.

NYBC originally imported a German effervescent NAC called ACC Akut (Hexal), but we were delighted when a North American supplier began to offer the very similar PharmaNAC, which we have stocked for the past year. (PharmaNAC is actually a higher dose of NAC per tab–900mg–than ACC Akut’s 600mg, though we have been able to keep the price about the same due to lower shipping costs.)

NYBC’s mission as a nonprofit buyers’ co-op also motivated us to devise a low-cost alternative to K-Pax for those who don’t have access to subsidized versions of this product. The NYBC MAC-Pack provides a close equivalent to K-Pax, but the cost has been brought down to less than half that of K-Pax.

Note: it’s also possible to order non-effervescent NAC and ThiolNAC separately:

NAC 500mg/90 tabs

ThiolNAC (500mg NAC and 200mg alpha lipoic acid/90 tabs)

ThiolNAC (NAC + alpha lipoic acid combination) is back at NYBC

ThiolNAC, a combination of the two antioxidants NAC (N-Acetyl-Cysteine) and Alpha Lipoic Acid, is again available as a combination supplement from the New York Buyers’ Club. The manufacturer of this supplement is Montiff, which also produced NYBC’s previous version of ThiolNAC.

ThiolNAC (NYBC): NAC 500mg, Lipoic 200mg [90 tablets/bottle].

NAC (N-acetyl-cysteine) is recommended for its antioxidant properties and because studies have suggested it may improve immune function. Often used in Europe to treat chronic bronchitis and chronic sinusitis. Also recommended if you are taking acetaminophen (Tylenol). Alpha Lipoic Acid is widely recognized as a potent antioxidant and liver protective agent. Research suggests it has the capacity to protect many organs and tissues from damaging inflammation due its antioxidant power. Long used to treat neuropathy in diabetics.

Note: ThiolNAC can be used to replace the separate NAC and Lipoic components of NYBC’s MAC (Multivitamin Antioxidant Combo) Pack, the purchasing co-op’s low-cost alternative to K-Pax.