The eight types of hepatitis are A, B, C, D, E, autoimmune, alcoholic, and nonalcoholic steatohepatitis (NASH). Types A through E are caused by a blood-borne viral infection that causes inflammation in the liver. Autoimmune hepatitis, alcoholic hepatitis, and NASH are not caused by infection.

Hepatitis A: Hepatitis A can occur in isolated cases or spread among large groups of people. You can catch it from close personal contact with a person who has it or from food or water that has been contaminated.

It is usually a self-limiting illness with flulike symptoms. Once you’ve had hepatitis A, you cannot get it again. It may take several months to recover fully. A vaccine for people over the age of two is available for lifelong protection against hepatitis A.

Hepatitis B: Hepatitis B is the most common serious liver infection in the world and is more serious than hepatitis A. It can lead to cirrhosis, liver cancer, or liver failure. In most people, it is a self-limiting illness. But, 90 percent of infected babies, 30 to 50 percent of infected children, and 5 to 10 percent of infected adults will also develop a chronic infection.

A vaccine is available to help prevent hepatitis B infection. It is currently recommended that all babies be vaccinated. Each year 100,000 Americans contract hepatitis B and 5,000 to 6,000 Americans will die from it. It is estimated that 1.25 million Americans have chronic hepatitis B.

Worldwide, it affects 400 million people and there are 1 million deaths per year. It is passed directly through blood. Since 1992, blood collected for transfusions is carefully screened for hepatitis B (and C). Prior to that time, infection through blood transfusion was common.

You can get hepatitis B from having unprotected sex with someone who has it, by sharing needles for drug use or tattooing, or by an accidental needle poke with an infected needle. During childbirth, a mother could pass it on to her child.

Hepatitis C: Hepatitis C accounts for about 15 percent of acute viral hepatitis, 60 to 70 percent of chronic hepatitis, and up to 50 percent of cirrhosis, end-stage liver disease, and liver cancer. In America, four million people, or 18 percent of our population, have been diagnosed with antibodies to the disease.

This indicates that they currently have an infection or previously were exposed to the virus. There are 10,000 to 12,000 deaths each year because of hepatitis C. Seventy-five percent of people with acute hepatitis C will ultimately develop chronic hepatitis. Millions more of us may be infected but have not been diagnosed.

Many people with hepatitis C are asymptomatic and may not know they have the disease. In those who do have symptoms, they are generally mild and include fatigue, liver discomfort or tenderness, nausea, muscle and joint pains, and a poor appetite. The course of this disease varies radically.

No symptoms might occur for up to twenty years and liver enzymes might not be elevated. If a liver biopsy is performed and the injury is mild, the outcome is usually good. On the other hand, if severe symptoms occur and liver enzymes are elevated, many people will ultimately develop cirrhosis and end-stage liver disease.

Or the illness may be characterized by elevated liver enzymes with few symptoms, with an uncertain outcome. It is estimated that 20 percent of those with chronic hepatitis C will develop cirrhosis within ten to twenty years. After that time, a small group will develop liver cancer.

Hepatitis C is the most common reason for liver transplants. Hepatitis C is passed via blood. The hepatitis C virus was only isolated in 1988, so many people were infected by blood transfusion prior to that time. Since 1992, blood has been routinely screened for hepatitis.

You can get hepatitis C from having unprotected sex with someone who has it, by sharing needles for drug use or tattooing, or by an accidental needle poke with an infected needle. During childbirth, a mother could pass it to her child. In 10 percent of cases, the source of the infection is unknown.

Standard treatment for hepatitis C is interferon and antiviral medications. Their success rate is only 30 percent and the side effects can be severe. This is why so many people with chronic hepatitis are looking at alternative therapies. Patients on interferon therapy have found St.-John’s-wort and ginger to help with side effects of treatment.

Hepatitis D: You can only get hepatitis D if you already have hepatitis B. It exists as a co-infection. You contract it the same way you contract hepatitis B and C.

Hepatitis E: Hepatitis E spreads by consuming contaminated drinking water and food. At this point in time, the only Americans who contract this form of hepatitis get it outside of the country, probably in a developing nation. For best prevention, drink bottled water when traveling, and only use ice made with bottled water. Don’t eat raw shellfish, and avoid uncooked fruits and vegetables that are not peeled by you personally.

Autoimmune hepatitis: Autoimmune hepatitis occurs when your body’s immune system attacks your own liver cells and is probably due to a genetic defect. About 70 percent of people with this illness are women, and it’s usually diagnosed between the ages of fifteen and forty.

It is a long-term illness and if left untreated can lead to cirrhosis and eventual liver failure. With treatment, about 70 percent of people with autoimmune hepatitis go into remission or experience a decrease in symptoms. It is usually treated with prednisone and azathioprine, both of which have unwanted side effects.

About half also have another autoimmune illness, such as Hashimoto’s thyroiditis, Grave’s disease, Sjögren’s syndrome, ulcerative colitis, or autoimmune anemia. The most common symptoms are fatigue, enlarged liver, jaundice, itching, skin rashes, joint pain, lack of menstrual periods in women, and abdominal discomfort.

Alcoholic hepatitis: Alcoholic hepatitis is a self-inflicted, progressive liver disease caused by the toxicity of alcohol. Unlike hepatitis A, B, C, and D, it is not an infectious disease. It is also known as alcoholic steatohepatitis, acute hepatic insufficiency of patients with chronic alcoholism, florid alcoholic cirrhosis, subacute alcoholic cirrhosis, and fatty liver with hepatic failure.

Alcoholic liver disease affects more than two million people (1 percent of our population) but affects many more who remain completely asymptomatic. It is the fourth leading cause of death in urban adult men age twenty-four to sixty-five. It is estimated that up to 35 percent of heavy drinkers have alcoholic hepatitis.

This is often undetected until the disease has progressed. Women and nonwhite males are more susceptible to alcoholic liver damage with smaller amounts of alcoholic consumption. On average, it is estimated that men develop cirrhosis taking in about two ounces daily of ethanol, and women with less than one ounce daily.

This is an illness that can kill you. Overall, the one-year survival rate after hospitalization for alcoholic hepatitis is about 40 percent. Symptoms, when present, can include abdominal pain, fever, jaundice, and liver failure. It can progress to cirrhosis or liver cancer.

The long-term outcome depends on whether the person stops drinking alcohol and whether they have progressed to cirrhosis. If you have this and keep drinking alcohol, you will develop cirrhosis. If you stop drinking, it gradually resolves over a period of weeks to months.

People may experience a worsening of liver function during the first weeks of abstinence. Because of alcohol excess, many people with alcoholic hepatitis are malnourished and deficient in antioxidant nutrients. They drink instead of eating. Use of Tylenol while drinking alcoholic beverages is well documented to accelerate liver disease.

No one should drink booze and take Tylenol. N-acetyl cysteine (NAC), catechin (from green tea), and milk thistle (silymarin) have been shown to be helpful in recovery. Nonalcoholic steatohepatitis (NASH): NASH is another noninfectious type of hepatitis.

It also is called pseudoalcoholic hepatitis, diabetic hepatitis, fatty-liver hepatitis, and alcohol-like hepatitis. It causes few problems in most people who have it but can lead to cirrhosis. Children especially may experience vague discomfort located at the liver.

It often goes unrecognized but is common in those with elevated liver enzymes who have no other diagnosis. In a recent study of children with NASH, nearly all were very obese. NASH was first discovered in 1980. Until recently, it was believed to be primarily a disease that affected obese, diabetic women.

However, recent studies have shown that healthy, lean men, women, and children can all be affected. Inflammation of the liver, mitochondrial damage, and free radical pathology are apparent in this disease. Liver enzymes are elevated, and there is an increased need for antioxidant nutrients.

Iron, on the other hand, is a pro-oxidant. It has been shown that high iron levels accelerate progression of NASH. Ultimately, NASH is diagnosed with a liver biopsy. It is believed that a rich diet and lack of exercise can cause this illness. It can also be caused by drugs such as amiodarone, perhexiline maleate, glucocorticoids, synthetic estrogens, and tamoxifen.

Surgeries, such as jejunal bypass, gastroplasty (stomach stapling), biliopancreatic diversion, or extensive small bowel resectioning can also trigger NASH. If you are overweight and trying to lose weight, be sure to do so gradually. Quick weight loss can aggravate the disease.

Many people with hepatitis have no obvious symptoms. But when they do, the most common ones are fatigue, mild fever, headache, muscle aches, tiredness, loss of appetite, nausea, vomiting, and diarrhea. As the illness progresses, sufferers become jaundiced, which is evident by the yellow color of the skin and whites of the eyes.

They may experience stomach pain and have darkcolored urine with pale-colored bowel movements. Diagnosis of hepatitis is done with a routine blood test for liver enzymes. Further testing needs to be done to determine which type of hepatitis is present. A liver biopsy may be performed.

It is well documented that people with hepatitis have an increased need for antioxidants. While much more research could be done in this area, taking antioxidants offers a simple and effective way to help protect liver function. It is advisable to take several antioxidant nutrients either in combination or separately.

Antioxidants include: vitamin C, E, selenium, N-acetyl cysteine, lipoic acid, S-adenosylmethionine (SAMe), flavonoids, and many herbs have antioxidant properties as well. In foods, they are found in fruits and vegetables, preferably fresh and organically grown. Bert Berkson, M.D., is one of the leading experts on lipoic acid.

He reports that a combination of lipoic acid, selenium, and milk thistle rapidly dropped viral levels and brought three of his patients with hepatitis C back to normal health. Dosages were 300 milligrams of lipoic acid twice daily, 300 milligrams of milk thistle three times daily, and 200 micrograms of selenomethionine once daily.

He is currently doing a larger study using these three antioxidants. In a German study from 1976, forty-two patients with hepatitis were given intravenous lipoic acid. The treatment showed promise for many of the patients and, because of the low toxicity and lack of side effects, was recommended for long-term treatment.

Rest, sleep, and healthful eating help with an easy recovery. It’s also critically important not to drink any alcohol because alcohol is a direct liver toxin. If you are planning on traveling outside of North America, check to see if you are going to a country with known hepatitis problems.

You may want to get vaccinated against hepatitis A and B before you go. There are a huge number of nutrients, antioxidants, herbs, flavonoids, and phytonutrients that may be beneficial in helping reduce symptoms and the long-term effects of hepatitis and cirrhosis.

I found information on hepatitis and B-complex vitamins, phyllanthus, shiitake mushrooms, astragalus, fenugreek, schizandra, andrographis, phosphatidylcholine, thymus extract, chlorophyll, and many more natural compounds. If you don’t find something here that really helps, keep looking. I could have spent weeks researching this one topic.

Hepatitis is a serious illness. For best results, these healing options are meant to be used in combination. You don’t need to use them all, but pick several at least.

• Avoid alcoholic beverages. Alcohol is damaging to the liver. Don’t drink if you have any type of hepat

• Eat lots of fruits and vegetables. They contain antioxidant nutrients, vitamins, and minerals that help support your immune system. Eat at least five servings daily, preferably a lot more. Fresh juicing of organic vegetables is a great way to quickly multiply your nutrients and antioxidants.

• Take a multivitamin with minerals. Cover your bases. A good multivitamin will have base amounts of antioxidants, vitamins, and minerals. Look for one with at least 400 IU of vitamin E, 200 micrograms of selenium, and 250 milligrams or more of vitamin C.

• Take vitamin C. Studies have shown vitamin C levels to be very low in people with hepatitis. Vitamin C is well known for its antiviral and antioxidant effects. Much research was also done in the 1970s and early 1980s on vitamin C’s ability to naturally stimulate interferon production.

Interferon is the drug treatment of choice for people with chronic hepatitis (hepatitis C). Interferon is isolated at great expense, is only 30 percent effective, and the side effects make many people decide not to even try it. Linus Pauling theorized that vitamin C could be used to increase natural production of interferon.

Other researchers also reported that this was so. Robert Cathcart, M.D., a long-standing advocate of complementary medicine, uses high doses of intravenous vitamin C for hepatitis. He found that with doses of 40 to 100 grams, he was able to greatly improve symptoms in two to four days and clear jaundice within six days.

Other people have found similar effects. As little as 2 grams was able to prevent hepatitis B in hospitalized patients. However, there is little published research specifically on vitamin C and hepatitis. At a minimum, I recommend taking 2,000 milligrams of vitamin C daily.

Preferably, use dosages up to bowel tolerance and recalibrate your dosage every week. Determine your personalized dosage with a vitamin C flush.

• Take zinc. People with hepatitis are commonly zinc deficient. Zinc helps with healing of tissues and is important for prevention of scarring. Take 50 to 75 milligrams daily.

• Try whey protein or transfer factor. There are numerous studies on the use of transfer factor in people with hepatitis. They have been very positive. Transfer factor is isolated from cow colostrum, and is loaded with protective antibodies that help us fight infection.

A current study also demonstrates that a whey protein product called Immunocal was shown to be effective in patients with hepatitis B, but not hepatitis C. Take 12 to 30 grams of whey protein, daily and 300 milligrams transfer factor, 1 to 2 times daily.

• Try N-acetyl cysteine (NAC). Several research studies have found that glutathione levels are inversely related to the viral loads for hepatitis B and C. German researchers found that when NAC was added to hepatitis cultures, viral load decreased fifty fold. Take 1,000 to 2,000 micrograms twice daily.

• Try lipoic acid. Lipoic acid, also called thiotic acid, is a strong antioxidant and has been shown to be liver protective in mushroom and chemical poisoning. In studies with chemically induced hepatitis, lipoic acid has been shown to be effective in treatment. Take 200 to 300 milligrams twice daily.

• Try S-adenosylmethionine (SAMe).SAMe was given to 220 patients with liver disease. Twenty-six percent of them had hepatitis. There was a reduction of symptoms of itching and fatigue and an improved sense of well-being. Laboratory testing of conjugated bilirubin and alkaline phosphatase showed significant improvement. Patients were given 1,600 milligrams daily.

• Take vitamin E. People with hepatitis have lower levels of vitamin E. A 2001 pilot study published in Antiviral Research studied people with hepatitis B. Thirty-two patients were given either 300 IU of vitamin E twice daily for three months or no treatment. They were followed for one year.

In the vitamin E group, 47 percent (seven patients) had normalized alanine aminotransferase (ALT), a liver enzyme. Only one of the controls normalized ALT. Hepatitis B DNA was normalized in 53 percent of the vitamin E group and in only 18 percent in the control group.

A normalization of both ALT and DNA was seen in 47 percent of the vitamin E group and none of the control group. In another study, people with hepatitis B were given 600 IU of vitamin E daily for nine months. All symptoms of hepatitis disappeared in five of the twelve people tested.

In yet another study, looking this time at people with hepatitis C, there was some additional improvement when people were given 544 IU of vitamin E with interferon therapy. And in a different study, people with hepatitis C were given 400 IU of vitamin E twice daily for twelve weeks.

There was improvement in eleven out of twenty-three patients, 48 percent. ALT levels were decreased by 45 percent and AST, a liver enzyme, decreased 37 percent after a six-month follow-up. Vitamin E is nontoxic and worth trying in all types of hepatitis. Take 600 to 1,000 IU of vitamin E daily. Look for d-alphatocopherol and mixed tocopherols, rather than dl-alphatocopherol.

• Try milk thistle or Silybum marianum (silymarin). Milk thistle has been used for liver protection for centuries and has few side effects. There is currently an ongoing human study sponsored by the National Center for Complementary and Alternative Medicine (NCCAM) at the NIH.

They hope the research will show if silymarin reduces symptoms in people with hepatitis C and/or cirrhosis, whether it prevents the progression of liver disease in people with hepatitis C but who have normal liver enzyme levels, whether it helps clear up the infections, and finally whether it improves people’s quality of life.

Another study at the NIH is looking at optimal dosages of silymarin. Silymarin has already been shown to be useful in people with cirrhosis caused by alcohol abuse. Look for a product that has been standardized for silymarin content. A company that has done that will clearly label it on the bottle. Take 420 milligrams daily.

• Try Picrorhiza kurroa. Picrorhiza, an herb commonly used in Ayurvedic medicine, has been less well studied than milk thistle, but studies indicate that it is equally effective with nearly identical effects. It has anti-inflammatory and liver protective properties.

Indian researchers also used Picrorhiza in acute hepatitis A and showed it to be helpful in a speedy recovery. Take 400 to 1,500 milligrams in capsules.

• Try licorice. Licorice has been shown to reduce elevated liver enzymes in people with hepatitis. It appears to be the glycyrrhizin that tempers NF-kappa B and inflammatory cytokines. It also naturally raises the body’s interferon levels. In Japan, it is often used intravenously for hepatitis B and C. Glycyrrhizin can elevate blood pressure levels, so use with caution.

• Try sho-saiko-to. Sho-saiko-to is a Chinese remedy that contains bupleurum and other traditional Chinese herbs. Several trials were done in people with hepatitis B infection and one small trial in people with hepatitis C. Sho-saiko-to helps reduce symptoms and normalize blood liver enzymes in people with active viral hepatitis.

It has also been found to help reduce the incidence of liver cancer in people with hepatitis. Take 2.5 grams three times daily. It should not be used in combination with interferon therapy.

• Take catechins. Catechins are a type of flavonoids found in green tea. Study results have been mixed, but favorable results have been seen in dosages of 500 to 750 milligrams three times daily. A recent Chinese study on ducklings showed significant reduction in liver damage and protected liver function.

In two recent studies, catechin was found to reduce liver damage and hepatitis that was chemically induced by halothane, an anesthetic drug used in surgery. Halothane is known to induce hepatitis in people. Regarding dosage, I recommend that you drink green tea as often as you like.

• Drink Rooibos tea (Aspalathus linearis).Rooibos tea is also called red tea. It is a relatively new food product and offers a delicious caffeine-free alternative to people who drink tea. Research was done in rats, but I was delighted to see that, at least in this initial report, it showed a regression of liver damage and cirrhosis and a lowering of liver enzymes (ALT and AST).

The researchers consider it to be a useful plant for patients with liver disease. Other studies show it to have antioxidant effects. It appears to have the same properties as green tea. I recommend that you drink it as often as you like.

• Try quercetin. Another flavonoid with antioxidant effects is quercetin. Although studies need to be done in people, animal research shows that treatment with quercetin dehydrate reduced oxidative damage from hepatitis twofold. Another mouse study found liver protective effects of quercetin when combined with amla.

Bougainvillea spectabilis has been used in Chinese folk medicine for treatment of hepatitis. The active component of Bougainvillea is quercetin. Take 1,000 to 3,000 milligrams of quercetin daily, plus 900 to 2,700 milligrams of amla daily.