Complementary Medicine - Cam
Liver Cirrhosis (Holistic)
About This Condition
Get added support for this serious disease by taking care of your nutritional needs. According to research or other evidence, the following self-care steps may be helpful.
About This Condition
Cirrhosis is a condition of severe damage to the liver that impairs its ability to function normally.
In the United States, the most common cause of liver cirrhosis is chronic alcoholism . Liver cirrhosis may also result from chronic viral infection of the liver ( hepatitis types B, C, and D) and a number of inherited diseases, such as cystic fibrosis , hemochromatosis, and Wilson’s disease . If severe, liver cirrhosis may lead to liver failure and death. In the Western world, liver cirrhosis is the third leading cause of death in people from ages 45 to 65 (after cardiovascular disease and cancer).1 Liver cirrhosis may also cause a dangerous brain abnormality called portal-systemic encephalopathy (PSE), which may lead to coma. Another form of cirrhosis, primary biliary cirrhosis (PBC), damages the bile ducts in the liver, and occurs primarily in women over 35 years of age. The cause of PBC is not known.
Many people with cirrhosis have no symptoms for years. Others may have weakness, loss of appetite, malaise, and weight loss. With blocked bile flow, it is common for people with cirrhosis to have jaundice, itching, and fatty yellow skin nodules. Later in the disease, there may be massive bleeding inside the throat, brain abnormalities due to accumulation of ammonia in the blood, liver failure, and death.
Healthy Lifestyle Tips
Alcoholism is the leading cause of liver cirrhosis in the Western world. Drinking too much alcohol also impairs the absorption and accelerates loss of several nutrients.2 , 3 , 4 Therefore, avoidance of alcohol is strongly recommended for people with liver cirrhosis. Alcohol is directly toxic to the liver. In people with alcohol-induced liver cirrhosis, even moderate alcohol consumption increases the risk of portal hypertension, a dangerous blood pressure abnormality in the liver’s circulation.5
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
What Are Star Ratings?
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
1. Beers MH, Berkow R (eds). The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck and Co., Inc., 1999, 372–4.
2. Halsted CH. Alcohol: medical and nutritional effects. In Ziegler EE, Filer LJ (eds). Present Knowledge in Nutrition, 7th ed. ILSI Press, Washington, DC, 1996, 553.
3. Roggin GM, Iber FL, Kater RM, Tabon F. Malabsorption in the chronic alcoholic. Johns Hopkins Med J 1969;125:321–30.
4. Roggin GM, Iber FL, Linscheer WG. Intraluminal fat digestion in the chronic alcoholic. Gut 1972;13:107–11.
5. Luca A, Garcia-Pagan JC, Bosch J, et al. Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis. Gastroenterology 1997;112:1284–9.
6. Lochs H, Plauth M. Liver cirrhosis: rationale and modalities for nutritional support—the European Society of Parenteral and Enteral Nutrition consensus and beyond. Curr Opin Clin Nutr Metab Care 1999;2:345–9.
7. Lieber CS. Nutrition in liver disorders. In: Shils ME, Olson JA, Shike M, Ross AC (eds). Modern Nutrition in Health and Disease, 9th ed. Baltimore, MD: Williams and Wilkins, 1999, 1179–80.
8. Rodriguez-Moreno F, Gonzalez-Reimers E, Santolaria-Fernandez F, et al. Zinc, copper, manganese, and iron in chronic alcoholic liver disease. Alcohol 1997;14:39–44.
9. Gibbs K, Walshe JM. Studies with radioactive copper (64 Cu and 67 Cu); the incorporation of radioactive copper into caeruloplasmin in Wilson’s disease and in primary biliary cirrhosis. Clin Sci 1971;41:189–202.
10. Lieber CS. Nutrition in liver disorders. In: Shils ME, Olson JA, Shike M, Ross AC (eds). Modern Nutrition in Health and Disease, 9th ed. Baltimore, MD: Williams and Wilkins, 1999:1179–80.
11. Mato JM, Camara J, Fernandez de Paz J, et al. S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial. J Hepatol 1999;30:1081–9.
12. Miglio F, Stefanini GF, Corazza GR, et al. Double-blind studies of the therapeutic action of S-Adenosylmethionine (SAMe) in oral administration, in liver cirrhosis and other chronic hepatitides. Minerva Med 1975;66:1595–9 [In Italian].
13. Gorbakov VV, Galik VP, Kirillov SM. Experience in heptral treatment of diffuse liver diseases. Ter Arkh 1998;70:82–6 [in Russian].
14. Loguercio C, Nardi G, Argenzio F, et al. Effect of S-adenosyl-L-methionine administration on red blood cell cysteine and glutathione levels in alcoholic patients with and without liver disease. Alcohol Alcohol 1994;29:597–604.
15. Frezza M, Centini G, Cammareri G, et al. S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepatogastroenterology 1990;37 Suppl 2:122–5.
16. Frezza M, Surrenti C, Manzillo G, et al. Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study. Gastroenterology 1990;99:211–5.
17. Malaguarnera M, Gargante MP, Cristaldi E, et al. Acetyl-L-carnitine treatment in minimal hepatic encephalopathy. Dig Dis Sci 2008;53:3018–25.
18. Malaguarnera M, Vacante M, Giordano M, et al. Oral acetyl-L-carnitine therapy reduces fatigue in overt hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr. 2011;93:799–808
19. Liu Q, Duan ZP, Ha DK, et al. Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology 2004;39:1441–9.
20. Lieber CS. Nutrition in liver disorders. In: Shils ME, Olson JA, Shike M, Ross AC (eds). Modern Nutrition in Health and Disease, 9th ed. Baltimore, MD: Williams and Wilkins, 1999, 1179–80.
21. Beers MH, Berkow R (eds). The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck and Co., Inc., 1999, 362–4.
22. Nompleggi DJ, Bonkovsky HL. Nutritional supplementation in chronic liver disease: an analytical review. Hepatology 1994;19:518–33 [review].
23. Horst D, Grace ND, Conn HO, et al. Comparison of dietary protein with an oral, branched chain-enriched amino acid supplement in chronic portal-systemic encephalopathy: a randomized controlled trial. Hepatology 1984;4:279–87.
24. Okita M, Watanabe A, Nagashima H. Treatment of liver cirrhosis with branched chain amino acid-supplemented diet. Gastroenterol Jpn 1981;16:389–92.
25. Maddrey WC. Branched chain amino acid therapy in liver disease. J Am Coll Nutr 1985;4:639–50 [review].
26. Wahren J, Denis J, Desurmont P, et al. Is intravenous administration of branched chain amino acids effective in the treatment of hepatic encephalopathy? A multicenter study. Hepatology 1983;3:475–80.
27. Egberts E-H, Schomerus H, Hamster W, Jürgens P. Branched chain amino acids in the treatment of latent portosystemic encephalopathy. A doublel-blind placebo-controlled crossover study. Gastroenterology 1985;88:887–95.
28. Muto Y, Sato S, Watanabe A, et al. Effects of oral branched-chain amino acid granules on event-free survival in patients with liver cirrhosis. Clin Gastroenterol Hepatol 2005;3:705–13.
29. Dioguardi FS, Brigatti M, Dell’Oca M, et al. Effects of chronic oral branched-chain amino acid supplementation in a subpopulation of cirrhotics. Clin Physiol Biochem 1990;8:101–7.
30. Marchesini G, Dioguardi FS, Bianchi GP, et al. Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy. A randomized double-blind casein-controlled trial. The Italian Multicenter Study Group. J Hepatol 1990;11:92–101.
31. Chin SE, Shepherd RW, Thomas BJ, et al. Nutritional support in children with end-stage liver disease: a randomized crossover trial of a branched-chain amino acid supplement. Am J Clin Nutr 1992;56:158–63.
32. Kato M, Miwa Y, Tajika M, et al. Preferential use of branched-chain amino acids as an energy substrate in patients with liver cirrhosis. Internal Med 1998;37:429–34.
33. Stauch S, Kircheis G, Adler G, et al. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study. J Hepatol 1998;28:856–64.
34. Kircheis G, Nilius R, Held C, et al. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology 1997;25:1351–60.
35. Staedt U, Leweling H, Gladisch R, et al. Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. J Hepatol 1993;19:424–30.
36. Salmi HA, Sarna S. Effect of silymarin on chemical, functional and morphological alterations of the liver. A double-blind controlled study. Scand J Gastroenterol 1982;17:517–21.
37. Feher J, Deak G, Muzes G, et al. Liver-protective action of silymarin therapy in chronic alcoholic liver diseases. Orv Hetil 1989;130:2723–7 [in Hungarian].
38. Muzes G, Deak G, Lang I, et al. Effect of silymarin (Legalon) therapy on the antioxidant defense mechanism and lipid peroxidation in alcoholic liver disease (double blind protocol.) Orv Hetil 1990:131:863–6 [in Hungarian].
39. Velussi M, Cernigoi AM, De Monte A, et al. Long-term (12 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol 1997;26:871–9.
40. Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105–13.
41. Velussi M, Cernogoi AM, De Monte A, et al. Long-term (12 months) treatment with an antioxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatology 1997;26:871–9.
42. Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a double-blind, randomized and multicenter trial. J Hepatol 1998;28:731–3.
43. Kumada T, et al. Effect of shakuyaku-kanzo-to (Tsumura TJ-68) on muscle cramps accompanying cirrhosis in a placebo-controlled double-blind parallel study. J Clin Ther Med 1999;15:499–523.
44. Ma X, Zhao J, Lieber CS. Polyenylphosphatidylcholine attenuates non-alcoholic hepatic fibrosis and accelerates its regression. J Hepatol 1996;24:604–13.
45. Lieber CS, Robins SJ, Leo MA. Hepatic phosphatidylethanolamine methyltransferase activity is decreased by ethanol and increased by phosphatidylcholine. Alcohol Clin Exp Res 1994;18:592–5.
46. Lieber CS, Robins SJ, Li J, et al. Phosphatidylcholine protects against fibrosis and cirrhosis in the baboon. Gastroenterology 1994;106:152–9.
47. Lieber CS, DeCarli LM, Mak KM, et al. Attenuation of alcohol-induced hepatic fibrosis by polyunsaturated lecithin. Hepatology 1990;12:1390–8.
48. Fassati P, Horejsi J, Fassati M, et al. Essential choline phospholipids and their effect on HBsAg and selected biochemical tests in cirrhosis of the liver. Cas Lek Cesk 1981 22;120:56–60 [in Czech].
49. Suryakumar G, Gupta A. Medicinal and therapeutic potential of Sea buckthorn (Hippophaerhamnoides L.). J Ethnopharmacol 2011;138:268-78.
50. Huang DL, Chang XZ, Gui HN, et al. Analysis of 156 cases of chronic hepatitis treated with sea buckthorn. ZhongxiyiJieheZazhi 1991;11:697-6980 [in Chinese].
51. Gao ZL, Gu XH, Cheng FT, Jiang FH. Effect of sea buckthorn on liver fibrosis: a clinical study. World J Gastroenterol 2003;9:1615-7.
52. Yamamoto M, Oka H, Kanno T, et al. Controlled prospective trial to evaluate sho-saiko-to for the prevention of hepatotcellular carcinoma in patients with cirrhosis of the liver. Gan To Kagaku Ryoho (Jpn J Cancer Chemother) 1989;16:1519–24 [in Japanese].
53. Taniguchi S, Kaneto K, Hamada T. Acquired zinc deficiency associated with alcoholic liver cirrhosis. Int J Dermatol 1995;34:651–2.
54. Scholmerich J, Lohle E, Kottgen E, Gerok W. Zinc and vitamin A deficiency in liver cirrhosis. Hepatogastroenterology 1983;30:119–25.
55. Reding P, Duchateau J, Bataille C. Oral zinc supplementation improves hepatic encephalopathy. Results of a randomised controlled trial. Lancet 1984;2(8401):493–5.
56. Marchesini G, Fabbri A, Bianchi G, et al. Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis. Hepatology 1996;23:1084–92.
57. Takuma Y, Nouso K, Makino Y, et al. Clinical trial: oral zinc in hepatic encephalopathy. Aliment Pharmacol Ther 2010;32:1080–90
58. Sturniolo GC, D’Inca R, Parisi G, et al. Taste alterations in liver cirrhosis: are they related to zinc deficiency? J Trace Elem Electrolytes Health Dis 1992;6:15–9.
59. Weismann K, Christensen E, Dreyer V. Zinc supplementation in alcoholic cirrhosis. A double-blind clinical trial. Acta Med Scand 1979;205(5):361–6.
60. Vlahcevic ZR, Miller JR, Farrar JT, Swell L. Kinetics and pool size of primary bile acids in man. Gastroenterology 1971;61:85–90.
61. Angulo P, Batts KP, Therneau TM, et al. Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis. Hepatology 1999;29:644–7.
62. Larghi A, Crosignani A, Battezzati PM, et al. Ursodeoxycholic and tauro-ursodeoxycholic acids for the treatment of primary biliary cirrhosis: a pilot crossover study. Aliment Pharmacol Ther. 1997;11:409–14.
63. Crosignani A, Battezzati PM, Setchell KD, et al. Tauroursodeoxycholic acid for treatment of primary biliary cirrhosis. A dose-response study. Dig Dis Sci 1996;41:809–15.
64. Setchell KD, Rodrigues CM, Podda M, Crosignani A. Metabolism of orally administered tauroursodeoxycholic acid in patients with primary biliary cirrhosis. Gut 1996;38:439–46.
65. Ferri F, Bernocchi P, Fedeli S. Taurodeoxycholic acid in the treatment of primary biliary cirrhosis. A controlled study in comparison to ursodeoxycholic acid. Clin Ter 1993;143:321–6 [in Italian].
66. Pares A, Caballeria L, Rodes J, et al. Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. UDCA-Cooperative Group from the Spanish Association for the Study of the Liver. J Hepatol 2000;32:561–6.
67. Pugliese D, Sabba C, Ettorre G et al. Acute systemic and splanchnic haemodynamic effects of l-carnitine in patients with cirrhosis. Drugs Exp Clin Res 1992;18:147–53.
68. Burk RF, Early DS, Hill KE, et al. Plasma selenium in patients with cirrhosis. Hepatology 1998;27:794–8.
69. Feher J, Lengyel G, Blazovics A. Oxidative stress in the liver and biliary tract diseases. Scand J Gastroenterol Suppl 1998;228:38–46.
70. Van Gossum A, Neve J. Low selenium status in alcoholic cirrhosis is correlated with aminopyrine breath test. Preliminary effects of selenium supplementation. Biol Trace Elem Res 1995;47:201–7.
71. Ferro D, Basili S, Practico D, et al. Vitamin E reduces monocyte tissue factor expression in cirrhotic patients. Blood 1999;93:2945–50.
72. de la Maza MP, Petermann M, Bunout D, Hirsch S. Effects of long-term vitamin E supplementation in alcoholic cirrhotics. J Am Coll Nutr 1995;14:192–6.
Last Review: 10-15-2013
Copyright © 2013 Aisle7. All rights reserved. Aisle7.com
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.