Sunday, July 18, 2010

The Liver Clock by.... Nicole Cutler, L.Ac.

Hepatitis C

July 6, 2010

While most of us check the time throughout the day to stay on schedule, few realize that the liver also has a timed agenda. By heeding your liver's innate clock, those with Hepatitis C can help relieve some of the extra burden on this multitasking organ.

by Nicole Cutler, L.Ac.

Chronic Hepatitis C is a worldwide problem, infecting the livers of an estimated four million people in the U.S. alone. Until a guaranteed cure is devised for Hepatitis C, those with the virus must make every effort to support their liver's health by relieving it of unnecessary tasks. While there are a variety of strategies employed to support liver health, one that is often overlooked is working with the liver's schedule.

In charge of a long list of life-sustaining functions, the liver is an extremely busy organ. A few of its crucial duties, include:

• Producing bile, which helps carry away waste and breaks down fats in the small intestine during digestion.
• Producing certain proteins for blood plasma.
• Making cholesterol and special proteins to help carry fats through the body.
• Converting excess glucose into glycogen for storage.
• Converting poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine).
• Clearing the blood of drugs and other poisonous substances.
• Resisting infections by producing immune factors and removing bacteria from the bloodstream.
Not surprisingly, the liver can't accomplish all of its amazing feats simultaneously. All of the body's organs, including the liver, have periodic cycles where different functions are emphasized at different times. The liver is no different, with a cycle completing every 24 hours.

The Liver Cycle

Although scientists are just beginning to recognize the phases of the liver's cycle, the following appear to describe the hepatic clock:

• The liver synthesizes complex chemicals and processes toxins the most when the production of bile is lowest.
• Along the same lines, chemical synthesis and toxin processing is lowest while the liver's production of bile is highest.
• Because bile is needed for food processing, the liver makes a greater proportion during the day - and less at night.
• Bile production is assumed to be at its highest at 9am and lowest at 9pm.
• After 9pm, the liver switches to its other primary functions, synthesizing chemicals and processing accumulated toxins.
• The cycle begins shifting around 3am, when the liver slows chemical synthesis and readies itself for bile production.
• The liver cycle shifts again around 3pm, when chemical synthesis begins to increase and bile production decreases.

Thus, the liver is most prepared to aid digestion with its synthesis of bile between 9am and 9pm. This is important information for those with chronic Hepatitis C who want to work with - and not against their liver.

Practical Application of the Liver Clock

Although our busy lifestyles often dictate when we eat and when we sleep, those with Hepatitis C could benefit from scheduling necessities around their liver's needs. Since bile production is down late at night, eating a big meal past 9pm puts an additional strain on the liver. Thus, experts advise eating the last meal of the day long before the nine o'clock hour.

In addition, the liver's schedule of producing chemicals and detoxification (crucial for liver health) is best accomplished without additional demands. For this reason, most experts suggest retiring for the night close to 9pm whenever possible. Although this seems extremely early for many adults, those who try it report achieving a deeper and more restful sleep.

The liver's clock may not mesh with a modern, busy schedule. However, eating early and going to bed early cooperates with your liver's natural rhythm. By taking small steps to conform to your liver's cycle, those with Hepatitis C can remove the extra challenge that multitasking can place on their liver.

Buhner, Stephen Harrod, Herbs for Hepatitis C and the Liver, Storey Publishing, North Adams, MA, 2000: p 18-19., Peripheral Circadian Clocks Take Center Stage in Homeostasis, Alyssa Kneller, Retrieved September 21, 2009, Focus, Harvard Medical, Dental and Public Health Schools, September 2008., The Liver: Anatomy and Functions, Retrieved September 21, 2009, The University of Virginia, 2009., Key Liver Functions, Retrieved September 18, 2009,, 2009.

Saturday, July 3, 2010

Janet’s Story.....................

It was suppose to be a routine annual physical, I got blood taken and I really didn’t think much about it. When his office called and said he wanted to see me, I thought it odd but when we met he said my cholesterol seemed to spike which was unusual for me and we took blood again. So when they called me two days later and asked to see me again, I was suspicious. I never felt tired or run down or had any symptoms I associated with Hep C. I thought only people who used needles got it, so I was angry and dismissive when he told me to see a gastroenterologist and get properly tested, I was convince he was just wrong.

I had a friend who was a doctor at NYU I called her and she recommended Dr Tobias, after checking him out and see how well respected in the field he was, I made an appt to go see him, I was pretty freaked out by this time. I had gone online wanting to be more informed about what this Hepatitis C virus was about and had read so many scary stories on line and statistic I literally thought I was going to die.
I must say going to see a specialist like Dr. Tobias was the best thing I could have done. He assured me I wasn’t going to die anytime soon and say about 80% of his patients find out they are infected like I did. He mapped out what needed to be done – more blood test, and a liver biopsy, which we did about 2 months after my first visit. It was confirmed I had it and was currently at Level 1, the doctor told me about my options which consisted of starting treatment (Peginterferon and Ribovirin) which after learning about it and speaking to a dozen people who had been thru this treatment I decided to hold off, it seemed very toxic to me and the side effects too great. Again I’m feeling fine and hadn’t had any symptoms so the idea of under going thru such a treatment for a year wasn’t appealing. Dr Tobias was patient with me, he knew I wasn’t in any danger and I saw him very few months and he monitored my blood.

I decided to do what I could to help myself, I stopped drinking (not that I was a big drinker but even socially) I started eating better and upped my work out schedule

and tried to not get too stressed out (stress effects the liver). I looked into homeopathic solutions and started a regiment of taking Sho-Saiko-To three times a day an herb that showed some promise, not as a cure but to help the liver function properly. Did that for over 3 years and while my liver didn’t get any worse and my ALT level stayed normal I decide after my second biopsy last summer to go off and see if there was any change, there wasn’t so I’ve been free of any supplements for almost a year now.
My recent biopsy last summer showed that the virus has spread and now I’m a level 2.

I’ve started discussions with my doctor about treatment and there are a lot of new drugs that show a lot of promised that will be available in the fall of 2011. These new treatment show a greater chance of me clearing the virus (80%) as opposed to 50 – 60% of the current treatment.
I’m not under any illusions that it will be a walk in the park but I’m prepared and I have a great support group of friends and family, co workers around me. I would love to have this behind me and have met so many wonderful people who have recovered by Hep C and have gone on to lead healthy lives.

If I can suggest to anyone first leaving of their having Hep C – you yourself a service and get to a good doctor, ask around there are support groups and online forums. Staying in your head worrying about the “what ifs” is scary, get the facts and seek help. There’s lot of new drugs on the horizon that can help.

The companionship of a dog..............................

About four years ago, in one of the newer subway cars, lit up so much you feel like you are in a fish bowl, I sat across from a poster with a man’s face, part of it looked, looked, well, like a burnt marshmallow. It said something like: If your face looked like your liver you would get treatment.

No how, where or when. Gee thanks. I would, if I could, if I should.

Allot stuff in a short time led me from a relatively happy, healthy, self-sufficient & productive life to that point of life-less-ness, 31/2 yrs of stuff, not nice stuff.……I put my dog of 12ys to sleep, saw the second plane hit the world trade center & worked next to the city’s ME office, where, for years, the remains of 9/11 victims were dealt with.……I began to drink vodka, , insane amounts of vodka.…….one, then the other person I worked for moved on , job got too hard, job got sabotaged, job got too easy, got no job.......pre- then full on menopause, which became disruptive then destructive. .…… short term, followed by working memory, began to fail…….poor long term memory since childhood…… I was thirsty all the time & my brain was being fried; sunlight hurt, florescent lights hurt……. … closest & dearest friend had been using me but I had no clue & out of the blue he publicly dumped me…..already a loner I isolated my self, had no social support, no friends……It is so very easy to louse yourself in a city so big…....I let myself get into the craziness of methamphetamine abuse. I experienced case of bursitis so bad I had to take cross-town buses for several months. Stuff like that.

November of 2004  I was diagnosed with HepC, w/ a high titer & some liver damage. I stopped drinking, cold, immediately started sleeping too much & crying. Ridiculous, public displays of emotion.
Most likely I got the virus in my mid 20’s, but I hoped that I got it later in my 30’s when I worked on AIDS research projects with infected blood. I figured I had time, that odds were against successful treatment & better drugs were on the way. Alone I started to “fix” my apartment, look into other jobs, career changes & school. I tried to be self-employed. Initially found good dental care at schools but later had my gums mangled by a practicing hygienist. I was successfully evaluated for a clinical trial with a protease inhibitor, but for some mysterious reason was not included. I looked into other ways to get medical care but was only able to find mental heath care [later]. I had bounced back & forth between a zombie-like state & the high energy the neurotoxin caused from mid 2003 to mid 2007. Finally I just stopped. My life, my apartment & myself were in embarrassing disrepair & remain so to this day. I was deep into depression, had no sense of time, no credibility & had accomplished nothing.

Less than a 1½ ago I got a dog quit smoking & cut way down on caffeine. I already ate right & walked allot. I got some mental health care & LATER found a support group. Age, drugs & alcohol use or lack there of, loss of estrogen, chronic infection, the ever popular stress & so on. Any, all, or a combination have taken their toll. It’s hard to know. I still remain unemployable on so many levels. I can’t afford insurance & I am afraid to gamble with what little savings I have on anything other than current living expenses.

I may have come a long way, I’m clean, sober & able to read & daydream again but in my mind I am still sitting on that train, soooo tired with my side hurting looking at the man with the burnt marshmallow face wondering if I should & how I’m supposed to get treatment & pay my rent at the same time. The only thing I know for sure is that I need to have a dog.


Recently, it occurred to me having Hep C is the best thing that ever happened to me. Odd as this sounds, this is why:

The majority of my life has been spent thinking about the sexual abuse which I was a victim of starting at age 11. Until I was in my early 30's I had never told anyone what had taken place. The abuse was not a single event and went on for most of my teenage years. During this time, I had been victimized by at least six different pedophiles, did not live at home choosing the streets in Vancouver instead. One of the evil things about sexual abuse is the victim, being me, tends to blame themselves for what took place. As a result, from the time the abuse took place until I was in my 50's, I did my best to bury myself in drug and alcohol abuse.

I never told anyone about the sexual abuse until I was in my mid 30's after attempting suicide. After the attempt and during my stay in the hospital I was lucky in speaking with a nurse who encouraged me to attend community counselling which I did. I would like to say counselling "fixed me" - this was not to be the case though. Yes, the counselling did help to an extent, but my abuse of various substances, soft and hard drugs, continued to the day I discovered I was Hep C positive in 2007. Having Hep C was a milestone in my life and I finally turned the corner and stopped drinking and doing drugs.

I had to face the fact I had been living two separate lives for many decades. One, was my working life - somehow even with the substance abuse I had managed to build a successful career. The second life I lived was spent thinking about and trying to forget what had happened to me. I had next to no friends over this time - I was married once and then divorced two years later. Socially, I was very inept. I simply felt like I did not fit in anywhere and avoided social interaction as much as possible. I realize now I had allowed myself to become a victim. Because of this, my inner voice was entirely focused on past events and I spent next to no time thinking about my future. I simply drifted along pretty much following the path of least resistance. When I had no alternative and had to attend a social event, I often got drunk or stoned enough to make a fool of myself. This of course amplified my self-isolation even more.

So why, at age 52, was discovering I was Hep C positive a good thing? First, it ended my cycle of substance abuse. Second, I learned for the first time in my life who I really was and that I did have value as a person. During my first, Interferon / Ribavirin treatment to try and kill the virus, I discovered a local Hep C support group. Sitting in a room with others dealing with Hep C was one of the most energizing experiences of my life. I found I wanted to help others and in turn wanted to help myself as well.

I volunteered with a non-profit Hep C society focused on the education, prevention and peer support. Since I was not working, I was able available as a volunteer much of the time. My inner voice changed, I began thinking about ways to help and further support others. My focus shifted to the future and how best to spend my time as a volunteer. I found this so energizing and really the final step in turning my life around. I've met some great people - who I want to spend time with. I no longer feel like I am being judged negatively by myself or others. In short, being positive for Hep C has helped me to want and develop a positive inner voice.