Diet for hepatitis c

Contents

Lucinda’s List: What to Eat When You Have Hepatitis C

“He that takes medicine and neglects diet, wastes the skill of the physician.” ~Chinese Proverb

A question I am often asked by hepatitis C patients is, “What is the best diet for hepatitis C?” This may seem like a simple question, but telling someone what to eat is like telling them what religion to join. There is not a simple answer, and no single nutrition plan works for everyone. Also, there are quite a few opinions about what we should and shouldn’t eat, and treading on those opinions is risky.

While browsing for quick and healthy recipes, I discovered that many of the recipes I found used processed food, sugar, and ingredients that I don’t use. To me they weren’t healthy, but to someone who is accustomed to a high-calorie, high-fat diet, these recipes may offer a vast improvement. Eating a nutritious diet depends on where you are starting from, and it reflects your heritage, where you live, what is available, your income, and your lifestyle. For instance, someone who can’t cook or doesn’t have access to a kitchen has different needs than someone who likes to cook and can.

The bottom line for me is simplicity. I stock ingredients that I can transform in to a quick, delicious meal when I am short on time and big on hunger. On nearly any given moment, I can make a healthy omelet, frittata, polenta or quinoa dish, salad, or wrap. I always have whole grain ingredients, veggies, fruit, herbs, dried tomatoes, nuts, eggs and beans in my kitchen.

Ingredients to Limit

Although there is wide variation in nutrition advice, nearly all experts agree on foods to avoid or limit. These are:

  • Sugar and unrefined carbohydrates
    • Soda, many fruit drinks, and sweetened energy drinks and teas
    • Most bakery goods such as pastries, donuts, cookies, white bread, white pasta
  • Trans-fats, saturated fats, and high-fat foods
    • Fried foods
    • Butter, cream, and full-fat cheese
    • Bacon, beef, ham, lamb, sausage, organ meats
    • Trans fats are being phased out, but check ingredients for partially hydrogenated oil in foods such as microwave popcorn, frozen desserts, crackers, and stick margarine
  • Sodium
    • Processed food, frozen foods, canned foods, and deli-meats
    • Snack foods with empty calories (potato chips, candy, etc.)

Nutritious Choices

As to what to eat, here are the guidelines I follow:

  • Eat vegetables — lots of them and in as many colors as possible.
  • Consume fruit and whole grains in moderate amounts.
  • Eat plant-based or lean protein choices, such as egg whites, nonfat yogurt or milk, beans, nuts, fish and poultry.
  • Choose healthy fats, such as canola and olive oil.
  • Eat a fiber-rich diet.
  • Reduce sodium intake. Avoid processed foods, which are often high in sodium and other additives.
  • Don’t overdo it. A serving of nuts is healthy; a can of nuts is not.

Someone told me that summer bodies are made in the winter. I’d expand that to, “The food you eat today determines tomorrow’s health.” Food tastes good in the moment, but the effects can be devastating. To me, most indulgences are not worth a lifetime of coronary artery diseases, fatty liver, or diabetes. When I do indulge, I make it a small and savor it. I do this so I can also savor my health.

How to Fight Hepatitis C 8 Ways

Hepatitis C is not a death sentence and you are NOT helpless. There are 8 ways you can help your body fight Hepatitis C right now to make a difference in your liver health.
When I was diagnosed with Hep C it was overwhelming to learn the damage the virus does to the liver. I researched and talked with my physician and a registered dietitian about how I could help my liver fight HCV. What I discovered help me get back in the driver’s seat of my health and empowered me to move forward.
#1 Proactive Healthy Lifestyle
Mindfulness on living a healthy lifestyle helps your liver work better.
Make a Healthy Plan and Work the Plan. Nutrition is one area of disease where a person has control and can actively help in the recovery of liver damage and minimizing further damage.
Help your Liver with Good Nutrition. What you put in your body matters!
An unhealthy diet can lead to liver disease and compromise the function of your liver. The American Liver Foundation states, “eating high fatty foods will put you at risk of being overweight and having non-alcoholic fatty liver disease.”
It adds stress to your liver and compromises your immune system. Think in terms of a highly efficient engine and filter. You’re liver and immune system is your body’s engine and filter. You need to eat the right fuel in order to operate effectively. Help your body help your liver.
General Nutrition for Healthy Living & Liver Disease

  • Eat a diet low in saturated and no trans fat.
  • Avoid fried foods.
  • Eat lean (low fat) protein such as fish, white meat chicken, white meat turkey without the skin. Limit red meat due to these are generally higher fat and harder for the body to break down.
  • Eat lots of fresh vegetables and fruits, choose organic if possible.
  • Eat complex carbohydrates made with whole grains and high fiber.
  • Drink 8 to 12 eight ounces of water daily, filtered water if possible. Less chemicals and additives.
  • Stay away from processed foods as much as possible. Fresh or frozen is best!
  • Reduce sugar and high sodium foods.
  • Choose low fat or non-fat dairy products.
  • Avoid sugar substitutes like aspartame (Nutra Sweet, Equal, Splenda, Sweet N Low and others) these are toxic for your liver. Use real sugar, just less of it.

Medical professionals recommend following a generalized healthy diet as stated above. The closer you are to your healthy weight the less stress this puts on your liver. Talk to your doctor or a registered dietitian for dietary guidelines and amounts that are right for you.
#2 Avoid Alcohol
American Liver Foundation states that alcohol can damage or destroy liver cells. Liver damage can lead to the buildup of fat in your liver (fatty liver), inflammation or swelling of your liver (alcoholic hepatitis), and/or scarring of your liver (cirrhosis).
For people with liver disease, even a small amount of alcohol can make the disease worse. A good analogy a doctor told me was to think of hepatitis as a smoldering fire. Alcohol is like gasoline. Don’t throw gasoline on the fire. It’s not worth it.
#3 Exercise
Exercise plays an important role in liver health and boost’s the immune system. Regular exercise will increase energy levels, decease stress on the liver, and in many cases even delay the onset of certain complications associated with liver disease.
Your energy levels can be boosted by even 10 minute walks or other exercise. Start with small blocks of time and continue to add extra minutes when you can. Small changes make big differences!
#4 Manage your Medications
Medications, vitamins, and supplements you take pass through your liver. Your liver is responsible for processing all of these substances. According to the American Liver Foundation, it is important to understand exactly how you should be taking your medications in order to avoid putting undue stress on your liver.
Be discerning when taking vitamins, minerals, and supplements. A good rule of thumb to remember, everything you take has to an effect on your liver and immune system.
Vitamins, minerals and supplements if taken correctly can play a part in good health, but when taken incorrectly can harm your liver. Be especially careful with herbal and alternative liver treatments.
Certain herbs can be dangerous and toxic to your liver and can increase your liver damage. Just because something says it’s natural doesn’t mean it’s safe. Talk to your doctor before taking anything.
#5 Avoid Environmental Pollutants/Toxins
Toxins can injure your liver cells. Avoid direct contact with chemicals from cleaning products, insecticides, fumes from paint thinners and aerosol sprays.
DO NOT Smoke. And avoid second hand smoke.
#6 A Positive Attitude and Can Do Spirit affects every part of your life and is a vital tool for good health.
A depressive state can chemically affect your health in a negative way and suppress your immune system, leaving you at greater risk for infections and other health issues. See your doctor if you are experiencing depression, or problems with anxiety or insomnia.
A support system is an important tool to help you mentally and emotionally. Good support systems can include: family, friends, church, healthcare team, and support from others who share the same liver disease. A connection with others is good for your health and well being.
#7 See your doctor for regular physical exams and tests.
Write down questions about your liver condition and care. Talk to your doctor about treatment for Hep C. Don’t be afraid to get a second opinion if you don’t feel right about their advice.
#8 Treatment for Hepatitis C
Treatment is available for Hep C, talk to you doctor about which treatment is right for you. See Life Beyond Hepatitis C for Treatment Journey Experiences of other Hep C Patients and articles on New Treatment for Hep C.
Research and Trial studies for brand new treatment are in the works right now and show great promise.
Be Proactive with your health. Take care of your liver. Never take for granted the positive differences you can make.
What ways are you taking care of your liver?

This entry was originally published on Life Beyond Hepatitis C June 26. It is reprinted with permission.

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Foods Good for Hepatitis C

We need good foods to help us when we have hepatitis C. The virus attacks our liver, so it makes sense to eat the right foods. We can focus on foods that are easy for the liver to digest. It’s also important to eat foods that help the liver to heal.

Easy to Eat

Leafy greens like those used in salads are always cleansing for your body. Be sure and top them with a tasty, low salt salad dressing. Then simply enjoy the benefits. Having a big bowl of salad for lunch is an easy way to get rid of toxins.

Other green vegetables include avocados. They are not only delish, but they’re a healthy type of fat. They also help to cleanse the liver with a special antioxidant. Slice some on your salad, or mix it up for guacamole.

Keep going green with broccoli and brussels sprouts. Any kind of cabbage is very healthy and helps our food digest. By getting a little boost in digestion help, our liver gets a break.

Delicious sources of protein include beans, chickpeas, eggs, fish, chicken, and yogurt. Lean beef is not as easy on the liver, so don’t eat it daily. However, it can be used in a big dish casserole or soup to add protein and flavoring.

Healing foods and drinks

Lemons can be a tasty squeeze into our water or as a topping for a salad. Any way you use them, they help to cleanse and help you digest foods more properly without being hard on the liver.

Green tea is known for it’s antioxidant power. It is full of catechins, which are high powered antioxidants. Studies have shown an improved liver function from drinking green tea daily.

Another drink boasts a reduction in liver cancer. People who drink a few cups of coffee per day have a decreased risk of liver cancer. Start your day with a boost of energy and a boost against liver cancer!

Flavorful health

Garlic is known to help begin the process of cleansing your body of toxins. It is easily added to soups, or big dish meals like casserole. But you can also squeeze some into your salad dressing. Adding it to dips can turn a boring veggie plate into a tasty treat.

If you are eating a liver healthy diet, you know that adding some herbs and spices to a beans can take them to a whole different level of flavor. Turmeric is a spice that is so good for the liver. It helps to activate your body’s digestion. Your bile duct is a part of the way your liver processes fats, and turmeric helps with that. As an added bonus, it also helps to reduce inflammation. Our liver stays inflamed with the hepatitis C virus. It’s simple way to help it out is to add turmeric to meals.

Our liver works hard to filter our body and remove toxins and other harmful things that we get from the environment. We can give it a boost by eating healthy foods that are good for us when we have hepatitis C.

What to Eat With Hepatitis C

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Eating right isn’t always a picnic, but if you’ve been diagnosed with chronic hepatitis C, you’ll want to make sure your diet is as healthy as possible.

Your liver processes what you consume and helps convert it into energy and nutrients your body can use. It also removes toxins from your blood. Eating a healthy diet can help your liver function properly, possibly decrease the symptoms of hepatitis C, and even help repair some of the damage the disease may cause.

Consuming a nutritious diet can also help you maintain a healthy weight, which can prevent further liver damage from occurring. Overweight people, in general, are at greater risk of developing nonalcoholic fatty liver disease. This unhealthy buildup of fat in the liver cells can lead to cirrhosis (liver scarring), liver cancer, or liver failure over time, just like hepatitis C can.

Nourish Your Body

Here’s what to eat (and avoid) in order to better manage your condition—and feel better as a result.

Consume foods from all food groups. A healthy, balanced diet includes fruits, grains, vegetables, and protein. Follow the principles of the U.S. government’s dietary guidelines:

  • At meals, make half your plate fruits and vegetables.

  • Switch to skim or 1% milk and yogurt. Nonfat and low-fat dairy products have the same amount of nutrients as whole-fat dairy products, but half the amount of fat and calories.

  • Make at least half the grains you consume whole grains, such as whole-grain cereal, bread, and pasta.

  • Choose lean meat and poultry, and keep portions small.

  • Substitute beans for meat and other protein sources occasionally. Beans are high in fiber and protein.

  • Cut back on foods high in solid fat, added sugars, and salt, such as cakes, cookies, ice cream, pizza, cheese, sausage, and hot dogs, or avoid them altogether. If you’re taking hepatitis C medication, greasy, fatty foods may upset your stomach.

Talk with your doctor about whether it’s okay to drink alcohol. Avoid alcohol if your doctor says you should. Drinking alcoholic beverages can lead to serious liver damage in people with hepatitis C. Not only is alcohol toxic to your liver, it prevents your body from absorbing some nutrients. It also can make your hepatitis C medications less effective.

If you do choose to drink alcohol, limit it to no more than one drink per day for women or two drinks per day for men. One drink equals 12 ounces of beer or wine cooler, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits or liquor, such as gin, vodka, or rum.

Drink plenty of water. Unless you’re on a diet in which fluid is restricted, be sure to drink when you’re thirsty. This helps you stay hydrated so your liver can function better.

Eat to reduce the side effects of medication. Hepatitis C medication may cause nausea, vomiting, diarrhea, and loss of appetite. To reduce these side effects, keep a food diary and note the foods that make you feel better. Then, build your diet around them. Stay away from the foods that make you feel worse.

Also, try to eat small, frequent meals, even if you’re not very hungry. Small amounts of food may be easier to digest.

Finally, if you have cirrhosis of the liver as a result of hepatitis C, ask your doctor about any diet changes you may need to make. They may include eating less protein, salt or iron-rich foods, or drinking less fluid. Talk with your doctor before taking any dietary supplements, since some vitamins may cause liver damage.

Key Takeaways

  • Eating a healthy diet can help your liver function properly, possibly decrease the symptoms of hepatitis C, and help repair damage caused by the disease.

  • A healthy, balanced diet includes fruits, grains, vegetables, and protein.

  • Avoid alcohol if your doctor says you should. It can lead to serious liver damage in people with hepatitis C.

  • Your medication may cause nausea, diarrhea, and loss of appetite. To reduce these side effects, keep a food diary, note the foods that make you feel better, and build your diet around them.

Viral Hepatitis and Liver Disease

Diet and Nutrition: Entire Lesson – Hepatitis C for Patients

Everything you eat and drink passes through your liver. Your liver changes food into stored energy and chemicals necessary for life. Your liver makes nutrients available so your body can use them to build cells, give you energy, and maintain normal body functions.

How diet affects the liver

A bad diet sometimes can lead to liver problems. If your diet provides too many calories, you will gain weight. Being overweight is linked to the buildup of fat in the liver, called “fatty liver.” Over many years, having a fatty liver when you already have hepatitis C will make it more likely to develop cirrhosis. Being overweight and having a fatty liver also have been shown to make it less likely that hepatitis C will successfully be cleared with interferon and ribavirin.

One’s diet also can contain toxins that are harmful to the liver. Some toxins act quickly. Eating certain poisonous mushrooms, for example, can cause liver failure and death within days. Other toxins, such as alcohol, damage the liver over time.

A good diet, by contrast, can actually improve liver health in a person with hepatitis C. A balanced diet can lead to better liver functioning and lowered risk of cirrhosis (scarring) of the liver. It also can help the immune system stay strong and fight off illness.

Finally, people infected with hepatitis C have higher rates of diabetes than those who are not infected, but a good diet can help reduce body fat and control blood sugar. This lowers diabetes risk.

Even though following a generally healthy diet and keeping a normal body weight (measured as Body Mass Index, or BMI) may not seem like a specific treatment for hepatitis C, it is a great way of protecting your liver against hepatitis C. With a normal BMI and good diet and exercise, you are helping reduce inflammation in the liver and slow down the progression to cirrhosis from hepatitis C than if you are overweight, have diabetes, have high cholesterol and have fatty liver.

How hepatitis C affects diet

If you have hepatitis, you usually don’t need a special diet. Just trying to eat healthy and not being overweight and avoid alcohol is all that is needed.

There are special cases, however, when hepatitis C can affect the diet:

  • Patients with cirrhosis
    As liver disease progresses, patients may lose their appetite and become so tired they have a hard time eating. They may become very thin and poorly nourished and be less able to fight off disease. They may need to limit salt in their diet to prevent their body from putting fluid into their legs and abdomen.
  • Other medical conditions and diet
    People who have other medical conditions may need other specific changes in their diet. Conditions that warrant specific dietary restrictions include high blood pressure, heart disease, diabetes mellitus, high cholesterol, celiac sprue or chronic kidney disease.

Eating tips

People with hepatitis C don’t need to follow a special “hepatitis C diet.” The advice that an average, healthy person gets will work just as well for people with hepatitis C, unless those people also have cirrhosis or another condition, such as diabetes, HIV, or kidney disease.

General dietary advice:

  • Eat regular, balanced meals
  • Maintain healthy calorie intake
  • Eat whole-grain cereals, breads, and grains
  • Eat lots of fruits and vegetables
  • Get adequate protein
  • Go easy on fatty, salty, and sugary foods
  • Drink enough fluids
  • Reach and maintain a healthy weight

Cautions:

  • Avoid alcohol
  • Be careful with dietary supplements

Eat regular, balanced meals

Eating regularly means eating at least 3 meals a day. One way to keep your energy level up is to eat small meals or snacks at least every 3 to 4 hours.

If you are currently on hepatitis C treatment, eating often also can help prevent nausea, which is sometimes a side effect of the medicine.

Balanced meals include a variety of foods from all 4 food groups:

  • Whole-grain breads, cereals, and grains
  • Vegetables and fruits
  • Dairy products
  • Meats, fish, dried beans, soy, nuts, and eggs

Each of these food groups gives you important nutrients.

Eat plenty of cereals, breads, and grains

Cereals, breads, pasta, tortillas, and grits are full of B vitamins and minerals.

Try to buy at least half of your grains as “whole grains.” Whole grains include the bran and the germ of the grain and provide lots of fiber (to keep you “regular”). “Refined grains,” such as white bread and white rice, have the bran and germ removed. Whole wheat bread slices provide at least twice the amount of fiber, zinc, vitamin B6, and magnesium as white bread.

Tips:

Choose foods that name one of the following whole-grain ingredients first on the label’s ingredient list:

  • brown rice
  • bulgur
  • graham flour
  • oatmeal
  • whole oats
  • whole rye
  • whole wheat
  • wild rice
  • whole-grain corn

Eat lots of fruits and vegetables

Fruits and vegetables are important sources of many nutrients, including potassium, fiber, vitamin C, beta-carotene (a form of vitamin A), and folic acid. Some of these substances are antioxidants that can fight cell damage. As a bonus, most fruits and vegetables are naturally low in fat, sodium, and calories.

Eat at least 5 servings of fruits and vegetables a day.

Tips:

Fresh, frozen, or canned fruits are all good choices. If you buy canned vegetables, buy the ones with “no added salt.”

Buy fresh fruits and vegetables in season when they may be less expensive and at their peak flavor.

Buy vegetables that are easy to prepare. Pick up prewashed bags of salad greens and add baby carrots or cherry tomatoes for a salad in minutes. Buy packages of baby carrots or celery sticks for quick snacks.

Get enough protein

Protein is needed to fight infection and to heal damaged liver cells. Protein helps rebuild and maintain muscle mass and it aids in healing and repair of body tissues.

Good protein sources can be divided into 2 groups:

Dairy products

Besides providing protein, dairy products are the richest source of calcium and one of the few sources in the diet of vitamin D. Dairy products include milk, cheese, yogurt, ice cream, and puddings made with milk.

Tips:

Choose dairy products that are low-fat or fat-free. Go easy on dairy products that have lots of fat and little calcium, such as cream cheese, cream, and butter.

Meats, fish, dried beans, soy, nuts, and eggs

This group of foods provides protein, as well as B vitamins, vitamin E, iron, zinc, and magnesium.

Tips:

Choose lean meats. Boil, bake, or stir-fry them instead of frying.

Caution about iron

Some people with hepatitis C have above-average iron levels in their body. If you have too much iron, your doctor may ask you to eat fewer iron-rich foods, such as red meats, liver, and iron-fortified cereals. You also should avoid cooking with iron-coated cookware because the iron from the pots gets absorbed into food.

Go easy on fatty, salty, and sugary foods

Fats and oils are used to store energy in the body, protect body tissues, and transport vitamins through the blood. Some fats are better for you than others.

“Good” fats can be found in nuts and seeds, flax seed, olive oil, and fish oils.

“Bad” fats are found mostly in animal sources such as meat and poultry, whole or reduced-fat milk, and butter. They also are present as “trans” fats in fried foods, fast foods, and some processed products, such as cookies and crackers.

All fats, whether good or bad, contain calories and can add unwanted pounds if you eat too much.

Salty foods

If you are like most people in the United States, you already eat too much sodium (salt). Most salt in the diet comes from processed foods, such as crackers, chips, and canned soups.

If you need a lower sodium diet, you will need to read food labels to know which foods are the best choices. Learn how to read a food label.

Sugary foods

Sugar goes by many names: sucrose, corn syrup, honey, maple syrup, and fructose. Sugary foods tend to offer little more than calories. Many of them (such as pastries and desserts) tend to be high in fat, too.

There is nothing wrong with having sugary foods now and then. But if you fill up on sweets, you won’t have room for foods that are better for your health.

Drink plenty of fluids

Drink at least 6 to 8 glasses of fluid a day.

You don’t have to limit yourself to water. Milk, juice, herbal teas, soup, pudding, and frozen fruit bars all count as fluids, too. If you have a fever, or have experienced vomiting or diarrhea, you will need extra fluids.

Reach and stay at a healthy weight

Weighing either too much or too little can allow hepatitis C to progress more quickly in your body.

But what is a healthy weight?

The Body Mass Index (BMI) Table is a tool that can help you decide. You can find your BMI by using a BMI calculator, like this one from the National Heart, Lung, and Blood Institute. Type in your height and weight, and your BMI will appear in the figure’s heart.

If your BMI is under 20 or over 30, ask your health care provider to refer you to a dietitian, who can create a diet to help you reach a healthier weight. (Note: If you work out and have lots of muscle, your BMI may indicate that you are overweight, even if you aren’t.)

If you are overweight

If the recommended BMI seems too difficult to reach, aim for a slow loss of 10 percent of your current weight. (For example, if your current weight is 200 pounds, try to lose 20 pounds.) Just losing that much weight can help with some of the problems linked to having too much fat.

Risks from being overweight

Overweight people sometimes develop fatty deposits in the liver (called “fatty liver”) and have abnormal liver test results. Fatty liver can cause long-term problems in people who have chronic hepatitis C. Being overweight also can make your hepatitis C treatment less effective.

Being too fat also can put you at higher risk for diabetes, heart disease, high blood pressure, and some cancers.

But people who lose weight slowly can reverse these changes. Keeping off extra weight can improve your liver enzymes and fibrosis, even though the hepatitis C virus is still in your body.

Avoid fad diets, because losing weight too fast can put strain on the liver.

Importance of exercise

Exercise is important, and not just because it helps to keep your weight down. Exercise can improve your appetite, relieve some of the side effects of hepatitis C medications if you are taking them, boost your immune system, and improve your sense of well-being.

Try to have 10-minute blocks of exercise throughout the day. Low-impact exercises such as walking or swimming are the best. For example, start with a 10-minute walk. Participate at a comfortable level, take rest breaks, and increase your activity level slowly (15 to 30 minutes, 3 to 5 days a week).

Remember that patients with cirrhosis can put on “fluid weight.” This is different from “fat weight,” which is what most of us put on. Fluid weight is managed in a different way. Talk to your health care provider if you have cirrhosis or are retaining fluid in your legs or abdomen.

Remember, if you are overweight, it is important that you begin an exercise routine and start eating a healthy, well-balanced diet. Always talk to your doctor before starting a diet and exercise program.

If you are underweight

Before trying to gain weight, talk to your health care provider. You may need to be referred to a dietitian for special diet counseling.

Be careful with dietary supplements

The best way to get vitamins and minerals is through food. Food provides the greatest range of nutrients. However, a multivitamin/mineral supplement can be helpful, especially if you lose your appetite or can’t eat a healthy diet. Folate is particularly important vitamin and is not obtained easily from food but is found in multivitamins.

Before taking any supplement, talk to a doctor or dietitian. If you take supplements, don’t exceed the recommended doses. Some supplements in high amounts can be dangerous, particularly fat-soluble vitamins, such as A, D, E, and K. Here are some special concerns:

Iron and Vitamin C

Some people with hepatitis C, particularly those with cirrhosis, have above-average levels of iron in their body. Too much iron can damage organs. If these people take multivitamin/mineral pills, they should take the ones without iron. These pills usually are marketed as formulas for men or adults over 50. These people also should avoid taking large doses of vitamin C because vitamin C helps the body absorb iron.

You do not want to take iron supplements if you have hepatitis C, unless you are specifically told to take iron by your provider.

Vitamin A

Vitamin A, if taken in doses larger than the recommended 10,000 IU, can harm the liver. Vitamin A is even more toxic in someone who drinks alcohol.

You won’t get too much vitamin A from food, but be careful taking routine dietary supplements with high doses. There’s a non-toxic form of vitamin A, present in many fruits and vegetables, called beta-carotene. If you take vitamin A supplements, look for those with beta-carotene.

Vitamin D

Vitamin D is important for health in normal amounts (such as diets with plenty of milk). The body also can make vitamin D when exposed to sunlight. Taking supplements of 800 IU of vitamin D daily may help people with poor diets or long winter seasons, or those who are housebound.

Vitamin E

Vitamin E supplements do not have benefits, though it used to be believed that Vitamin E prevented heart disease. High doses (greater than 400 IU/day) can have be dangerous.

Vitamin K

Vitamin K is involved in blood clotting. It is present in the diet mostly in green vegetables. It also is produced by bacteria in the intestines. Vitamin K supplements generally are not taken, nor are they recommended.

Herbal products

Just because something is “natural” doesn’t mean it is harmless. Certain herbs, including Kava-Kava and pennyroyal, can cause liver damage. For a more extensive list of herbal cautions, see Alternative or Complementary Approaches.

Always talk to your doctor before taking megavitamin therapy, herbal products, or any other dietary supplement. Remember, your first concern should be safety.

Diet and Nutrition: Resources

  • My HealtheVet
    Take advantage of the VA’s Healthy Living Centers, where you’ll find information and tools for healthy eating, physical activity, and other lifestyle issues.
  • Choose My Plate
    Choose My Plate is a program that can help you choose the foods and amounts that are right for you. It replaces the Food Pyramid, from the U.S. Department of Agriculture.
  • How to read a food label
    This guide can help you read food labels, from the Food and Drug Administration.
  • Body Mass Index calculator
    This tool can help you decide if you are at a healthy weight, from the National Heart, Lung, and Blood Institute.

Hepatitis C

In this section:

  • What is hepatitis C?
  • How common is hepatitis C in the United States?
  • Who is more likely to get hepatitis C?
  • Should I be screened for hepatitis C?
  • What are the complications of hepatitis C?
  • What are the symptoms of hepatitis C?
  • What causes hepatitis C?
  • How do doctors diagnose hepatitis C?
  • What tests do doctors use to diagnose hepatitis C?
  • How do doctors treat hepatitis C?
  • How do doctors treat the complications of hepatitis C?
  • How can I protect myself from hepatitis C infection?
  • How can I prevent spreading hepatitis C to others?
  • Is a hepatitis C vaccine available?
  • What should I eat and drink if I have hepatitis C?

What is hepatitis C?

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.

Hepatitis C can cause an acute or chronic infection.

Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.

Acute hepatitis C

Acute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.

Chronic hepatitis C

Chronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn’t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.13

Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer.

How common is hepatitis C in the United States?

In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14

Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C don’t have symptoms and don’t know they have this infection. About 75 percent of U.S. adults who have hepatitis C are baby boomers, born between 1945 and 1965.14

Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.15,16

New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17

Who is more likely to get hepatitis C?

People more likely to get hepatitis C are those who

  • have injected drugs
  • had a blood transfusion or organ transplant before July 1992
  • have hemophilia and received clotting factor before 1987
  • have been on kidney dialysis
  • have been in contact with blood or infected needles at work
  • have had tattoos or body piercings
  • have worked or lived in a prison
  • were born to a mother with hepatitis C
  • are infected with HIV
  • have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
  • are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.13

Should I be screened for hepatitis C?

Your doctor may recommend screening for hepatitis C if you

  • have a high chance of being infected
  • were born between 1945 and 1965

Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

Your doctor may recommend screening you for hepatitis C if you were born between 1945 and 1965.

What are the complications of hepatitis C?

Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.

Cirrhosis

Cirrhosis is a condition in which the liver slowly breaks down and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse, the liver begins to fail.

Liver failure

Also called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.

Liver cancer

Having chronic hepatitis C increases your chance of developing liver cancer. If chronic hepatitis C causes severe liver damage or cirrhosis before you receive hepatitis C treatment, you will continue to have an increased chance of liver cancer even after treatment. Your doctor may order an ultrasound test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis C?

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

  • dark yellow urine
  • feeling tired
  • fever
  • gray- or clay-colored stools
  • joint pain
  • loss of appetite
  • nausea
  • pain in your abdomen
  • vomiting
  • yellowish eyes and skin, called jaundice

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by

  • sharing drug needles or other drug materials with an infected person
  • getting an accidental stick with a needle that was used on an infected person
  • being tattooed or pierced with tools or inks that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person before they were used on you
  • having contact with the blood or open sores of an infected person
  • using an infected person’s razor, toothbrush, or nail clippers
  • being born to a mother with hepatitis C
  • having unprotected sex with an infected person

You can’t get hepatitis C from

  • being coughed or sneezed on by an infected person
  • drinking water or eating food
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

A baby can’t get hepatitis C from breast milk.18

How do doctors diagnose hepatitis C?

Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.

Medical history

Your doctor will ask about your symptoms and whether you have any history of blood transfusions or injected drug use.

Physical exam

During a physical exam, your doctor will typically examine your body to check for signs of liver damage such as

  • changes in skin color
  • swelling in your lower legs, feet, or ankles
  • tenderness or swelling in your abdomen

What tests do doctors use to diagnose hepatitis C?

Doctors use blood tests to diagnose hepatitis C. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.

Blood tests for hepatitis C include the following:

  • Screening test for antibodies to the hepatitis C virus. A screening blood test will show whether you have developed antibodies to the hepatitis C virus. A positive antibody test means you were exposed to the hepatitis C virus at some point. However, the virus may no longer be present in your blood if your body fought off the infection on its own or if you received treatment that cured the infection.
  • Hepatitis C RNA test. If your antibody test is positive, your doctor will use a hepatitis C RNA test to detect RNA—a type of genetic material—from the hepatitis C virus. The hepatitis C RNA test can show whether you still have the hepatitis C virus and how much virus is in your blood. This information can help your doctor treat the infection. To see if you are responding to treatment, your doctor may order this test while you are undergoing treatment to find out if the amount of virus in your blood is changing.
  • Genotype test. Your doctor can use this test to find out what strain, or form, of hepatitis C virus you have. At least six specific strains—called genotypes—of hepatitis C exist. Genotype 1 is the most common hepatitis C genotype in the United States.1 Your doctor will recommend treatment based on which hepatitis C genotype you have.

Your doctor may order one or more blood tests to diagnose hepatitis C.

Additional tests

If you’ve had chronic hepatitis C for a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may include

  • blood tests
  • transient elastography, a special ultrasound of your liver
  • liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liver

Doctors typically use liver biopsy only if other tests don’t provide enough information about a person’s liver damage or disease. Talk with your doctor about which tests are best for you.

How do doctors treat hepatitis C?

Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.

Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.

Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:

Newer medicines are sometimes used along with these older hepatitis C medicines:

  • ribavirin
  • peginterferon alfa-2a (Pegasys) or peginterferon alfa-2b (PEG-Intron)

Doctors treat hepatitis C with antiviral medicines that attack the virus.

You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on

  • which hepatitis C genotype you have
  • how much liver damage you have
  • whether you have been treated for hepatitis C in the past

Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.

Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.

For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

Cost of hepatitis C medicines

The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.

Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.

How do doctors treat the complications of hepatitis C?

If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.

If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis C infection?

If you don’t have hepatitis C, you can help protect yourself from hepatitis C infection by

  • not sharing drug needles or other drug materials
  • wearing gloves if you have to touch another person’s blood or open sores
  • making sure your tattoo artist or body piercer uses sterile tools and unopened ink
  • not sharing personal items such toothbrushes, razors, or nail clippers

Hepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C.

Do not share drug needles or other drug materials.

If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection.

If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.

How can I prevent spreading hepatitis C to others?

If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Don’t donate blood or blood products, semen, organs, or tissue.

Is a hepatitis C vaccine available?

Researchers are still working on a vaccine for hepatitis C. If you have hepatitis C, talk with your doctor about vaccines for hepatitis A and hepatitis B. These vaccines can protect you from hepatitis A and hepatitis B infections, which could further damage your liver.

What should I eat and drink if I have hepatitis C?

If you have hepatitis C, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

Diet

Iron

The liver is important to the metabolism of iron.

Although it varies from person to person, most of the iron we consume leaves the body naturally.

People with chronic hepatitis C sometimes have difficulty in releasing iron. This can result in an overload of iron in the liver, blood and other organs. This overload can increase tissue damage in the liver.

Menstruating women are less likely to experience iron overload due to their loss of blood each month.

Because of this, people with chronic hepatitis C should reduce the amount of iron-rich foods in their diets. These include red meats, liver, oysters, lentils, apricots and iron-fortified cereals. However, iron is an essential part of your diet so do not cut it out entirely.

It is important to avoid taking iron supplements, unless advised by your doctor. It can make liver damage worse because the body has no way of removing excess iron and it accumulates in the organs and tissues, including the liver. Multivitamin tablets often include iron, so check the label.

Also, beware that vitamin C increases the absorption of iron from food.

Fat

Fat can cause abnormalities such as fatty deposits in the liver, fatty inflammation or fatty cirrhosis.

Of course, small amounts of fat should be consumed as part of a balanced diet.

Replacing saturated fats with unsaturated fats can improve your health by helping to lower cholesterol levels in your blood.

Saturated fats are mostly found in fatty meats and full-fat dairy products, as well as in cakes and biscuits. Unsaturated fats are found in fish and foods that come from plants. These include olive oil, nuts, avocado and margarines.

The effect of eating fatty foods is a separate issue to gaining weight.

Protein

Protein is necessary for the building and maintenance of muscle, and the repair and healing of the body. 60-120 grams per day of protein is adequate for an adult.

Large amounts of protein in the diet can lead to a build-up of protein breakdown products in the blood. This is because they are normally removed through the liver.

If the levels of protein breakdown products are high, a complication known as encephalopathy can occur. This condition affects mental function and often causes brain fog.

Several older studies illustrate that a diet which cuts out protein from meat improves the symptoms of encephalopathy. However, recent studies suggest it is preferable to continue eating adequate amounts of protein as low protein intake can contribute to malnutrition.

It is difficult to strike a balance between getting the protein that your body needs without causing a build-up of protein breakdown products in the blood. Roughly 1-1.5 grams of protein per kilogram of body weight is advisable.

Salt

Cirrhosis can lead to an accumulation of fluid in the abdomen. This is known as ascites, and it is a symptom of end stage liver disease.

People who experience ascites should restrict their sodium intake to less than 1000mg per day.

This is difficult as many foods have a surprisingly high salt content. If it is necessary for you limit your sodium intake, avoid adding salt to food and check the salt content of food products you consume.

You might like to use an app such as Sodium Tracker to help you track your sodium intake. It can help you to add up the amount of sodium in every food product you eat each day, which you can find on nutritional informational labels. Please go to this link for more information go here: https://appsto.re/gb/Qxr7B.i

Sugar

There appears to be a connection between hepatitis C and issues with regulation of blood sugar levels. This increases the risk of developing diabetes.

The liver regulates blood sugar levels by converting the food we eat into substances the body can use. They are then released as energy when the body need them.

People with end stage liver disease have difficulty in regulating blood sugar. One remedy is to have small, frequent meals that keep blood sugar levels more constant.

Coffee / Caffeine

Recent studies have suggested that daily consumption of caffeinated drinks is associated with less advanced liver scarring in people with hepatitis C.

100mg of caffeine (equivalent to 2.5 cups of coffee) is associated with roughly one-third reduction in advanced scarring, but higher intake is not believed to produce a further benefit.

Leafy vegetables

Studies suggest that leafy vegetables can lessen the fatty acid composition in your liver, and help to protect against artherogenic fatty acids which form fatty deposits in arteries.

A build-up of fatty deposits in arteries can cause a condition called atherosclerosis which is a major risk factor for coronary heart disease. There is more information about hepatitis C’s link to CHD here: http://www.hepctrust.org.uk/information/hepatitis-c-and-overall-health

Great leafy vegetables to eat include kale, collard greens, sweet potato greens, spinach and cabbage.

Juicing

Including juices in your diet can be useful for people with hepatitis C.

Juicing does not necessarily provide more health benefits than eating whole fruit and vegetables, but drinking juices can help to get energy when eating large meals is not possible.

It is also important to keep whole fruit and vegetables as a part of your diet because juices don’t contain any fibre.

What are good combinations to try?

Store-bought juices can be expensive, but making them yourself with a juicer can save you money.

Apples, beetroot, broccoli, carrots, celery, cucumber, ginger, parsley, watercress and wheatgrass can all be good for your liver.

Popular combinations include:

● Carrot, apple, beetroot and ginger

● Cucumber, carrot and beetroot

● Celery, carrot and beetroot

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