Guest guest Posted February 10, 2000 Report Share Posted February 10, 2000 <<You need to be very careful before using any alternative therapies, particularly herbs or other " natural " medicines that you may have heard about, such as ginseng or licorice root.>> If you are going for a biopsy, blood thinners like ginseng and ginko should be discontinued for two weeks ahead of time. Personally, as an observer of how ginseng is disappearing from the forests, if most people stopped using it, would be fine with me. Ginseng is for old people to take, not young and middle aged. I use ashwaganda instead of ginseng, it is sometimes called Indian (from India) ginseng. I have included below several studies about licorice root. Glycyrrhizin is the an active ingredient from licorice root. As usual, I believe that herbs have ingredients in concert, so taking some out may not be the full benefit, but hey, doctors are trained to act like doctors, so what can we do? If you are looking for licorice at stores that sell supplements, many times the only licorice available is the deglycyrrhized kind, so be careful you get the right thing. Licorice is good for digestive problems even without the glycyrrhizin, and that is a common useage of it. WARNING: The reason the glycyrrhizin is removed, is because if you use glycyrrhizin for extended periods of time, it can raise blood pressure. That side effect is not mentioned in the following studies, but has been demonstrated on other occasions. If you are already a little high blood pressure, or do plan to try using it for extended periods of time, be sure to carefully monitor your blood pressure. Just in case. Eur J Gastroenterol Hepatol 1999 Oct;11(10):1077-83 Combined ursodeoxycholic acid and glycyrrhizin therapy for chronic hepatitis C virus infection: a randomized controlled trial in 170 patients. Tsubota A, Kumada H, Arase Y, ma K, Saitoh S, Ikeda K, Kobayashi M, Suzuki Y, Murashima N Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. OBJECTIVE AND DESIGN: To assess the efficacy and safety of combination therapy using ursodeoxycholic acid with glycyrrhizin for chronic hepatitis C virus infection, we conducted a prospective randomized controlled trial of glycyrrhizin (group G) compared with glycyrrhizin plus ursodeoxycholic acid (group G+U) in 170 patients. METHODS: All patients had elevated serum aminotransferase levels over 6 months before entry into the trial. Glycyrrhizin was administered to both groups for 24 weeks, and in group G+U, ursodeoxycholic acid (600 mg/day) was administered orally as well. RESULTS: Serum aspartate transaminase and alanine transaminase concentrations significantly decreased during treatment in both groups, but serum gamma-glutamyl transpeptidase concentrations fell significantly only in group G+U. Concentrations of all three enzymes fell significantly more in group G+U than in group G, and had normalized in more cases when the trial ended at 24 weeks. However, levels of HCV viraemia did not change during the trial in either group. Multiple regression analysis linked only the treatment regimen, not HCV-related factors or liver histology, to the degree of serum enzyme reduction. No adverse effects were noted in either group. CONCLUSIONS: The combined therapy with ursodeoxycholic acid and glycyrrhizin is safe and effective in improving liver-specific enzyme abnormalities, and may be an alternative to interferon in chronic hepatitis C virus infection, especially for interferon-resistant or unstable patients. PMID: 10524635, UI: 99452266 Aliment Pharmacol Ther 1998 Mar;12(3):199-205 Review article: glycyrrhizin as a potential treatment for chronic hepatitis C. van Rossum TG, Vulto AG, de Man RA, Brouwer JT, Schalm SW Department of Hepatogastroenterology, Erasmus University Hospital, Rotterdam, The Netherlands. Chronic hepatitis C is a slowly progressive liver disease that may evolve into cirrhosis with its potential complications of liver failure or hepatocellular carcinoma. Current therapy with alpha-interferon is directed at viral clearance, but sustained response is only achieved in 20-40% of patients without cirrhosis, and less than 20% in patients with cirrhosis who have the greatest need for therapy. Treatment for those who do not respond to anti-viral therapy is highly desirable. In Japan glycyrrhizin has been used for more than 20 years as treatment for chronic hepatitis. In randomized controlled trials, glycyrrhizin induced a significant reduction of serum aminotransferases and an improvement in liver histology compared to placebo. Recently, these short-term effects have been amplified by a well-conducted retrospective study suggesting that long-term usage of glycyrrhizin prevents development of hepatocellular carcinoma in chronic hepatitis C. The mechanism by which glycyrrhizin improves liver biochemistry and histology are undefined. Metabolism, pharmacokinetics, side-effects, and anti-viral and hepatoprotective effects of glycyrrhizin are discussed. Publication Types: Review Review, tutorial PMID: 9570253, UI: 98230178 J Gastroenterol Hepatol 1999 Nov;14(11):1093-9 Intravenous glycyrrhizin for the treatment of chronic hepatitis C: a double-blind, randomized, placebo-controlled phase I/II trial. van Rossum TG, Vulto AG, Hop WC, Brouwer JT, Niesters HG, Schalm SW Department of Hepatogastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands. BACKGROUND: In Japan, glycyrrhizin therapy is widely used for chronic hepatitis C and reportedly reduces the progression of liver disease to hepatocellular carcinoma. The aims of this study were to evaluate the effect of glycyrrhizin on serum alanine aminotransferase (ALT), hepatitis C virus (HCV)-RNA and its safety in European patients. METHODS: Fifty-seven patients with chronic hepatitis C, non-responders or unlikely to respond (genotype 1/cirrhosis) to interferon therapy, were randomized to one of the four dose groups: 240, 160 or 80 mg glycyrrhizin or placebo (0 mg glycyrrhizin). Medication was administered intravenously thrice weekly for 4 weeks; follow up also lasted for 4 weeks. RESULTS: Within 2 days of start of therapy, serum ALT had dropped 15% below baseline in the three dosage groups (P < 0.02). The mean ALT decrease at the end of active treatment was 26%, significantly higher than the placebo group (6%). A clear dose-response effect was not observed (29, 26, 23% ALT decrease for 240, 160 and 80 mg, respectively). Normalization of ALT at the end of treatment occurred in 10% (four of 41). The effect on ALT disappeared after cessation of therapy. During treatment, viral clearance was not observed: the mean decrease in plasma HCV-RNA after active treatment was 4.1 x 10(6) genome equivalents/mL (95% confidence interval, 0-8.2 x 10(6); P > 0.1). No major side-effects were noted. None of the patients withdrew from the study because of intolerance. CONCLUSIONS: Glycyrrhizin up to 240 mg, thrice weekly, lowers serum ALT during treatment, but has no effect on HCV-RNA levels. The drug appears to be safe and is well tolerated. In view of the reported long-term effect of glycyrrhizin, further controlled investigation of the Japanese mode of administration (six times weekly) for induction appears of interest. PMID: 10574137, UI: 20039294 __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2000 Report Share Posted February 10, 2000 <<You need to be very careful before using any alternative therapies, particularly herbs or other " natural " medicines that you may have heard about, such as ginseng or licorice root.>> If you are going for a biopsy, blood thinners like ginseng and ginko should be discontinued for two weeks ahead of time. Personally, as an observer of how ginseng is disappearing from the forests, if most people stopped using it, would be fine with me. Ginseng is for old people to take, not young and middle aged. I use ashwaganda instead of ginseng, it is sometimes called Indian (from India) ginseng. I have included below several studies about licorice root. Glycyrrhizin is the an active ingredient from licorice root. As usual, I believe that herbs have ingredients in concert, so taking some out may not be the full benefit, but hey, doctors are trained to act like doctors, so what can we do? If you are looking for licorice at stores that sell supplements, many times the only licorice available is the deglycyrrhized kind, so be careful you get the right thing. Licorice is good for digestive problems even without the glycyrrhizin, and that is a common useage of it. WARNING: The reason the glycyrrhizin is removed, is because if you use glycyrrhizin for extended periods of time, it can raise blood pressure. That side effect is not mentioned in the following studies, but has been demonstrated on other occasions. If you are already a little high blood pressure, or do plan to try using it for extended periods of time, be sure to carefully monitor your blood pressure. Just in case. Eur J Gastroenterol Hepatol 1999 Oct;11(10):1077-83 Combined ursodeoxycholic acid and glycyrrhizin therapy for chronic hepatitis C virus infection: a randomized controlled trial in 170 patients. Tsubota A, Kumada H, Arase Y, ma K, Saitoh S, Ikeda K, Kobayashi M, Suzuki Y, Murashima N Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. OBJECTIVE AND DESIGN: To assess the efficacy and safety of combination therapy using ursodeoxycholic acid with glycyrrhizin for chronic hepatitis C virus infection, we conducted a prospective randomized controlled trial of glycyrrhizin (group G) compared with glycyrrhizin plus ursodeoxycholic acid (group G+U) in 170 patients. METHODS: All patients had elevated serum aminotransferase levels over 6 months before entry into the trial. Glycyrrhizin was administered to both groups for 24 weeks, and in group G+U, ursodeoxycholic acid (600 mg/day) was administered orally as well. RESULTS: Serum aspartate transaminase and alanine transaminase concentrations significantly decreased during treatment in both groups, but serum gamma-glutamyl transpeptidase concentrations fell significantly only in group G+U. Concentrations of all three enzymes fell significantly more in group G+U than in group G, and had normalized in more cases when the trial ended at 24 weeks. However, levels of HCV viraemia did not change during the trial in either group. Multiple regression analysis linked only the treatment regimen, not HCV-related factors or liver histology, to the degree of serum enzyme reduction. No adverse effects were noted in either group. CONCLUSIONS: The combined therapy with ursodeoxycholic acid and glycyrrhizin is safe and effective in improving liver-specific enzyme abnormalities, and may be an alternative to interferon in chronic hepatitis C virus infection, especially for interferon-resistant or unstable patients. PMID: 10524635, UI: 99452266 Aliment Pharmacol Ther 1998 Mar;12(3):199-205 Review article: glycyrrhizin as a potential treatment for chronic hepatitis C. van Rossum TG, Vulto AG, de Man RA, Brouwer JT, Schalm SW Department of Hepatogastroenterology, Erasmus University Hospital, Rotterdam, The Netherlands. Chronic hepatitis C is a slowly progressive liver disease that may evolve into cirrhosis with its potential complications of liver failure or hepatocellular carcinoma. Current therapy with alpha-interferon is directed at viral clearance, but sustained response is only achieved in 20-40% of patients without cirrhosis, and less than 20% in patients with cirrhosis who have the greatest need for therapy. Treatment for those who do not respond to anti-viral therapy is highly desirable. In Japan glycyrrhizin has been used for more than 20 years as treatment for chronic hepatitis. In randomized controlled trials, glycyrrhizin induced a significant reduction of serum aminotransferases and an improvement in liver histology compared to placebo. Recently, these short-term effects have been amplified by a well-conducted retrospective study suggesting that long-term usage of glycyrrhizin prevents development of hepatocellular carcinoma in chronic hepatitis C. The mechanism by which glycyrrhizin improves liver biochemistry and histology are undefined. Metabolism, pharmacokinetics, side-effects, and anti-viral and hepatoprotective effects of glycyrrhizin are discussed. Publication Types: Review Review, tutorial PMID: 9570253, UI: 98230178 J Gastroenterol Hepatol 1999 Nov;14(11):1093-9 Intravenous glycyrrhizin for the treatment of chronic hepatitis C: a double-blind, randomized, placebo-controlled phase I/II trial. van Rossum TG, Vulto AG, Hop WC, Brouwer JT, Niesters HG, Schalm SW Department of Hepatogastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands. BACKGROUND: In Japan, glycyrrhizin therapy is widely used for chronic hepatitis C and reportedly reduces the progression of liver disease to hepatocellular carcinoma. The aims of this study were to evaluate the effect of glycyrrhizin on serum alanine aminotransferase (ALT), hepatitis C virus (HCV)-RNA and its safety in European patients. METHODS: Fifty-seven patients with chronic hepatitis C, non-responders or unlikely to respond (genotype 1/cirrhosis) to interferon therapy, were randomized to one of the four dose groups: 240, 160 or 80 mg glycyrrhizin or placebo (0 mg glycyrrhizin). Medication was administered intravenously thrice weekly for 4 weeks; follow up also lasted for 4 weeks. RESULTS: Within 2 days of start of therapy, serum ALT had dropped 15% below baseline in the three dosage groups (P < 0.02). The mean ALT decrease at the end of active treatment was 26%, significantly higher than the placebo group (6%). A clear dose-response effect was not observed (29, 26, 23% ALT decrease for 240, 160 and 80 mg, respectively). Normalization of ALT at the end of treatment occurred in 10% (four of 41). The effect on ALT disappeared after cessation of therapy. During treatment, viral clearance was not observed: the mean decrease in plasma HCV-RNA after active treatment was 4.1 x 10(6) genome equivalents/mL (95% confidence interval, 0-8.2 x 10(6); P > 0.1). No major side-effects were noted. None of the patients withdrew from the study because of intolerance. CONCLUSIONS: Glycyrrhizin up to 240 mg, thrice weekly, lowers serum ALT during treatment, but has no effect on HCV-RNA levels. The drug appears to be safe and is well tolerated. In view of the reported long-term effect of glycyrrhizin, further controlled investigation of the Japanese mode of administration (six times weekly) for induction appears of interest. PMID: 10574137, UI: 20039294 __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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