Pyrsopoulos and Reddy (₄) did not consider the need to restrict any diet for patients with acute and chronic hepatitis. However, those with liver cirrhosis need to be on low-sodium and high-protein diet (i.e., white meat protein such as pork, turkey and fish). Shannon also took a similar view. She wrote: No specific diet has been shown to help in treating hepatitis (₁₁). Palmer (₂), however, felt that dietary restriction for patients with liver problems is necessary. If we understand the biology of the liver, it stands to reason that everything that enters the body must pass through the liver to be processed – either synthesis or detoxification. Thus everything that we ingest will have some beneficial or adverse effect on the liver. It is for this reason that people – whether sick or healthy – should eat a diet with the eye towards protecting liver health. This is even for important for people with liver disease. At CA Care (in Malaysia), we advised cancer patients (including those with hepatitis) to avoid alcohol and caffeine, processed food, polyunsaturated oil, table salt, meat, white sugar, milk and dairy products (₁₂).

A 67-year-old man from Singapore. Sometime in the 1980s he was diagnosed as a hepatitis B carrier. In the years from 1980 to 1996, regular monitoring through blood tests, indicated liver function values to be within normal limits. There was nothing to be worried about and there was nothing to be done too.

However, on 28 December 1996, a CT scan report indicated a tiny (few mm) hypodense nodule seen in the medial segment of the left lobe of liver close to its diaphragmatic surface. This was too small to characterize. It could represent a small cyst. Moreover, his liver enzyme values shot up to 61 (ALT) and 44 (AST) (Table 1).

In June 1998, he suffered a silent hepatitis-related liver infection but with no indication of jaundice. He continued to feel all right with no apparent discomforts. The CT scan of the liver done on 25 June 1998 indicated a few tiny hypodense foci seen in both lobes of the liver. They were too small to characterize accurately but could be due to tiny cysts. The increase from one spot in the liver to many spots perhaps indicated gradual deterioration of his condition.

Figure 1

Table 1: Monitoring of ALT and AST levels from 1996 to 1999

In 1998, he moved to live in Wichita, USA. He continued to feel good but noticed a darkening of his urine. The values of his liver function tests were erratic and were consistently at the levels above normal limit. As a result, in early December 1998, the doctor put him on medication – lamivudine, 100 mg. There were some indications of improvement after taking this drug (Table 1). After two years on the drug, the problem returned when he suffered a chronic liver infection and his ALT and AST levels shot up high (Table 2).

Figure 2

Table 2: Monitoring ALT and AST levels from 2000 to 2002

In June 2000, the patient returned to Singapore. He continued to take the drug, lamivudine until October 2000. The blood test results done on 24 July 2000 showed values far above normal range (Table 2). A biopsy of the liver, done on 29 August 2000 indicated moderate chronic hepatitis with mild fibrosis. In short, he was getting worse even with medication.

With no other option left, he decided to participate in a clinical trial (where the drugs entecavir was tested and evaluated against lamivudine) conducted in Singapore. Unfortunately, the response was unfavourable. His ALT shot up, sometimes up to 812 and his AST rose to 388. he dropped out of the above clinical trial on 23 October 2000.

Then on 12 February 2001, the doctor in Singapore recommended that he participates in another clinical trial. This time he was put on both entecavir and lamivudine. The trial was completed on 13 May 2002 with a positive result (ALT=21, AST=23).

On 23 December 2001, he came to see us in Penang and was started on our liver herbs: Capsule A + B, Liver-P and LL-tea. In addition to herbs, he was asked to change his diet and avoid meat, milk and dairy products, oil, white sugar and table salts. This means he was both on our herbs and his doctor's medication (entecavir and lamivudine).

On 13 May 2002, he went off the second clinical trial and stopped all doctor's medication. The doctor continued to monitor him monthly and was very pleased with the state of his liver and its function. The blood test showed values within normal limit.

An ultrasound of the liver done on 29 November 2002 indicated that the liver parenchyma was of homogenous echnogenicity and no focal lesions were seen within it. The results of his liver function test were all within normal limits (Table 2).

The patient wrote to us saying: After Christmas 2002, when I started taking the herbs, I did find positive effects on my personal health. My facial outlook seemed to be healthier. Even my endocrinologist remarked that my diabetes was much better and very well under control. He even said that my pancreas has rejuvenated. I had new growth of black hair; the slightly bald patch at the back of my head became less bald.

The patient sent us an e-mail: My most recent blood test done on 6 February 2003 showed ALT=28, AST=27, both values were within normal limit.

On 24 February 2003 we received a fax from the patient saying that the herbs helped me a great deal and they really strengthened my immune system, enjoying general health of body, mind and spirit. I also took your advice to eat right and to be free from stress. Indeed God is great and is an awesome Healer.

His health was fine until June 2003 after a two-week trip to Cambodia. During this time he was not taking any herbs and worse still was a on a “bad” diet. As a result in July and the next few months his ALT and AST levels were very much elevated (Table 3). He came to see us in Penang and was asked to go on the herbs more seriously.

Figure 3

Table 3: Monitoring ALT and AST levels from 2003 to 2005

On 23 September 2003, he wrote: My diabetes is very well under control. For nearly a year now, I had to reduce my insulin intake. In fact, my endocrinologist told me that my pancreas has rejuvenated and that I'm no more dependent on insulin. My lipid result is excellent.

In response to our enquiry he wrote on 27 September 2003: I am not on any doctor's medication for more than a year already (note: 2 ^nd clinical trial completed in May 2002).

On 29 September 2003, he again wrote: Interestingly, from the scan of my liver, I noticed that in 28 December 1996, the finding was: “A tiny (few mm) hypodense nodule seen in the medial segment of the left lobe of the liver close to the diaphragmatic surface. This is too small to characterize. It could represent a small cyst”. From my most recent scan which I sent you showed NO MORE of such cyst.

On 12 December 2003, he wrote us again: Since 9 December 2003 my hepatologist has prescribed for me 10 mg of Adefovir. I still feel fine and am in good health. Your herbs which I take regularly have, I believe, done me good. As I've told you, the ultrasound of my liver has improved. The liver seems to be in good shape.

On 13 February 2004, we received an e-mail from him: My diabetic situation is very well controlled. I give myself a reduced dosage of insulin twice a day... In fact, my doctor was surprised that my pancreas has rejuvenated, so much so, if I diet carefully, I may not even need to have insulin. But, for the sake of maintaining my body weight and health, I was advised to give such reduced rate of insulin. By March 2004, his ALT and AST level had gone back to normal (Table 3).

On 8 December 2004, he wrote to say that he was doing very well. He wrote: I believe the herbs as well as eating right have kept both of us (husband and wife) healthy and fit.

On 7 January 2005, he e-mailed us his medical report which indicated normal liver function values (Table 3). He also faxed us the report of his liver ultrasonography done on 7 January 2005:

The liver is of normal size and has a smooth outline. There is a small echongenic lesion seen in the left lobe of the liver, 5mm in size, this may be an incidental hemangioma. No other focal lesion is seen in the rest of the liver. COMMENTS: There appears to be a small echogenic lesion, 5mm in size, in the left lobe of the liver and this may be an incidental haemangioma. The liver, otherwise, shows normal appearances.

We would like to thank the patient for being very diligent in keeping his records and his willingness to share his healing experience with us. Without his contribution it would not be possible for us to practise evidence-based herbal therapy.