Managing Chronic Hepatitis C Symptoms: Traditional vs. Western Medicine

Hepatitis C issues

Hello Dr.
Lin! Thank you for answering my questions about hepatitis C last time.
However, my mother has been feeling increasingly unwell lately.
Her symptoms are as follows: 1.
Dry mouth and throat, no matter how much water she drinks, she still feels thirsty.
2.
Heavy coating on her tongue, and she has had mouth sores that have lasted for half a month without healing.
3.
She drinks a large glass of water before bed, leading to 4 to 5 nighttime urinations; she goes to bed at 11 PM and doesn't fall asleep until around 2 AM (she says that if she doesn't drink that much water before bed, she feels too thirsty to sleep, but this results in insufficient sleep; what should we do?).
4.
She experiences leg cramps while sleeping at night.
Could you please advise on how to improve these symptoms? Would it be better to seek treatment from traditional Chinese medicine for gradual adjustment, or is Western medicine more effective? (She is very concerned about potential side effects.)

Hen danxin jia ren de wo, 20~29 year old female. Ask Date: 2007/08/12

Dr. Lin Qingzhong reply Traditional Chinese Medicine

Dear (Worried about my family),
1.
Your mother has hepatitis C, which is named after the type of virus that causes it.
Since hepatitis C is not easily cured in the short term, both traditional Chinese medicine (TCM) and Western medicine have their unique approaches and medications, each with its own patient preferences.
It is best to combine both TCM and Western medicine in treatment.
Regardless of the medications from either system, please follow the instructions of both TCM and Western physicians.
In TCM, the treatment for hepatitis C should be based on the patient's clinical presentation and differentiated accordingly.
Your mother experiences dry mouth, a thick tongue coating, frequent sleep disturbances (and nocturia), and easy fatigue: with GOT at 120 and GPT at 235, the TCM diagnosis likely falls under the damp-heat pattern.
She can visit my clinic for treatment using aromatic damp-dispelling and clearing turbidity methods.
2.
"Your mother has dry mouth, mouth sores, and feels thirsty no matter how much water she drinks.
Her tongue coating is very thick, and the mouth sores have persisted for half a month." In TCM, this indicates an "internal heat combined with dampness." The internal heat causes excessive thirst, making it difficult to quench, while the dampness leads to a thick and greasy tongue coating.
This could be related to hepatitis C or menopause, which not only raises liver function markers but also causes changes in body constitution.
Additionally, mouth sores may be due to vitamin deficiencies, menopause, or viral infections.
3.
For the treatment of "hepatitis C," it is essential to ensure adequate sleep and moderate physical activity.
TCM believes that "when a person lies down, blood returns to the liver." Work should be appropriate, and only with good sleep can the liver rest properly, reducing the chances of recurrent inflammation from hepatitis C.
Your mother drinks a large glass of water before bed, leading to 4 to 5 trips to the bathroom at night.
She goes to bed at 11 PM and only falls asleep around 2 AM.
Therefore, it is recommended that she reduces her water intake before bed and uses mouth rinsing to alleviate thirst.
She should also visit my TCM clinic for a diagnosis based on her constitution and receive medication to improve her sleep and manage "hepatitis C."
4.
Experiencing leg cramps at night is a common concern among elderly patients in my clinic.
Western medicine suggests this may be due to "calcium deficiency" or "excessive walking or exercise" leading to lactic acid accumulation.
TCM believes that "the liver governs the tendons," and poor liver function can lead to fatigue, muscle soreness, and cramps.
In TCM, cramps are thought to be caused by "qi stagnation and blood stasis." In my clinic, I often use acupuncture or treat the liver according to the patient's constitution and provide medication based on diagnosis to improve cramping symptoms.
Wishing you all the best,
Dr.
Lin Qingzhong
Director, Department of Traditional Chinese Medicine
Fengyuan Hospital

Reply Date: 2007/08/12

More Info

Managing chronic Hepatitis C symptoms can be a complex process, especially when considering the different approaches of traditional Chinese medicine (TCM) and Western medicine. Each has its own strengths and weaknesses, and the best approach often involves a combination of both.

Understanding the Symptoms
Your mother’s symptoms—dry mouth, heavy tongue coating, mouth sores, frequent nighttime urination, difficulty sleeping, and leg cramps—are indeed concerning and may be related to her chronic Hepatitis C condition. Chronic Hepatitis C can lead to various systemic effects, including fatigue, malaise, and even complications that affect other organ systems.
1. Dry Mouth and Heavy Tongue Coating: These symptoms may indicate an imbalance in the body's internal environment. In TCM, this could be seen as a sign of "internal heat" combined with "dampness." This imbalance can lead to dryness and inflammation, which might explain the persistent mouth sores.

2. Frequent Nighttime Urination: This could be a result of excessive fluid intake before bed, but it may also indicate kidney involvement or a need for better fluid management.
3. Sleep Disturbances: Sleep issues are common in individuals with chronic illnesses, and they can be exacerbated by discomfort, anxiety, or the need to urinate frequently.

4. Leg Cramps: These can be attributed to electrolyte imbalances, dehydration, or muscle fatigue, which may be more pronounced in someone with chronic liver disease.

Treatment Approaches
#
Traditional Chinese Medicine (TCM)
In TCM, the treatment would focus on restoring balance to the body. This could involve:
- Herbal Remedies: Specific herbs can be prescribed to clear heat and dampness, nourish the body, and promote healing. For example, herbs like Huang Qin (Scutellaria baicalensis) may help clear heat, while Dang Gui (Angelica sinensis) can nourish the blood and improve circulation.

- Acupuncture: This practice can help alleviate symptoms such as leg cramps and improve overall energy levels. It may also help with sleep disturbances by promoting relaxation.

- Dietary Adjustments: TCM emphasizes the importance of diet in managing health. Foods that are cooling and hydrating, such as pears, cucumbers, and mung beans, may be beneficial, while spicy or greasy foods should be avoided.

#
Western Medicine
Western medicine offers a more direct approach to managing Hepatitis C and its symptoms:
- Antiviral Therapy: If your mother has not yet been treated with antiviral medications, this should be a priority. Direct-acting antivirals (DAAs) have revolutionized the treatment of Hepatitis C, with high cure rates and fewer side effects compared to older treatments.

- Symptomatic Treatment: For dry mouth, saliva substitutes or medications that stimulate saliva production can be helpful. For sleep disturbances, a healthcare provider may recommend sleep hygiene practices or, if necessary, short-term use of sleep aids.

- Nutritional Support: A dietitian can help create a balanced diet that supports liver health and addresses any deficiencies that may contribute to her symptoms.

Combining Approaches
Given your mother's concerns about side effects from Western medications, a combined approach may be the most beneficial. Here are some recommendations:
1. Consult Both Practitioners: Work with both a TCM practitioner and a Western medicine doctor. Ensure that both are aware of the treatments being administered to avoid any potential interactions.

2. Monitor Symptoms: Keep a detailed log of her symptoms, dietary habits, and any treatments being used. This can help both practitioners tailor their approaches effectively.

3. Focus on Lifestyle Changes: Encourage hydration throughout the day rather than large amounts before bed. This can help reduce nighttime urination. Additionally, gentle exercises like walking or yoga can improve overall well-being and help with sleep.

4. Regular Follow-ups: Regular monitoring of liver function and overall health is crucial. This will help in adjusting treatments as necessary and ensuring that any complications are addressed promptly.

In conclusion, managing chronic Hepatitis C symptoms requires a multifaceted approach that considers both traditional and modern medical practices. By integrating both TCM and Western medicine, you can help your mother find relief from her symptoms while addressing the underlying condition effectively. Always consult healthcare professionals before making any changes to her treatment plan.

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