Hepatitis C: Glutamine and N-Acetyl 
                        Cysteine 
                        by Michael Mooney (March, 2000)
                        Recent headlines underline how seriously Hepatitis C (HCV) 
                        affects HIV(+) people. Some reports, like the one below 
                        show as much as three times the increase in the rate of 
                        death from HCV over the last few years.
                      
Liver 
                        Disease Raises Questions for AIDS Patients 
                        Reuters (11/19/99)
                        A report presented at the annual meeting 
                        of the Infectious Diseases Society of America in Philadelphia 
                        shows that liver disease is a leading cause of death among 
                        HIV patients at a Massachusetts hospital, especially among 
                        those also infected with hepatitis C. Dr. Barbara McGovern 
                        of the Tufts University School of Medicine found that 
                        HIV patients taking highly active antiretroviral therapy 
                        (HAART) were at risk for liver disease because 
                        of the drugs' potential toxicity. McGovern performed a 
                        retrospective review of HIV-positive patients who died 
                        at the hospital between May 1998 and April 1999, comparing 
                        them to those who died in 1991. The findings revealed 
                        that 50 percent of the 22 deaths among HIV patients in 
                        the 1998-to-1999 period were due to end-stage liver disease, 
                        compared to 15 percent of the 27 AIDS deaths in 1991, 
                        before HAART was available.
                       
                      Earlier this year, a friend with HCV began to use the 
                        amino acids glutamine and N-acetyl cysteine (NAC), 
                        after I suggested that these nutrients might help because 
                        of their effect of improving glutathione production in 
                        the liver. Glutathione is the main antioxidant that the 
                        body makes and it is critically important for detoxifying 
                        activities done by the liver. 
                      He first checked with his doctor, who stated he agreed 
                        that this might be productive even though popular medical 
                        opinion was that amino acids might cause problems because 
                        they could produce an increase in ammonia levels. 
                      I suggested that he try a dose that is relatively low 
                        for a short time, and then have his doctor check his liver 
                        functions, and ammonia level. The dose I suggested was 
                        500 mg of NAC, along with 2,000 mg of powdered glutamine 
                        twice per day. 
                      He started doing this and only two days after he began 
                        using these dietary supplements, his wife reported to 
                        me that she noticed that he was thinking much more clearly, 
                        and that his energy level had increased radically. Three 
                        weeks later, he returned to his doctor for routine tests. 
                      
                      His doctor was extremely surprised to find that his liver 
                        function tests and ammonia levels had decreased signficantly 
                        and were now in the normal range. They had been elevated 
                        for over three years.
                      I suggested that he keep working with his doctor and 
                        double the dose every month or so and have the doctor 
                        retest to make sure that there wasn't some kind of negative 
                        effect caused at a some higher dose. The idea was to increase 
                        gradually in an effort to find an optimal dose for him. 
                        I also suggested that, based on what I have seen in HIV, 
                        an optimal top dose might be 500 to 1000 mg of NAC and 
                        4,000 mg of glutamine three times per day. (One heaping 
                        teaspoon of glutamine powder is about 4,000 mg.)
                      It you decide to experiment with these nutrients, consult 
                        your doctor first, and have them follow you with the appropriate 
                        lab tests.
                      Disclaimer: 
                        
                        This article is provided for educational purposes only, 
                        and is in no way a substitute for the advice of a qualified 
                        medical doctor or a recommendation to do other than your 
                        doctor determines is best for you. You should present 
                        this information to your doctor for their analysis because 
                        appropriate medical therapy should be tailored by a knowledgeable 
                        doctor for the individual as no two individuals are alike. 
                        I do not recommend self-medicating with any pharmaceutical 
                        drug or nutrient as you should consult with a qualified 
                        medical doctor who can determine your individual situation. 
                        If you use the information I present without the approval 
                        of your doctor, you do so strictly at your own risk and 
                        no responsibility is implied or intended on my part.
                      Reports from people 
                        with Hepatitis C:
                      Dennis in NYC writes: My liver got much 
                        better since I have taken Milk Thistle (silymarin 
                        herb extract) and choline/inositol 500 mg (250 
                        mg each of choline and inositol). I took three pills 
                        of each three times a day for about a year. Now my liver 
                        tests as being in very good health. 
                      Bob answered: That's great. So you're 
                        saying you have a coinfection of HIV and Hep C and after 
                        taking these supplements for a year that it appears to 
                        have solved the problem? I have heard of silymarin but 
                        not the choline/inositol for liver problems. what does 
                        the choline/inositol specifically do for the liver?
                      Dennis answers: A few years ago, I was 
                        told that I had a light case of Hep C (along with 
                        HIV). I researched the liver to see what would help 
                        and found that there is a large amount of choline in the 
                        liver used to metabolize "stuff." (I sound 
                        very scientific, I joke.) So I started to take inositol/choline 
                        500 mg (250mg of each) three times a day. About 
                        9 months later, I went to Dr. Jacobson in NYC who is a 
                        liver specialist (maybe the only one) and he 
                        had a DNA (RNA?) test done and said, "The 
                        hepatitis C appears to be gone." Talk about anecdotal 
                        evidence. Who knows what did it because I also took 3 
                        milk thistle pills a day.
                      
                      This is why I suggest that people take Alfalfa and Lipoic 
                        Acid.
                      See chapter 19 
                        and 25 
                        in the newest edition of Triumph Over Hepatitis C
                      In Good Health
                      Lloyd