Can I postpone a treatment?

[JustMe11111]

Hi everyone. I have chronic hepatitis B since I am born but I found out about it when I was 17 in 2010 (10 years ago) my gp did not refer me to a specialist. I now live in another country and was doing my blood test regularly (as I have stopped meat and diary and wanted to make sure it is all okay, not particularly because of hepatitis). So my ALT levels started being high in end of 2015- mid 2016 and got elevated slowly in the next years (not more than twice the ref). Since last year November I had ALT elevated even more - about 68 with ref up to 35 and AST 47 from ref up to 35. They found out my HbEAg is now active as well (I do not think I ever had it checked previously). So then I had ultrasound done and FibroScan and everything seems to be alright. However my ALT and now AST keep elevating (other liver enzymes are alright) but I also have high DNA and HbSAg quantitative. In end of Nov DNA was 380 189 300 and HbsAg quantitative was 55 791. In Feb this year ALT was 82 and AST - 49, DNA 446 683 200. So since Nov I started taking Milk Thistle and Olive Leaf and then in Feb start taking much more herbs and vitamins such as Mushrooms, Dandelion, licorice root, selen, q10 etc. I have been reading a lot about hepatitis B and some books about people curing/controlling the virus with herbs. So I really do not want to start treatment as recommended by my Dr - Tenofovir as it is not sure for how long I have to take it and what the side effects in the end could be. So now I had another blood test since Feb and I was taking all of my herbs and vitamins all the time, I am not smoking, not drinking, I work out a lot, I am very fit so I feel great. My DNA is now reduced again to about 310 million and HbsAg quantitative to about 5000. However my ALT is much more elevated - 322 so my Dr urges me to start therapy even though the virus load is getting lower. She is worried about the scarring which the high ALT may cause. However I am still not sure starting a therapy is the right thing to do as there is a decrease in some numbers and my fibroscan and ultrasound were previously alright. I had ALT tested in June in my country and it was about 3 times elevated but now is much more. What would you guys advise me and what is your opinion? I have 2 weeks to collect my medications so I have to decide pretty much within that period what to do. I feel like I want to consult with another Dr too. Thank you.

[Lynn K]

There is little to no evidence to support herbal treatments for liver disease. The longer you have elevated liver enzymes the more risk you have of developing scarring over time.

One thing I can say for certain is you do not want to develop liver cirrhosis.

I would strongly recommend following your doctors advice. If unsure see a different doctor for a second opinion but I’m reasonably confident a different doctor will agree with your first doctors opinion.

[JustMe11111]

I think we all know why herbs are not as tested and there are not enough evidence how they work. Pharmaceutical companies are most interested in getting profits not in treating patients. Anyways from what I am reading about the phases for active chronic hepatitis B I am most likely going through the 2nd phase which is immune clearance. So basically the immune system if now fighting with the virus which can spontaneously clear the HBeAg and go to inactive stage. Something which nobody can tell how long can take and with what type of damage I will end up. However considering I am still only 26, in good health overall, living healthy life, there are greater chances of going through that stage without need of therapy. However some Dr would rather to recommend therapy to avoid scarring and damage to the liver. But being on therapy for ages would surely have some impact on the body too. So I am wondering which one is going to be more dangerous.

[Lynn K]

There have been a number of clinical trials for many different herbal approaches there has been little to no evidence to support efficacy for these methods.

In my personal opinion there is medicine and there is not medicine

Sure on rare occasions there have been some treatments that have come from natural sources Taxol for Brest cancer comes to mind but those successes have been few and far between

But in any event if unsure get a second opinion about treatment and consider researching the long term effects of being on this treatment.

I’m not a doctor and your not a doctor. You need your doctors expert medical advice to help you make this important decision about your health.

Best of luck