Hepatitis

Hepatitis is when the liver gets inflamed. It is diagnosed by elevations in two simple liver blood tests: ALT or AST — formerly called SGOT and SGPT.

Chronic hepatitis is most often associated with mild ALT and/or AST elevations (under 200):

1. Fatty infiltration of the liver — often associated with being overweight.
2. Excess alcohol.
3. Medication toxicity, especially with cholesterol lowering medications called statins, which I consider to be grossly overused in those without known heart or blood vessel disease (see High Cholesterol). Another common cause is acetaminophen/Tylenol/paracetamol.
4. Autoimmune hepatitis (e.g., with lupus).
5. Hemochromatosis (genetic iron excess).
6. Acute viral hepatitis, which persisted.

Acute hepatitis (lasting under six months) is often associated with very high ALT and AST levels in the 1,000s. These are most often from viral infections or a chemical/drug toxicity. The most common viral causes include those below.

Common Viral Causes of Hepatitis

Hepatitis A

Hepatitis A is often from contaminated food or water in countries with poor water hygiene. Symptoms begin 2-6 weeks after the exposure to the contaminant. It most often resolves on its own with no permanent harm.

Hepatitis B

Hepatitis B is usually blood borne (e.g., from a blood transfusion or a contaminated needle) or sexually transmitted in the U.S. and Western Europe. It clears on its own in 95% of adults, but may become chronic in a small percent — especially those also positive for the Hepatitis D virus.

Hepatitis B is epidemic in Asia and Africa. In these areas, the infection is most often transmitted from mother to child during pregnancy. I consider the hepatitis B vaccine to be very worthwhile as part of childhood vaccination worldwide. In adults who get the vaccine, if the person does not show immunity after the 3rd vaccine injection, I recommend not getting a 4th, as I have seen this occassionally trigger CFS/fibromyalgia.

Hepatitis C

Hepatitis C is also usually blood borne (e.g., from a blood transfusion or a contaminated needle) or sexually transmitted. It usually will not cause symptoms or marked liver test elevation, and is most often picked up on routine blood testing. If it persists over six months, a significant percent of cases (on the order of 3-20%) will go on to develop liver failure (see Cirrhosis). In recent studies, promising new antiviral medications have been found to eliminate the hepatitis C.

Infectious mononucleosis

Infectious Mononucleosis (aka "Mono" — the "kissing disease") has normally occurred in most people by the time they are 30 years old, and can be associated with liver inflammation that is usually not severe or dangerous (exposure to possible trauma, like participating in contact sports, should be avoided until it resolves).  It normally resolves on its own, and can be helped by simple treatments. (See Mononucleosis.)

Importance of Early Detection and Treatment

Simple blood tests can usually determine the cause of most cases of hepatitis. As the liver has remarkable regenerative ability (it can heal itself) if treated early, liver support given early rather than when cirrhosis is present is preferred.