Primary Biliary Cirrhosis

Background

This is a condition where the bile ducts in the liver are slowly damaged, and most likely is an autoimmune disease in which the body attacks its own cells. What triggers primary biliary cirrhosis isn’t clear.

Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins. When bile ducts are damaged, as in primary biliary cirrhosis (PBC), harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

The question of PBC is usually raised when standard liver blood tests show inflammation. At that time, a blood test for anti-mitochondrial antibodies (AMAs) can be helpful. These antibodies almost never occur in people who don’t have the disease, even if they have other liver disorders. For that reason, a positive AMA test is considered a very reliable indicator of the disease. Unfortunately, in some cases of PBC this test is negative and therefore further testing with liver scans, MRIs, and biopsies are sometimes needed

Treatments

Standard medical treatment

This is geared predominantly at helping the secondary symptoms such as fatigue, itching, bone loss and poor digestion.

The 1st line of treatment is the medication Ursodeoxycholic acid (UDCA), which is also known as ursodiol (Actigall, Urso). UDCA is a bile acid that helps move bile through your liver.

A number of studies have looked at the use of a medication called colchicine to improve outcome in PBC. Results have been conflicting, but I consider it a reasonable treatment to be used long term, especially if itching is a problem. It is more likely to be recommended by holistic doctors than gastroenterologists.

Natural treatments include:

• Taking a good high potency multivitamin (powder form is best) as well as a fish oil supplement, as the loss of bile contributes to nutritional deficiencies.
• For poor digestion, health food stores often carry Ox bile supplements.
• To support liver health in general, I strongly recommend lipoic acid 300 mg twice a day, NAC (N-acetylcysteine) 500 mg 1-2x day, and the herb milk thistle. All of these can offer liver support.