If you don’t have access to treatment right now, if you’ve gone through the treatment and weren’t able to clear the virus or if you’re infected with another virus such as HIV that can be harmful to the liver, there are several things you can do to help keep your liver healthier.

Get your Hepatitis A and Hepatitis B vaccinations:
You’ve got one viral infection your liver has to deal with. Prevent other viral infections that are known to harm the liver and are vaccine preventable.

Eliminate Harmful Chemicals From Your Body:
A. ALL alcohol, in any amount, is harmful to your liver. Eliminate all alcohols from your diet.
B. ALL illicit drugs are harmful to your liver. Studies have shown that the use of marijuana can cause   the liver to progress to scarring sooner. It doesn’t make any difference on how the drug is used (injecting, smoking, eating, inhaling), they are all harmful to your liver. Eliminate all illegal drug use. Talk with your provider or a counselor to identify ways to help you stop the use of any illegal drugs.
C. Decrease polluted air that you breathe, such as:
    1) Second-hand cigarette smoke
    2) Car exhaust
    3) Agricultural pesticides
    4) Smog

Get a Prescription Review:
Have your doctor or pharmacist review all your prescribed medications to ensure that none of your medications are toxic for your liver. Ask your provider about alternatives to any medications that may harm your liver.

Use Over The Counter Medications Properly:
Always follow the directions on the package, unless told otherwise by your medical provider.

Be Careful With Vitamins, Herbs and Mineral Use:
A. Some of the “Fat Soluble” vitamins can build up in your system and be toxic to your liver. Check with your provider before taking more than the daily recommendations.
B. Before taking any herbal supplement, research it and make sure that it doesn’t have the potential to damage to your liver, such as Kava, Valerian Root and Sassafras. Check with your doctor before adding any herbal supplements to your diet.
C. The liver has to store all the excess iron that you take in during a day. It’s important not to eat more iron in a 24 hour day than what your body actually uses. Extra iron stored in the liver can cause your liver to begin scarring sooner. Talk with a dietician or your doctor to find out how much iron you should eat in a day.

Modify Your Diet:
A. Decrease the amount of fatty foods and cholesterol that you eat. Extra fat stored in the liver can cause a liver to begin scarring sooner.
B. Increase the amount of actual water that you drink during a 24 hour day. Water helps flush the chemicals and poisons out of your body. To find out how much water you should drink in a 24 hour period: take your body weight in pounds and divide it by 2. This equals how many ounces of water you should drink each day.

Light Daily Exercise:
Light daily exercise such as walking will help boost your immune system as well as help decrease excess fat stored in your liver. Talk to your provider about what the best form of exercise would be for you.

Symptoms That Need to be Reported to Your Provider:
A. “White” or “Gray” colored stools
B. “Coca-Cola” colored urine
C.  Increased amount of time before a cut or wound stops bleeding
D.  The white part of your eyes turning yellow.

Courtesy: Hepatitis Prevention Program, Nebraska Department of Health & Human Services.

Hepatic Damaging Herbs

Name	Also Known As	Adverse Reaction
American Cranesbill	Alum Bloom, Alum Root, American Kino, Chocolate Flower, Crowfoot, Dove’s-Foot, Geranium Robertianum, Herb Robert, Old Maid’s Nightcap, Shameface, Spotted Cranesbill, Stinking Cranesbill, Storksbill, Wild Cranesbill, Wild Geranium	Hepatotoxicity with high tannin concentrations
Andrographis	Chuan Xin Lian, Creat, Green Chiretta, Indian Echinacea, Kalmegh, Kirata, Kiryat, Lanhelian, Vijianxi	Increased liver enzymes, decreased after discontinuation
Androstenedione	4-Androstene-3, 17-Dione	Elevated liver function test results with supplementation of some anabolic steroids
Arnica	Arnica Flowers, Arnica Root, Common Arnica, Leopard’s Bane, Mexican Arnica, Mountain Arnica, Mountain Daisy, Mountain Tobacco, Sneezewort, Wolf’s Bane	Hepatic Failure
Bayberry	Candleberry, Myrica, Southern Wax Myrtle, Spicebush, Sweet Oak, Tallow Schrub, Vegetable Tallow, Waxberry, Wax Myrtle Plant	Hepatic damage, may relate to tannin content
Betony	Bishopswort, Wood Betony	Hepatic Dysfunction
Bilberry	Bilberries, Bog Bilberries, European Blueberries, Huckleberry, Whortleberry	Hepatic Dysfunction caused by tannin content
Bistort	Adderwort, Common Bistort, Easter Ledges, Easter Mangiant, Knotweed, Oderwort, Osterick, Patience Dock, Snakeroot, Snakeweed, Twice Writhen	Hepatic Dysfunction
Blue Flag	Dagger Flower, Dragon Flower, Flag Lily, Fleur-De-Lis, Flower-De-Luce, Liver Lily, Poison Flag, Snake Lily, Water Flag, Wild Iris	Hepatotoxicity caused by tannin concentrations
Boneset	Agueweed, Crosswort, Eupatorium, Feverwort, Indian, Sage, Sweating Plant, Thoroughwort, Vegetable Antimony	Hepatotoxicity
Borage	Beebread, Boraginis Flos, Boraginis Herba, Boretsch, Common Borage, Common Bugloss, Cool Tankard, Ox’Tongue, Starflower	Hepatic Dysfunction
Buchu	Agathosma, Barosma Betulina, Betuline, Bocco, Diosma Betulina	Hepatotoxicity from volatile oil constituent (pulegone)
Buckthorn	Common Buckthorn, European Buckthorn, Hartshorn, Purging Buckthorn, Waythorn	Hepatotoxicity caused by tannin concentrations
Butterbur	European Pestroot, Sweet Coltsfoot, Western Coltsfoot	Hepatotoxicity
Capsicum	Bell Pepper, Capsaicin, Cayenne, Chili Pepper, Goat’s Pepper, Hot Pepper, Paprika, Pimiento, Pod Pepper, Red Pepper, Tabasco Pepper, Zanzibar Pepper	Hepatic dysfunction, when used orally on a regular basis
Celandine	Celandine Poppy, Common Celandine, Felonwort, Garden Celandine, Greater Celandine, Rock Poppy, Swallow Wort, Tetterwort, Wart Wort	Acute Cholestatic Hepatitis, Elevated liver function test results
Chaparral	Creosote Bush, Greasewood, Hediondilla	Hepatotoxicity (Cholestatic Hepatitis)
Chromium	Chromium Picolinate, Chromium Tripicolinate, CR	Hepatic Failure (1,000 mcg/day; Ceruli et al., 1998)
Cola Tree	Kola Nut, Kolanut	Hepatotoxicity caused by high tannin concentrations
Colostrum	Bovine Colostrum, Bovine Immunoglobulin Concentrate (BIC), Hyperimmune Bovine Concentrate (HBC), Immunized Bovine Colostrum (HBC)	Elevated liver enzyme levels
Colt’s Foot	Ass’s Foot, Bullsfoot, Coughwort, Farfara, Fieldhove, Filuis Ante Patrem, Foalswort, Hallfoot, Horsehoof, Kuandong Hua, Pas Diane	Potential Hepatic Veno-Occlusive disease caused by pyrrolizidine content
Comfrey	Ass Ear, Black Root, Blackwort, Boneset, Bruisewort, Consolida, Consoud Root, Gum Plant, Healing Herb, Knitback, Knitbone, Salsify, Slippery Root, Wallwort, Yalluc	Hepatotoxicity, specifically Veno-Occlusive disease from pyrrolizidine alkaloids
Condurango	Condor-Vine Bark, Condurango Bark, Condurango Blanco, Eagle Vine, Gonolobus Condurango Triana, Marsedenia Condurango	Hepatic Dysfunction
Corydalis	None Listed	Acute Hepatitis
Cowslip	American Cowslip, Artetyke, Arthritica, Buckles, Crewel, Drelip, Fairy Caps, Herb Peterpaigle, Keyflower, Key of Heaven, May Blob, Mayflower, Our Lady’s Keys, Paigle, Palsywort, Password, Peagles, Petty Mulleins, Plumrocks	Hepatotoxicity possibly caused by tannin concentrations
Damiana	Damiana Herb, Damiana Leaf, Herba De La Pastora, Mexican Damiana, Miziboc, Old Woman’s Broom, Rosemary	Hepatic dysfunction (large amounts) caused by tannin content
Fo-Ti	Chinese Cornbind, Elixir of Life, Fleeceflower, He Shou Wu, Kashuu (Japanese), Shou Wu Chih	Acute Hepatitis (Cholestatic Hepatitis)
Gossypol	American Upland Cotton, Common Cotton, Cotton, Upland Cotton, Wild Cotton	Hepatotoxicity
Gum Arabic	Acacia, Acacia Arabica Gum, Acacia Gum, Acacia Senegal, Acacia Ver, Egyptian Thorn, Gummae Mimosae, Senega	Hepatotoxicity with I.V. use
Horse Chesnut	Aescin, Chesnut, Escine	Hepatotoxicity
Iceland Moss	Cetraria, Consumption Moss, Iceland Lichen, Lichen Islandicus	Hepatotoxicity
Kava	Ava, Awa, Kava-Kava, Kawa, Kew, Sakau, Tonga, Yagona	Significant liver damage, including Hepatitis, Cirrhosis, and Liver Failure
Khat	Cat, Chat, Gad, Kat, Miraa, Qat, Tschut	Hepatotoxicity
Lady’s Mantle	Alchemilla, Bear’s Foot, Dewcup, Leontopodium, Lion’s Foot, Nine Hooks, Stellaria	Hepatic dysfunction, related to tannin component
Locust Bean	Carob, Carob Bean Gum, Carob Tree, St. John’s Bread	Liver damage, associate with plants high in tannin content
Mayapple	Devil’s-Apple, Hog Apple, Indian Apple, Mandrake, May Apple, Umbrella Plant, Wild Lemon	Hepatotoxicity
Mistletoe	All-Heal, Birdlime, Devil’s Fuge, European Mistletoe, Golden Bough, Viscum	Hepatitis
Oaks	British Oak, Brown Oak, Common Oak, Cortex Quercus, Escorce De Chene, Eichenlothe, Eicherinde, Encina, English Oak, Gravelier, Nutgall, Oak Apples, Oak Bark, Oak Galls, Pedunculate Oak, Stone Oak, Tanner’s Bark	Hepatic Necrosis with more than 1 g of tannins. Hepatotoxicity with tannic acid enemas & prolonged skin application
Parsley	Common Parsley, Garden Parsley	Hepatotoxicity associated with apiole and myristicin components
Pennyroyal	American Pennyroyal, European Pennyroyal, Mosquito Plant, Squawmint	Hepatic Failure
Pomegranate	Granatum, Punica Granatum	Hepatotoxicity related to high tannin component
Poplar	American Aspen, Black Poplar, Quaking Aspen, White Poplar	Hepatotoxicity related to high tannin
Ragwort	Cankerwort, Cocashweed, Coughweed, Dog Standard, False Valerian, Golden Ragwort, Golden senecio, Lfroot, Ragweed, St. James Wort, Staggerwort, Stammerwort, Stinking nanny Squaw Weed, Squawroot	Hepatotoxicity
Rhatany	Krameria Root, Mapato, Peruvian Rhatany, Pumachchu, Raiz Para Los Dientes, Ratanshiaqutrezel, Red Rhatany, Rhatania	Acute Hepatotoxicity with tannic acid
Shark Cartilage	Squalus Acanthias, Sphyrna Lewini	Hepatitis
Scullcap	Helmet Flower, Hoodwort, Skullcap	Hepatotoxicity
Soapwort	Bouncing Bet, Bruisewort, Crow Soap, Fuller’s Herb, Latherwort, Soap Root, Sweet Betty, Wild Sweet William	Hepatotoxicity
Sorrel	Belgian-Red Sorrel, Cuckoo’s Meate, Cuckoo Sorrow, Dock, Garden Sorrel, Greensauce, Green Sorrel, Sheep Sorrel, Sour Dock, Sourgrass, Sour Sauce, Soursuds	Hepatic Dysfunction caused by soluble oxalate salts
Spirulina	Blue-Green Algae, Dihe, Tecuitlatl	Increased serum Alkaline Phosphatase level
Squaw Vine	Checkerberry, Deerberry, Mitchella Repens, Mitchella Undulata, One-Berry, Partridge Berry, Running Box, Squawberry, Twin Berry, Two-Eyec Berry, Two-Eyed Checkerberry, Winter Clover	Hepatotoxicity (Rare)
Tonka Bean	Cumaku, Tonka Seed, Tonquin Bean, Torquin Bean	Hepatic Necrosis
Tormentil Root	Biscuits, Bloodroot, Earthbank, English Sarsaparilla, Ewe Daisy, Five-Fingers, Flesh and Blood, Septfoil, Seven Leaves, Shepherd’s Knapperty, Shepherd’s Knot, Thormantle	Hepatic Necrosis
Valerian	All-Heal, Amantilla, Baldrianwurzel, Great Wild Valerian, Herba Benedicta, Katzenwurzel, Phu Germanicum, Phu Parvum,Pinnis Dentatis, Setewale Capon’s tail, Setwall, Theriacaria,Valeriana, Valeriana Folis Pinnatis, Valeriana Radix	Hepatic Necrosis
Walnut	English Walnut, European Walnut, Juglone, Jupiter’s Nuts, Persian Walnut, Walnut Hull, Walnut Leaf	Hepatotoxicity caused by tannin component
Willow	Black Willow, White Willow	Hepatic Dysfunction

Courtesy: Hepatitis Prevention Program, Nebraska Department of Health & Human Services.

All information compiled from The Professional’s Handbook of Complementary & Alternative Medicines, 3rd Edition,@ 2004, Lippincott Williams & Wilkins, G.W. Fetrow Pharm D & Juan R. Avila Pharm D.