Hepatitis C: An In-Depth Guide

Liver care

Learning how to take care of the liver is a key part of living with hepatitis C. Caring for the liver includes knowing what can help the liver and knowing what can damage it.

Activities that help the liver

Eating Nutritious Foods

Good nutrition helps people with their overall health, especially because liver disease affects digestion and the metabolism, absorption and storage of nutrients.

Eating well gives people the energy and nutrients they need to feel well, have functioning immune systems, help their liver regenerate or maintain itself, and manage Hep C symptoms.

Eating well for people with Hep C means:

  • choosing a variety of foods each day, including protein to help fight infection and aid in liver regeneration 
  • taking in an adequate amount of calories but not more than needed
  • eating vegetables and fruit rich in vitamins A and C
  • avoiding alcohol to allow the liver to regenerate
  • limiting foods high in fat and sugar

For more information on eating healthy on a low budget, see Eating Healthy.

Vitamins and supplements may also be helpful in taking care of the liver. However, it is important to consult a doctor or pharmacist before beginning to taking a multivitamin. It is necessary for people with hepatitis C to avoid iron supplements and find a multivitamin without iron.

Consult a doctor or pharmacist before taking painkillers and other medications, vitamins, herbs and supplements. Some are more liver friendly than others. If you are on treatment for hepatitis C, speak with your doctor about possible interactions.

To learn more about herbs and supplements and hepatitis C, see complementary therapies.

Exercising

Exercise is part of staying healthy. Obesity and steatosis (fat build-up around the liver) can interfere with the effectiveness of Hep C treatment and also make liver problems worse. Light to moderate exercise can boost energy, reduce stress and prevent weight gain. For people with hepatitis C who are feeling unwell or who are experiencing side effects from treatment, it may be difficult to think of exercising. Exercise does not have to be strenuous or complicated; people can build gradually to exercising 15–30 minutes, three times per week. Finding physical activities that people enjoy and that are simple to do will make exercising easier. Ten minutes of activity here and there adds up!

Physical activity is recommended for all people with HCV, except those with decompensated liver disease or other metabolic complications.

Coffee

Although under debate, some studies have shown a relationship between drinking coffee and slower development of liver damage (cirrhosis), hepatocellular carcinoma (HCC) and lower liver enzyme levels. More studies are needed to verify this and clarify the mechanism of action.

Drinking too much coffee can cause other medical problems, but finding a balance by drinking two to three small cups of coffee per day may help a person with Hep C maintain a healthier liver. Making or buying coffee can also be a social activity and an affordable option for people on a fixed income.

Getting vaccinated for hepatitis A and B

Hepatitis A and B can also harm the liver. If a person does not have hepatitis A or B, they can get a vaccine for both, which would prevent them from getting Hep A or B. If a person has hepatitis B, it is possible to get treatment. Hepatitis A will usually go away on its own.

Activities that can damage the liver

Drinking Alcohol

Alcohol can increase damage to the liver and the likelihood of developing liver cancer. Drinking less alcohol—or not drinking it at all—is one of the best things someone with Hep C can do for their health. Not drinking also improves the chances of Hep C treatment working.

If a person wants to make this change in their life, they may need to try different strategies to discover what works for them. Here are some suggestions:

  • Set a drinking goal that seems manageable and try to stick to it.
  • Space out alcoholic drinks with non-alcoholic drinks such as water, juice or pop.
  • Switch to smaller drinks or drinks with lower alcohol content (a 3% beer instead of 5%, for example).
  • Water down hard alcohol by mixing it with juice, soda pop or water.
  • Seek support through a support group, addiction treatment or counselling.

Some people find that the best way is to stop drinking all together. Some people are able to do this on their own, while others find that some sort of support group works best.

For some people, recovering from a drug or alcohol addiction can be a lifelong process. Many people may go back to alcohol or drug use (also known as relapsing) from time to time. It is important to remember that if it happens, it is a normal part of recovery.

Smoking Cigarettes

Cigarette smoking damages the liver. If a person smokes and drinks alcohol, this can cause greater damage to the liver. Smoking can also cause heart disease, lung cancer and breathing problems. Like alcohol, nicotine is highly addictive and can be hard to cut back. Most provinces and territories have a smoker’s helpline website (smokershelpline.ca) that offers resources and support for quitting smoking. They are:

Province or Territory

Helpline Phone Numbers 

Alberta

 1-866-710-QUIT (1-866-710-7848)

British Columbia

 1-877-455-2233

Manitoba

 1-877-513-5333

New Brunswick

 1-877-513-5333

Newfoundland and Labrador

 1-800-363-5864

Northwest Territories

 1-866-286-5099

Nova Scotia

 1-877-513-5333

Nunavut

 1-866-3NU-QUIT (1-866-368-7848)

Ontario

 1-877-513-5333

Prince Edward Island 

 1-877-513-5333

Quebec

 1-866-527-7383

Saskatchewan

 1-877-513-5333

Yukon

 1-877-513-5333

Taking Over-the-Counter Painkillers

Painkillers are generally divided into two categories.

The first is the analgesic (painkilling) and antipyretic (fever reducing) drug called acetaminophen, the active ingredient in Tylenol.

The second category consists of non-steroidal anti-inflammatory drugs (NSAIDs), commonly known as ibuprofen or acetylsalicylic acid, the active ingredients in Advil and Aspirin.

Each category of drug can provide pain and fever relief, and the NSAIDs also have anti-inflammatory properties.

People with Hep C often use painkillers to manage side effects and symptoms, but they should never exceed the allowable or recommended dose. Both categories of drugs have shown liver-toxic effects when more than the recommended dose is taken. It is also possible to overdose on Tylenol. To learn more about how to prevent a Tylenol overdose, see Pain medications.

Doctors can provide additional information on how to manage pain and can recommend the best choice for patients with Hep C.

Using Drugs

There is not a lot of information about how street drugs affect the liver. Some research has shown that daily marijuana (pot) use may increase liver damage but more research is needed to confirm this.

Some people may decide to change their drug use when they find out they have hepatitis C by decreasing or stopping their drug use or using less harmful drugs.

Revised 2014.