EPPWS

Background: There has been an increase in the number of adults seeking liver transplantation for hepatitis C in the last few years and the count is going up rapidly. There is no reliable and effective therapy for chronic hepatitis C since interferon and antivirals work no more than 30% of the time, and liver transplant surgery is uncertain and tentative over the long run. This is because, ultimately, residual hepatitis C viremia infects the new liver. Furthermore, liver transplantation can be painful, disabling and extremely costly.

Treatment program: The author describes a low cost and efficacious treatment program in 3 patients with cirrhosis, portal hypertension and esophageal varices secondary to chronic hepatitis C infection. This effective and conservative regimen combines 3 potent antioxidants (alpha-lipoic acid [thioctic acid], silymarin, and selenium) that possess antiviral, free radical quenching and immune boosting qualities.

Conclusion: There are no remarkably effective treatments for chronic hepatitis C in general use. Interferon and antivirals have less than a 30% response rate and because of the residual viremia, a newly transplanted liver usually becomes infected again. The triple antioxidant combination of alpha-lipoic acid, silymarin and selenium was chosen for a conservative treatment of hepatitis C because these substances protect the liver from free radical damage, increase the levels of other fundamental antioxidants, and interfere with viral proliferation. The 3 patients presented in this paper followed the triple antioxidant program and recovered quickly and their laboratory values remarkably improved. Furthermore, liver transplantation was avoided and the patients are back at work, carrying out their normal activities, and feeling healthy. The author offers a more conservative approach to the treatment of hepatitis C, that is exceedingly less expensive. One year of the triple antioxidant therapy described in this paper costs less than $2,000, as compared to mor than $300,000 a year for liver transplant surgery. It appears reasonable, that prior to liver transplant surgery evaluation, or during the transplant evaluation process, the conservative triple antioxidant treatment approach should be considered. If these is a significant betterment in the patient's condition, liver transplant surgery may be avoided.

ABSTRACT
Alpha lipoic acid (ALA, thioctic acid),
among other actions, is an essential
coenzyme in the conversion of pyruvate
to acetyl co-enzyme A. Therefore,
it is necessary for the production of
energy for aerobic organisms.
Scientists have found that it can be
used medically to help regenerate
liver tissue, reverse the complications
of diabetes mellitus, slow or
stop the growth of cancer cells, and
chelate heavy metals, among other
actions. In this article, the authors
describe the cellular mitochondrial
damage from excessively high doses of this beneficial agent

The authors, in a previous article, described the long-term survival of a man with pancreatic cancer and metastases to the
liver, treated with intravenous alpha-lipoic acid and oral low-dose naltrexone (ALA/N) without any adverse effects. He is
alive and well 78 months after initial presentation. Three additional pancreatic cancer case studies are presented in this
article. At the time of this writing, the first patient, GB, is alive and well 39 months after presenting with adenocarcinoma of
the pancreas with metastases to the liver. The second patient, JK, who presented to the clinic with the same diagnosis was
treated with the ALA/N protocol and after 5 months of therapy, PET scan demonstrated no evidence of disease. The third
patient, RC, in addition to his pancreatic cancer with liver and retroperitoneal metastases, has a history of B-cell lymphoma
and prostate adenocarcinoma. After 4 months of the ALA/N protocol his PET scan demonstrated no signs of cancer. In this
article, the authors discuss the poly activity of ALA: as an agent that reduces oxidative stress, its ability to stabilize NFkB, its
ability to stimulate pro-oxidant apoptosic activity, and its discriminative ability to discourage the proliferation of malignant
cells. In addition, the ability of lowdose naltrexone to modulate an endogenous immune response is discussed. This is the
second article published on the ALA/N protocol and the authors believe the protocol warrants clinical trial.

The authors describe the long-termsurvival of a patient with
pancreatic cancer without any toxic adverse effects. The
treatment regimen includes the intravenous -lipoic acid
and low-dose naltrexone (ALA-N) protocol and a healthy
lifestyle program. The patient was told by a reputable university
oncology center in October 2002 that there was little
hope for his survival. Today, January 2006, however, he is
back at work, free from symptoms, and without appreciable
progression of his malignancy. The integrative protocol described
in this article may have the possibility of extending
the life of a patient who would be customarily considered to
be terminal. The authors believe that life scientists will one
day develop a cure for metastatic pancreatic cancer, perhaps
via gene therapy or another biological platform. But until
such protocols come to market, the ALA-N protocol should
be studied and considered, given its lack of toxicity at levels
reported. Several other patients are on this treatment protocol
and appear to be doing well at this time.
Keywords: pancreatic cancer; naltrexone; lipoic acid; survival

In this case report, we describe the treatment of a 64-year-old male patient diagnosed with metastatic renal cell carcinoma
(RCC) in June of 2008. In spite of a left nephrectomy and the standard oncological protocols, the patient developed a solitary
left lung metastasis that continued to grow. He was informed that given his diagnosis and poor response to conventional
therapy, any further treatment would, at best, be palliative. The patient arrived at the Integrative Medical Center of New
Mexico in August of 2010. He was in very poor health, weak, and cachectic. An integrative program—developed by one of
the authors using intravenous (IV) α-lipoic acid, IV vitamin C, low-dose naltrexone, and hydroxycitrate, and a healthy life
style program—was initiated. From August 2010 to August 2015, the patient’s RCC with left lung metastasis was followed
closely using computed tomography and positron emission tomography/computed tomography imaging. His most recent
positron emission tomography scan demonstrated no residual increased glucose uptake in his left lung. After only a few
treatments of IV α-lipoic acid and IV vitamin C, his symptoms began to improve, and the patient regained his baseline
weight. His energy and outlook improved, and he returned to work. The patient had stable disease with disappearance
of the signs and symptoms of stage IV RCC, a full 9 years following diagnosis, with a gentle integrative program, which is
essentially free of side effects. As of November 2017 the patient feels well and is working at his full-time job

In this case report, we describe the treatment of a 64-year-old male patient diagnosed with metastatic renal cell carcinoma
(RCC) in June of 2008. In spite of a left nephrectomy and the standard oncological protocols, the patient developed a solitary
left lung metastasis that continued to grow. He was informed that given his diagnosis and poor response to conventional
therapy, any further treatment would, at best, be palliative. The patient arrived at the Integrative Medical Center of New
Mexico in August of 2010. He was in very poor health, weak, and cachectic. An integrative program—developed by one of
the authors using intravenous (IV) α-lipoic acid, IV vitamin C, low-dose naltrexone, and hydroxycitrate, and a healthy life
style program—was initiated. From August 2010 to August 2015, the patient’s RCC with left lung metastasis was followed
closely using computed tomography and positron emission tomography/computed tomography imaging. His most recent
positron emission tomography scan demonstrated no residual increased glucose uptake in his left lung. After only a few
treatments of IV α-lipoic acid and IV vitamin C, his symptoms began to improve, and the patient regained his baseline
weight. His energy and outlook improved, and he returned to work. The patient had stable disease with disappearance
of the signs and symptoms of stage IV RCC, a full 9 years following diagnosis, with a gentle integrative program, which is
essentially free of side effects. As of November 2017 the patient feels well and is working at his full-time job.

Summary
Between August 8, 1974, and November
1, 1978, calls reporting 100 cases of
mushroom poisoning were received by the
National Institutes of Health. Thioctic
acid was sent (under IND # 9957) for the
treatment of seventy-five of these patients
thought to have ingested mushrooms containing
alpha-amanitin. Sixty-seven patients
recovered, and eight died. The lapse
of time between ingestion of mushrooms
and the start of the protocol appears to be
inversely related to the success of treatment.
Serum glutamic-oxaloacetic transaminase
and serum glutamic-pyruvic
transaminase appear to be the best indices
of the severity of poisoning. No toxicity
attributable to thioctic acid was observed
when thioctic acid was given from a container
shielded from light, containing glucose,
5% and saline, 0.85%.

Four patients ranging from 28 to 53 ingested hepatotoxic mushrooms of the genera Amanita and Galerina and developed symptoms of acute hepatic necrosis. Liver enzymes were as high as 4000 u/l on admission. They were all treated with antibiotics to occupy the binding sites and Thioctic acid (alpha lipoic acid), an FDA investigational drug (9957). All four patients made rapid recoveries.

The author treated 4 severely ill patients who consumed hepatotoxic mushrooms of the genera Amanita and Galerina. They had very high liver enzymes reaching 4000 u/l. After being treated with antibiotics to occupy binding sites and the FDA investigational drug thioctic acid (alpha lipoic acid} all four patients recovered quickly.

Between August 8, 1974, and November 1, 1978, calls reporting 100 cases of mushroom poisoning were received by the National Institutes of Health. Thioctic acid was sent (under IND # 9957) for the treatment of seventy-five of these patients thought to have ingested mushrooms containing alpha-amanitin. Sixty-seven patients recovered, and eight died. The lapse of time between ingestion of mushrooms and the start of the protocol appears to be inversely related to the success of treatment. Serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase appear to be the best indices of the severity of poisoning. No toxicity attributable to thioctic acid was observed when thioctic acid was given from a container shielded from light, containing glucose, 5% and saline, 0.85%.