Medical Health Encyclopedia

A 2000 study of 15 patients with chronic liver disease concluded that methylphenidate (Ritalin) improves chronic fatigue symptoms in patients with cirrhosis and chronic hepatitis. All patients reported some improvement in fatigue, and no side effects were severe enough to warrant withdrawal from the study. The researchers recommended that treatment for chronic fatigue in patients with liver disease combine methylphenidate with physical therapy and nutritional counseling. Results of the study need to be confirmed in a randomized prospective trial.

Alternative Remedies

Among the natural substances being investigated for liver disease are ginseng, glycyrrhizin (a compound in licorice), catechin (found in green tea), SAMe, and silymarin (found in milk thistle). Two natural substances that may have some benefits for people with cirrhosis are discussed in the following paragraphs:

Silymarin. A 2001 review analyzed studies on 10 herbal remedies used for liver disease. None showed any benefits except silymarin. Furthermore, an analysis of five studies on cirrhosis patients reported an association between silymarin and a 7% reduced mortality rates from liver-related diseases. Known side effects from silymarin include rare reports of gastrointestinal problems and allergic skin rashes.

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S-adenosylmethionine (SAMe). S-adenosylmethionine (SAMe) is a chemical found in all parts of the body, which declines with age. It has been investigated for years in Europe for arthritis, depression, and liver disease. Some preliminary studies suggest it may provide some protection against liver damage and scarring and may improve survival rates in alcoholic patients with cirrhosis. It is very expensive, however, and as with all unregulated products, long-term side effects, drug interactions, and other factors are not fully known.