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Hepatitis
An inflammation of the liver that can run silently — which is why the test matters more than how you feel.
Also known as: liver inflammation · hepatitis A/B/C/E · raised liver values
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
An inflammation of the liver. The causes are diverse: viruses (hepatitis A, B, C, E), alcohol, a fatty liver, certain medicines or toxins, and autoimmune processes. It can be acute (short) or chronic (long-lasting). It often goes unnoticed for a long time; when symptoms appear: fatigue, pressure in the right upper abdomen, nausea, yellowing of skin and eyes (jaundice), dark urine. Chronic hepatitis can slowly damage the liver — so the cause matters. Modern medicines can cure hepatitis C and control hepatitis B well. Blood values and medical follow-up guide the approach.
The key step: a blood test to distinguish virus, alcohol, fatty liver, medication and autoimmune.
Relieve the inflamed liver: no alcohol, medicines only after consultation.
Watch liver values over time to catch chronic damage early.
Treat according to the cause — e.g. modern antiviral medicines can cure hepatitis C.
In hepatitis C, today’s tablets cure the infection in eight to twelve weeks in more than ninety-five out of a hundred people — a real cure, not suppression. In hepatitis B the drugs hold the virus down for as long as they are taken; the virus stays in the cell nucleus.
Worldwide about 250 million people live with hepatitis B and some 50 million with hepatitis C; most do not know, because both run silently for decades. From infection to cirrhosis typically takes twenty to thirty years — a very long window in which treatment changes everything.
Especially the chronic form, often found by chance through raised liver values.
General exhaustion, loss of appetite and nausea are common early signs.
Yellow skin and eyes, dark urine and pale stools point to the liver.
A dull pressure under the right rib cage.
The most sensitive value for damage to liver cells. How high it climbs says little about the course — what counts is whether it stays raised over months.
If it rises, eyes and skin turn yellow and the urine darkens. That shows the liver is no longer managing its excretory task.
The most important value for how the liver is performing. If it lengthens during an acute inflammation, that is a reason to act at once.
Reacts to alcohol, medicines and a back-up of bile. Together with the alkaline phosphatase it separates the causes from one another.
Clarifies whether the virus is there now and whether there was ever contact. If the surface protein stays detectable for more than six months, the infection is lasting — not always treated, but always watched.
With liver values raised for unclear reasons this value belongs alongside. If the virus is still there, the illness is today usually curable within eight to twelve weeks with tablets.
The store lasts only a few weeks and empties quickly with alcohol and poor food. A lack hits nerves and brain first — which is why it is corrected here early and without hesitating.
The liver is the store, and alcohol disturbs both the uptake and the storing. A lack shows in the blood count as red cells that are too large.
With advanced liver disease a lack is common and contributes to loss of taste, poor wound healing and states of confusion.
The old rule of restricting protein in liver disease no longer holds. Too little of it breaks muscle down, and muscle is an important part of the reserve in this illness.
Much studied in liver disease: slight improvements in liver values, no clear effect on the course. It does not replace antiviral treatment.
A precursor of glutathione, the liver’s main detoxifying helper. In paracetamol poisoning it is the antidote — from which it is often concluded that it helps the liver generally. For chronic hepatitis that is not shown.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
With autoimmune hepatitis thyroid conditions come along more often, and the former interferon treatment itself triggered thyroid disorders. The value therefore belongs to the follow-up.
The liver makes this transport protein. With liver inflammation it rises — and with it the freely available share of testosterone and estradiol falls, although the total value looks normal.
An inflamed liver breaks alcohol down more slowly; how much is tolerated depends on the stage. Protein is usually kept at 1.0–1.2 g per kg body weight a day — too little wastes muscle.
In chronic hepatitis with high ferritin iron intake is limited. Without overload this does not apply — iron is then wanted as normal.
Silymarin is much studied in liver disease. Reviews find slight improvements in liver values but no clear effect on the course. In hepatitis it does not replace antiviral treatment.
In chronic hepatitis with fatty liver dietary change affects the course — weight and sugar are the levers here, not individual supplements.
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