DEAR DR. DONOHUE: Is there an alternative, holistic approach to treating hepatitis C? I am afraid of the treatment my doctor recommends because it takes a year and a side effect is depression. I already have a problem with depression. I am 49 years old and am told that treatment will take 20 years off my life. – R.P.

I don’t know a holistic treatment for hepatitis C infection. Treatment does not take 20 years off a person’s life. It adds years to life – when it is needed.

In North America, more than 4 million people are infected with the virus, and 70 percent of them will stay infected for life. Of that 70 percent, about 20 percent will develop cirrhosis or liver cancer. Looked at in a different light, 80 percent of the chronically infected will not come down with serious liver problems.

How to identify those who are destined to have serious liver complications and those who are not is difficult. The strain of the hepatitis C virus that infects a person provides some information on what the future holds. Infections with types 2 and 3 are not likely to cause big trouble. However, type 1 causes most infections in North America. A liver biopsy gives valuable information that reliably predicts progression to liver cirrhosis or cancer. A low level of viral RNA in the blood is a third indication of a favorable outcome.

Treatment entails taking two medicines. One is an oral medicine, ribavirin (Rebetol). It can lead to anemia. The other medicine is interferon (PEG-Intron, Pegasys). It is given in weekly injections and often for 48 weeks. The injections are under the skin, and patients often learn how to give themselves the injections. It can produce headaches, fever and muscle pain, most notably after the first treatment. Subsequent treatments don’t usually evoke such a response. It can also produce anxiety and depression.

If you are a candidate for treatment, then a discussion between your doctors – the one treating you for hepatitis and the one treating your depression – can arrive at a solution that is best for you.

Hepatitis C, along with hepatitis A and B, is one of our most common infections. Details of these three illnesses are covered in the recently written pamphlet on hepatitis. Readers can obtain a copy by writing: Dr. Donohue – No. 503. Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I want to know if one can have TB in the lymph nodes of the neck and not have it in the rest of the body. – S.G.

TB germs usually enter the body via airborne droplets that are breathed into the lungs. The germs might decide they don’t like the ambience of the lungs and strike out for other destinations. The kidneys, bones, covering of the brain and covering the heart can play host to the germs. Yes, lymph nodes are a popular second choice to the lungs.

An infected node forms a firm, red mass that often exudes pus. When TB dominated the infectious-disease scene, lymph node infection was common and was called scrofula. It still exists in some places.

The node or nodes can be infected without the lungs showing any signs of active infection. Treatment of node TB is similar to treatment of lung TB.

DEAR DR. DONOHUE: I am a 66-year-old man with type 2 diabetes. I received an e-mail whose gist is: Receptors in the stomach tell the brain what kind of food is eaten. If the food is carbohydrate, the message to the brain is to save it. If it is protein, the message is to use it. If protein is eaten first and enough time is allowed, then carbohydrates can be eaten without gaining weight. Is this correct? – J.F.

Correct? I don’t think so.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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