TOPIC:

There has been a bit of this lately. Here are some links:

www.medscape.com/viewarticle/859215_4

www.ncbi.nlm.nih.gov/pmc/articles/PMC4648805/

sciencevibe.com/2016/02/29/coffee-may-pr...iver-from-cirrhosis/

It is interesting. There is an association between increased coffee consumption and better liver health, mentioned in studies, yes. But, in my understanding, "association" itself does not mean "causative relation". Is "reverse" causal relation possible? For example, people having healthier liver, without cirrhosis - may just better tolerate coffee (and, consequently, may have statistically higher coffee consumption).

No wonder my fibroscan stayed at F0 then.
mmmmmmmm coffee

Is "reverse" causal relation possible? For example, people having healthier liver, without cirrhosis - may just better tolerate coffee (and, consequently, may have statistically higher coffee consumption).

This is indeed possible. It is the difference between observation and clinical trial. The clinical trial would be to have a large group assigned to drink coffee and another large group assigned to abstain. Because of the timelines involved - say a decade - this is unlikely to ever happen.

Not drink coffee for 10 years? Puh leez!
Not this corporate wage slave.

James-Freeman-facebook wrote: The clinical trial would be to have a large group assigned to drink coffee and another large group assigned to abstain. Because of the timelines involved - say a decade - this is unlikely to ever happen.

Yes, it seems, it requires some sort of long-term "randomized" trial for firm conclusion!

Aaaaaah!!!

As I understand it, Serg may very well be right but since there isn't any evidence to suggest that coffee consumption is a danger for hep c sufferers and on the contrary that the reverse may be true it surely makes sense for those of us who like the stuff to drink a bit more of it?
Dr James makes the point that no trial is ever going to take place, and I'd add that this may be so if for no other reason than because big pharma would find it tough to patent coffee (!), so we may never know the reason for this correlation but shouldn't worry about it.
I practice "natural medicine" and it's a field in which there's a shortage of data supporting the efficacy of what we do. This is likely to continue to be so but it would make very little sense to wait for it when everyday practice leads us to know on the basis of empirical information that a lot of what we do is helpful to patients.
I feel a little rant coming on: We hear too much of "evidence based medicine" nowadays and this can mean that effective procedures in orthodox and in natural medicine are ignored in favour of treatments which kill the patient almost as well as they kill the disease arguably because it suits the financial interests of pharmaceutical companies etc. and the prejudices of some (brainwashed) doctors. No discourtesy intended here to present company. Further, no one sensible can deny the benefits of current treatments for hep c and other serious diseases. Even if some of my friends think I don't really belong, could you think of me in the "sensible" bracket for a moment?
Please also take what follows as a small dig in the ribs: I remember reading somewhere, about 15 years ago, that 57% of commonly used surgical procedures had never been subject to a statistical evaluation of their effectiveness, but continued to be employed. Even if that figure has since reduced the point holds good. Common sense is an important weapon in every field of human endeavour, not excluding medicine.
And there's another issue which is that it is difficult to get research funding for any project which sounds whacky whether the potential source of money be a university, a drug company, or a manufacturer of medical equipment etc. Often this is reasonable but certainly not always. Think of the problems encountered by now famous people in medical/surgical history from Semmelweis to date. My issue here is that medical science is just as subject to prejudice, politics, corruption etc. as anything else.
Happy Christmas,
RSF.

PS The prejudice referred to above does seem to be a particular feature of the English speaking world. In continental Europe all sorts of treatments are used which would never be sanctioned in the UK, because it is known that they work. Russian medics really stand out here and always have. Could it be that this is because most of their doctors are women?!
Happy new year,
RSF.

Hi RSF,

the more I experience being treated, the more convinced I am that the best way for anyone with Hep C to look after their liver, is to piss of the Hep C.

It appears Dr Freeman's efforts with DAA's are the primary way to do this; but I am also very open to ALL ways to look after what is left of the damaged liver HCV has left.

Re: evidence based - I hear a lot about this were I work too, but often wonder about the 'evidence', questioning whether it is simply a reflection of what is under someone's nose at the time. Where I go for my liver, DAA treatment is alive and well, but me being retreated makes me feel like I am at the pointy end of a spear.

Yours



Jeff

Hello Jeff,

Going through re-treatment must be very hard, specially because it's lonely. 'The pointy end of a spear' is a shit place to be. But DAAs are clearly the way forward. The treatment you have already had has helped you and your liver is probably in better shape than before you started though the virus still present. Your ultrasound result is OK too so you've bought yourself some time.

My little rant was just that, an expression of personal frustration at the results of closed minds, and the cost to real people of such minds particularly when they belong to influential people. Grrrrr.

Warm wishes for 2017 and the finest kind of SVR,

RSF

PS I could put something in here. There is no "alternative" medicine. Just effective medicine.
RSF