Branched-Chain Amino Acids Treat Cirrhosis
People with cirrhosis of the liver may live longer, improve their liver function, have fewer hospital admissions and days in the hospital, and have an increased quality of life by taking supplemental branched-chain amino acids (BCAAs), according to a new study in Gastroenterology (2003;124:1792–801). This is encouraging for the thousands of people suffering from this devastating disease.
Cirrhosis is a chronic condition of the liver in which the cells become damaged and scar tissue forms. As more scar tissue forms, the functioning of the liver becomes impaired to the point that transplantation is often necessary for survival. Cirrhosis is the third leading cause of death in the United States in adults aged between 45 and 65 years. It is most often caused by excessive alcohol consumption, but may also be caused by chronic hepatitis (such as hepatitis B or hepatitis C viruses), autoimmune disease, diabetes, gallbladder disease, or trauma. There is currently no cure for cirrhosis; treatment is aimed primarily at treating symptoms and preventing or managing complications.
In the new study, 174 older adults with advanced cirrhosis were randomly assigned to receive one of three treatments for one year. The active-treatment group received 14.4 grams per day of BCAA (providing 7.2 grams of L-leucine, 3.6 grams of L-isoleucine, and 3.6 grams of L-valine per day), while the other groups received either a similar amount of lactalbumin (a milk protein) or maltodextrin (a carbohydrate). Lactalbumin and maltodextrin are commonly used to help treat malnutrition associated with cirrhosis. The number of participants who died or had disease progression, the number of hospital admissions, and the duration of hospital stay during the study were recorded. Other measurements, including nutritional status, liver function, anorexia, and quality of life, were taken periodically throughout the study.
The number of people with disease progression or who died was 57% lower in participants taking BCAAs than in those taking lactalbumin and 49% lower than in those taking maltodextrin. Those taking BCAAs were admitted to the hospital less than half as often and also spent fewer days in the hospital than those in the lactalbumin or maltodextrin groups. Liver function, nutritional status, and quality of life were all significantly improved after BCAA supplementation.
Scientists do not completely understand how BCAAs help cirrhosis, although improvements in nutrition probably account for some of the benefits. Some participants had an aversion to the taste of the BCAAs, which was provided in powder form; this led to lower compliance than was expected. BCAAs are available in capsule form, but a large number of capsules would have to be taken to achieve a dose of 14.4 grams per day. Some physicians recommend taking BCAAs on an empty stomach, because food proteins can inhibit the absorption of BCAAs or inhibit their uptake into cells.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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