Coffee for Hepatitis C

Preventing Liver Cancer with Coffee?
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Decades ago, researchers in Norway came upon an unexpected finding. Alcohol consumption was associated with liver inflammation (no surprise), but a protective association was found for coffee consumption. These findings were replicated in the U.S. and around the world. Those at risk for liver disease—who drank a lot of alcohol or were overweight—appeared to cut their risk in half if they drank more than two cups of coffee a day.

Liver cancer is one of the most feared complications of liver inflammation. Hepatocellular carcinoma is the third leading cause of cancer death, and the incidence has been rapidly rising in the United States and Europe, largely driven by the burden of hepatitis C infection and fatty liver disease. Putting together all the best studies done to date, those drinking the most coffee had half the risk of liver cancer compared to those that drank the least. Since the meta-analysis was published, a new study found that male smokers may be able to cut their risk of liver cancer more than 90% by drinking four or more cups of coffee a day. (Of course, they could also stop smoking!). It’s similar to heavy drinkers of alcohol: drinking more coffee may decrease liver inflammation, but not as much as drinking less alcohol.

Liver cancers are among the most avoidable cancers, through hepatitis B vaccination, control of hepatitis C transmission, and reduction of alcohol drinking. These three measures could, in principle, wipe out 90% of liver cancers worldwide. It remains unclear whether coffee drinking has an additional role on top of that, but in any case such a role would be limited compared to preventing liver damage in the first place. But what if you already have hepatitis C or are among the 30% of Americans with non-alcoholic fatty liver disease due to obesity, which may quadruple one’s risk of dying from liver cancer? Coffee seems to help with hepatitis C, reducing liver damage, disease activity, and mortality. It was only the lack of randomized, interventional studies on the topic that prevented us from concluding that coffee has a protective effect.

But in 2013 we got such a study, a randomized controlled trial on the effects of coffee consumption in chronic hepatitis C (highlighted in my video, Preventing Liver Cancer with Coffee). Forty patients with chronic hepatitis C were randomized into two groups: the first consumed four cups of coffee/day for 30 days, while the second remained coffee “abstinent.” Then the groups switched for the second month. Two months is too soon to detect changes in cancer rates, but the researchers were able to demonstrate that coffee consumption reduces oxidative DNA damage, increases the death of virus infected cells, stabilizes chromosomes, and reduces fibrosis, all of which could explain the role coffee appears to play in reducing the risk of disease progression and of evolution to cancer.

Is it time to write a prescription for coffee for those at risk for liver disease? Some say no: “[A]lthough the results are promising, additional work is needed to identify which specific component of coffee is the contributing factor in reducing liver disease and related mortality.” There are, after all, more than 1000 compounds that could be responsible for its beneficial effects. But that’s such a pharmacological worldview. Why do we have to know exactly what it is in the coffee bean before we can start using them to help people? Yes, more studies are needed, but in the interim, moderate, daily, unsweetened coffee ingestion is a reasonable adjunct to therapy for people at high risk such as those with fatty liver disease.

Daily consumption of caffeinated beverages can lead to physical dependence. Caffeine withdrawal symptoms can include days of headache, fatigue, difficulty with concentration, and mood disturbances. But this dependence could be a good thing: “The tendency for coffee to promote habitual consumption may ultimately be advantageous if its myriad potential health benefits are confirmed.”

More on coffee in:

Broccoli can boost the liver’s detoxifying enzymes (Prolonged Liver Function Enhancement from Broccoli) but one can overdo it (Liver Toxicity Due to Broccoli Juice?).

What other foods might reduce DNA damage? See:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a DayFrom Table to Able, and Food as Medicine.

Image Credit: Matthew Wicks / Flickr

  • Leslie

    How about decaf?

    Has decaf-coffee been attributed the same potential benefits of regular coffee, in regard to hepatitis?

    Could the benefits of the coffee on the liver have something to do with caffeine causing the liver to “release” its stored sugars, glucose, whatever the official terms for that are? Whereas, without out the caffeine the liver has hard time letting go of excess. And maybe caffeine releases other excesses and or toxins from liver?

    • jCarol

      This is my question also.

    • Panchito

      The liver responds to the bitterness of coffee. It stimulates bile. Coffee has B vitamins too. People with neurotransmitter imbalances could react negatively to caffeine.

    • Joseph Gonzales R.D.

      I am not sure about Hep C. These videos go into detail about the difference between decaf and caffeinated coffee. Good thought about the methods of action I am not entirely sure but of course going to the citations and reading the references will help

      Interestingly, today as I am reading Dr. G on Reddit. He said:
      “There is very little clinical (i.e. human, not in a test-tube) research on cannabis, which is the reason I haven’t covered it. But every year I renew my search to see if there’s anything new out there and will report as soon as I find anything! If you ever run across a study you think I may have missed, please email me at mhg1@cornell.edu.

      I’ve got a bunch of videos on coffee, my two most recent are Coffee and Mortality and Coffee and Artery Function. Bottom-line: I don’t recommend drinking coffee not because it’s unhealthy but because of the opportunity cost. Every cup of coffee is a missed opportunity to drink something even healthier (like green tea).”

  • David Noble

    I’m assuming that, for someone who’s wanting to live a healthy lifestyle, black coffee (complete with caffeine) is still on the ‘ok’ list?

    So for example, I eat a plant strong diet, drink plenty of water, don’t really drink much alcohol, but love one cup of black coffee a day – does the science at the moment still point at that one cup of coffee not being bad for me over the long term?

    • Thea

      David: I think you are right. Here is what Dr. Greger recently answered on the Reddit thing he has going right now:

      “I’ve got a bunch of videos on coffee, my two most recent are Coffee and Mortality and Coffee and Artery Function. Bottom-line: I don’t recommend drinking coffee not because it’s unhealthy but because of the opportunity cost. Every cup of coffee is a missed opportunity to drink something even healthier (like green tea).”

      So, I don’t think your one cup in light of all else you are doing is bad at all.

      • David Noble

        Excellent – so in other words it’s not doing notable damage, it’s just that theoretically something else would be ‘slightly’ more beneficial. I think I’ll take the hit to enjoy my cup a day :)

        • Joseph Gonzales R.D.

          Correct :-) I often do the same, as I enjoy coffee.

        • krisitan

          Im not sure David it depends. Dr Esseltstyn says that coffee is on the no list due its detrimental effects on the endothelial function. Both Dr Gregor and Esseltsyn are my gurus so it is something to consider.

      • Joseph Gonzales R.D.

        Awww you are amazing and beat me to it. Thanks, Thea!!!!!!!!!

    • Panchito

      The ‘science’ points to coffee being good. But some people could react negatively.

      Paper filtered coffee (drip) is healthier than non filtered (espresso/French press).
      Light roasted could be healthier

      Decaf could be bad (if chemically processed)
      3-4 cups/day is supossedly best ‘dose’

      Avoid hot plastic contact as it leaches nasties 50 times over at hot temperature.

    • Joseph Gonzales R.D.

      It’s not that the coffee is unhealthy. Check out this answer by Dr. Greger himself. ALSO – GO TO REDDIT TO READ HIS COMMENTS TODAY!

      “There is very little clinical (i.e. human, not in a test-tube) research on cannabis, which is the reason I haven’t covered it. But every year I renew my search to see if there’s anything new out there and will report as soon as I find anything! If you ever run across a study you think I may have missed, please email me at mhg1@cornell.edu.

      I’ve got a bunch of videos on coffee, my two most recent are Coffee and Mortality and Coffee and Artery Function. Bottom-line: I don’t recommend drinking coffee not because it’s unhealthy but because of the opportunity cost. Every cup of coffee is a missed opportunity to drink something even healthier (like green tea).”

      • Veganrunner

        Joseph of course what Dr. Greger is saying makes perfect sense but man if I switch out my coffee because there is something healthier I swear I will even think I am crazy. It is probably the only thing left in my diet that hasn’t already been switched out for something healthier! At some point we have to draw a line!

        • Joseph Gonzales R.D.

          Funny! Good point, but as Mister Rogers (or someone like that would say) true friends love you no matter what, even if you switch out coffee for green tea ;-)

  • John Surits

    And how about tea as well .

    • Joseph Gonzales R.D.

      For sure! Tea may be even better than coffee! Make sure to check out mine or Thea’s post further down. Dr. G answered a question on coffee and tea this morning.

      • David Johnson

        But only coffee, including decafe, helps lower uric acid, right?

  • JM

    Like so many ideas, there are at least two sides to this coin.

    Alex Rogers at proteinfactory, explains that the caffeine in coffee (in anything) puts your body into an Catabolic state – which breaks down muscle mass. This of course is bad, esp as you age. Maintaining muscle mass is imperative, for many reasons. So I stick to decaf., as this all makes sense to me.
    http://proteinfactory.com/anabolic-vs-catabolic-state/

    Some experts, one Mercola interviewed, claim this decaf is of no value, but I disagree, as I can feel the coffee working to heal me. It makes sense to me it still has most of it’s anti-oxidants after the decaf process since the antioxidants are in the beans and not in the caffeine. Dave Asprey of bulletproofexec says decaf is great, if processed properly.
    https://www.bulletproofexec.com/why-decaf-coffee-is-back-and-now-bulletproof/

    Interesting, here’s an article explaining why not to drink coffee in the morning on an empty stomach-
    http://naturalsociety.com/why-not-to-drink-coffee-on-an-empty-stomach/

    • Panchito

      All you need to be a coffee expert is to have an opinion and make a blog to show it.

  • bittersweet

    I’ve noticed that Dr. G. has been publishing positive “reviews” about coffee, and assuming the positivity is for-real in relation to some ailments, I do wonder about these citations I’ve read?

    FROM: “Calamity in a Cup: Caffeine, Are the Perks Worth the Price?”

    More than 80% of Americans drink coffee, the world’s #2 trade commodity, out-sold only by oil in volume and financial value.

    “Each 10 mg of caffeine consumed causes a 1 mg calcium loss in the bones.” American Journal of Epidemiology, 117:113-127, 1983; 132(4)675-684, 1990, and Nutritional Research 4(1)43-50, 1984.

    “Coffee drinkers, as compared to non-coffee drinkers, have a greater incidence of overweight, and consume more alchohol and cigarettes.” –American Journal of Cardiology, 52:1238-42, 1983.

    “Caffeine seems to increase coronary heart disease deaths independent of serum cholesterol levels.” –British Medical Journal 300:566-569, 1990.

    “Caffeine consumption should be considered as a risk factor for myocardial infarction (heart attack).” –American Journal of Epidemiology 138(8)602, 1993.

    “Rats that ate a refined-food diet and were offered 10% alchohol or water, gradually drank increasing amounts of alcohol. When given coffee, their alcohol consumption dramatically increased.” –Journal of the American Dietetic Association 61:159-162, 1972.

    “Coffee drinkers are more prone to use other drugs. Not only do they smoke more, but they more often use minor tranquilizers or sedative-hypnotics.” –Comprehensive Psychiatry 22:565-571, 1981.

    “A dose of 30-36 ounces of caffeine a day presents a significant health issue.” –British Journal of Addiction 78:251-258, 1988.

    “People consuming as little as 100 mg (6 ounces of coffee) per day had withdrawal symptoms.” –New England Journal of Medicine 327(16)1160, 1992.

    “The lethal dose of caffeine is 10 grams, or about 70 cups of coffee. Many people are taking 1/10 the lethal dose every day!” -A: Journal of Family Practice 4(6)1183, 1977.

    “A cup of coffee reduces iron absorption by 39%, and a cup of tea will reduce it by 65%. Drip coffee will lower iron absorption by 72%, while doubling coffee’s strength will reduce it 91%. In comparison, orange juice, with its vitamin C, may increase iron absorption in a meal by 250%.” –Am Journal of Clinical Nutrition 37:416-420, 1983; and, 32:2484-2489, 1979.

    “After observing that caffeine is capable of inducing acute psychotic symptoms, a state hospital staff eliminated caffeinated beverages from the diet of all patients. Almost immediately the patients were quieter and suffered less from insomnia and nervous agitation. Physical assaults on both people and property decreased significantly, too.” Hospital and Immunity Psychiatry, 42(1)84-85, Jan. 1991.

    “Studies have shown that people with psychiatric problems consume nearly twice as much caffeine as the general population.” Psychology Reports, 59(1)83-86

    “…normal people given caffeine were shown on psychiatric tests to have elevated levels of anxiety, depression and hostility. Amazingly, the doses of caffeine given in this test were much less than the average coffee drinker consumes each day.” Journal of Abnormal Psychology, 93(1)120-122, 1984

    “Caffeine can increase blood pressure, interfere with normal sleep patterns, and increase body fat stores.” Journal of the American Medical Association [JAMA], 231:965, 1975

    “Not only does it [caffeine] slow muscle function, but just 250 mg. (2-2.5 cups) causes a 30% decrease in brain blood flow.” Life Sciences, 47:1141-1146, 1990

    “…cyclic AMP [adenosine monophosphate] [accumulates abnormally in cells by stimulus of caffeine] also stimulates growth in glandular tissues, like breast tissues…[and] may product cell growth beyond normal boundaries. This can lead to fibrocystic disease (lumpy breasts) which may increase the risk of cancer.” Surgery, 86;105-109, and, Internal Medicine Alert 2:53, 1980, and, JAMA 255(2):259-260, 1980.

    “Caffeine also blocks pde [phosphodiesterase] from doing another important job: shutting down the release of free fatty acids from body stores of fat, thus increasing fats in the blood.” HA Horoer,, Review of Physiological Chemistry, 135th Edition, Lange Medical Publishing, 1971.

    “Triples risk of pancreatic cancer (3 cups/day)” NEJM 304:630-633, 1981.

    “Doubles fatal bladder cancer risk. (2 cups/day)” Am J of Publich Health 74(8)820-823, 1984.

    “Raises colon cancer risk 250% (2 cups/day)” Family Practice News 116(18), 1986.

    “Raises risk of fibrocystic disease (3 cups/day)” Surgery, 86:105-109, 1979.

    “Increases breast cancer risk (3 cups/day)” Surgery, 86:105-109, 1979.

    “Increases ovarian cancer risk (2 cups/day)” International J of Cancer 28(6)691-693, 1981.

    “Doubles female bladder cancer risk (1 cup/day)” Medical World News 63-73, 1/26/1976.

    “Even decaffeinated coffee has hundreds of potentially harmful chemical components. One class of these compounds is caffeols…which are very irritating to the gastrointestinal tract. In addition, many other chemicals which have been linked to cancer and heart disease are still present [in decaf].” Journal of the National Cancer Institute 54:587, 1975.

    “Many in mental institutions with depression and anxiety need no other treatment than to be taken off caffeine.” Journal of Rehabilitation, 45:July-August-September, 1992.

    “Certain depression and anxiety patients were able to be released from institutions after being taken off caffeine.” American Journal of Psychiatry, 133:12, 1976.

    “Caffeine confuses the vascular system because it dilates blood vessels near the skin while ordering the brain to constrict them. It constricts vessels in the brain while dilating them in other organs, which may result in high blood pressure. One to five cups of coffee a day increase heart attack risk by 60%; six or more increases it by 120%.” [not sure how many ounces is a “cup”? Used to be 6 ounces, but that size cup is rarely seen at coffee shops!] New England Journal of Medicine, 289:63-67, 1975

    “Stress-related hormones were considerably higher in people using caffeine as compared to those who ingested a placebo.” Psychosomatic Medicine 56:147-180, 1994.

    “People who ingested 400 mg (4 “cups”) of caffeine [not sure how many ounces is a “cup”? Used to be 6 ounces, but that size cup is rarely seen at coffee shops!], then placed in a stressful situation, showed a 3-fold increase in axiety as those consuming the same amouint without stress.” Psychiatry Reports 59(1)83-86, 1986.

    “…brown drink users lose body fluid due to the diuretic effect of tea, coffee, and soda.” Garatini, Silvo, “Caffeine, Coffee, and Health”, Raven Press, 1993, pp 98, 114.

    “Heavy tea drinkers often have vitamin B definciences, and tannin, a chemical component of tea, has been shown to interfere with iron absorption. Tea drinkers may feel fatigued and listless as a result. Tannin has also been linked to stomach cancer. While all methylxanthines have been implicated in goiter development, tea is highest in theophylline, which is most damaging to the thyroid.” Endocrinology, 85:410, 1961.

    “[caffeine] can elevate cholesterol & triglycerides.” New England Journal of Medicine, 308:1454-1457, 1983.

    “[caffeine] can aggravate eczema and pimples.” Custis, 40:421-422, 1987.

  • Nuri

    Referring to decaf: Most decaf is full of solvents and chemicals used to strip the caffeine from the coffee, which puts even more stress on the liver, so I wouldn’t think decaf was an option unless it was organic.

    I’m a little concerned about about this post insinuating that coffee is good for all people with liver issues; coffee (and even decaf and regular green tea) still has caffeine. Caffeine is very strong on the adrenals and the thyroid. In my opinion, simply drinking coffee and cutting back alcohol may be a poor health choice for people struggling with thyroid problems – and there are many many people in the US alone who have thyroid problems. Saying that one nutrient or one food or beverage helps with a certain health concern is misleading in the same way that saying ‘there’s a pill for every ill’ keeps people from taking responsibility for their own health by adopting a healthier lifestyle, because there’s (apparently) an easy fix-it. This is old-school medical thinking and doesn’t acknowledge that the systems of the body work together to improve health, rather than each one in isolation. Your thoughts?

    • Panchito

      My thoughts:

      1 Search for Swiss decaf: https://en.wikipedia.org/wiki/Decaffeination#Swiss_Water_process

      2 caffeine does not stimulate the adrenal glands. It is not an stimulant. It is a blocker and it blocks the adenosine receptors in the cells.

      3 caffeine, while being a natural insecticide, improves the memory of bees. Caffeine is good for the bees but bad for other insects. So is it bad?

      • Nuri

        Well, most people call it a stimulant, including this article http://science.howstuffworks.com/caffeine.htm, which is based in cold hard biology. It explains how caffeine binds to adenosine receptors (causing adenosine to be unable to bind to them), which speeds up nerve cells. That is CNS stimulation, hence, it is a stimulant.

        Here is another article that talks about the stimulant effects of caffeine on the adrenals, and why it matters. http://www.naturalnews.com/012352.html

        Coffee can be both a bad or a good thing, depending on the situation, but it is still a substance that taxes the adrenals. And insinuating that all people who do or may have compromised livers will be cured by coffee is … well, not the cleverest thing.

        • Panchito

          Hi.

          The following is the opinion of a caffeine expert, not a blog “topic of the day” writer

          http://www.smithsonianmag.com/ist/?next=/science-nature/this-is-how-your-brain-becomes-addicted-to-caffeine-26861037/

          “When caffeine molecules are blocking
          those receptors, they prevent this from occurring, thereby generating a
          sense of alertness and energy for a few hours. Additionally, some of the
          brain’s own natural stimulants (such as dopamine)
          work more effectively when the adenosine receptors are blocked, and all
          the surplus adenosine floating around in the brain cues the adrenal
          glands to secrete adrenaline, another stimulant.

          For this reason, caffeine isn’t technically a stimulant on its own, says Stephen R. Braun, the author or Buzzed: the Science and Lore of Caffeine and Alcohol, but a stimulant enabler: a substance that lets our natural stimulants run wild. Ingesting caffeine, he writes, is akin to “putting a block of wood under one of the brain’s primary brake pedals.” “

          • JM

            To a certain extent it seems you are arguing semantics from the perspective of end results; “…caffeine isn’t technically a stimulant on its own…”

            Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/

            http://proteinfactory.com/anabolic-vs-catabolic-state/
            Alex Rogers’ blog at proteinfactory, explains that the caffeine in coffee (in anything) puts your body into an Catabolic state, as Cortisol is released – which breaks down muscle mass. This of course is bad, esp as you age. Maintaining muscle mass is imperative, for many reasons. So I stick to decaf., as this all makes sense to me.

      • JM

        “All you need to be a coffee expert is to have an opinion and make a blog to show it.”

        (Panchito post below).

  • James Wald

    So many benefits from filtered coffee, but what about the drawbacks? I thought my daily cup wasn’t doing any harm until I learned that it was disrupting my deep sleep cycles. The half-life of caffeine is 6 hours, meaning 25% of your morning cup (50% of an afternoon cup!) is still in your body at bed time. That loss of sleep cases many health problems.

  • James Wald

    So many benefits from filtered coffee, but what about the drawbacks? I thought my daily cup wasn’t doing any harm until I learned that it was disrupting my deep sleep cycles. The half-life of caffeine is 6 hours, meaning 25% of your morning cup (50% of an afternoon cup!) is still in your body at bed time. That loss of sleep cases many health problems.

  • eldueno

    So that’s why someone invented Irish-coffee.

  • Matthew Smith

    I love Nutritionfacts.org and I love still being here. Did you know that coffee can reduce many risk factors for death, such as heart disease, by more than 30 percent? What could possibly be in there?http://blogs.wsj.com/japanrealtime/2015/05/08/drinking-coffee-green-tea-lowers-health-risks-study-suggests/
    There is a long running joke here that two+two could equal five! There are many proofs in math that one plus one equals three, such as matter, energy, and vector. The mysterious nature of form, function, and radiation. Church, Congregation, and Belief. Force, matter, and speed, with halving and squared. Position, direction, mass, energy, and form. Two plus two equals five! Or I guess its still four.

  • Marion Clignet

    I always thought it was milk in coffee that did the liver damage???

  • solarray51

    Is Dr. Gregor in favor of the hep B vaccine? He seems to imply so in this article. Surprises me as many believe vaccines are at worst tainted and at best not very effective or with side effects.

  • Gustav

    What about coffee and autoimmune diseases like Psoriasis? Could coffee consumption be bad in that regard?