FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, July 29, 2025

🩺 Is Cirrhosis Reversible?
An Integrative Orthomolecular Medicine Perspective

By Richard Z. Cheng, M.D., Ph.D.
Editor-in-Chief, Orthomolecular Medicine News Service

🔍 Key Point

Cirrhosis has long been viewed as an irreversible, end-stage liver disease. However, growing scientific evidence now confirms that liver fibrosis-and even cirrhosis-can be stabilized, improved, or reversed, especially in early or compensated stages. A comprehensive review by Jung and Yim (2017) documents both experimental and clinical evidence demonstrating regression of fibrosis and reversal of cirrhosis on serial biopsies (1).

From the Integrative Orthomolecular Medicine (IOM) perspective, cirrhosis often reflects deeper, correctable imbalances: chronic inflammation, toxin overload, nutrient depletion, oxidative stress, and mitochondrial dysfunction.

✅ When these root causes and common mechanisms are effectively addressed, the liver's natural regenerative capacity can be reactivated-supporting reversal of damage and long-term restoration of liver health.

1. Hepatitis C: Viral Clearance Can Trigger Regeneration

Hepatitis C-related cirrhosis is one of the clearest examples that liver damage isn't always permanent.

• Yoo et al. (2022): Patients with cirrhosis who cleared HCV through antiviral therapy showed fibrosis regression and reduced portal hypertension (2).
• Piedade et al. (2021): After viral clearance, liver stiffness dropped-closely tracking with lower risk of complications (3).
• Berenguer et al. (2025): In a Spanish study of 1,300 patients, many deaths after HCV clearance were due to non-viral issues like metabolic dysfunction and toxin exposure. Liver stiffness remained a powerful marker of ongoing risk (4).

👉 Takeaway: Clear the trigger and support the terrain-and the liver can heal.

📈 FibroScan: A Window into Healing

FibroScan (transient elastography) is a non-invasive, highly reliable method for measuring liver stiffness-an indirect measure of fibrosis.

From the IOM perspective, FibroScan gives us real-time feedback on the restoration of biological terrain through:

• Orthomolecular nutrition and antioxidants
• Low-carb and ketogenic diets
• Mitochondrial and detoxification support
• Intermittent fasting

📊 Supporting Data:

• AUC of 0.93-1.00 for cirrhosis diagnosis (5-7).
• Cutoff range: 14.5-18.0 kPa depending on etiology
• Outperforms biochemical markers like APRI and FIB-4 (6)
• Especially useful to track reversal and adjust treatment plans

2. 🍽️ Metabolic Liver Disease: Terrain Collapse and Recovery

Cirrhosis from NASH or MASH (nonalcoholic/metabolic steatohepatitis) is not just about excess fat in the liver. It's a sign of internal terrain breakdown-toxic overload, insulin resistance, and nutrient depletion.

The IOM approach focuses on restoring that terrain.

• Promrat et al. (2010): Just 7-10% weight loss through lifestyle changes led to liver healing in 72% of NASH patients (8).
• Semaglutide (GLP-1 RA A GLP-1 drug improved fibrosis in 36.8% of patients over 72 weeks (9).
• Tirzepatide: Resolved MASH in a significant number; fibrosis improves with longer treatment (10).
• Resmetirom (2024): A thyroid hormone-targeted drug that helped many patients reverse NASH and fibrosis (11).
• Efruxifermin (2023-2025): A fibroblast growth factor analog led to ≥1-stage fibrosis reversal in 39-41% of patients over 96 weeks-even those with advanced disease (12-14).

🔁 But here's what most mainstream protocols overlook: The real breakthrough isn't in the drug pipeline-it's already in the clinic. Nutritional ketosis, therapeutic fasting, and high-dose orthomolecular protocols have been reversing liver dysfunction for years. These root-cause-based strategies don't just replicate the results of experimental drugs-they often exceed them by restoring the body's internal balance without the cost, drug toxicities, or narrow targeting of pharmaceutical interventions.

3. 💊 Experimental Drugs vs. Root-Cause Restoration

Several new drugs aim to treat liver fibrosis. But most target late-stage symptoms, not the upstream disruptions that cause liver failure in the first place.

• BMS-986263 (HSP47 siRNA): Blocks scar-tissue proteins; reduced fibrosis markers (15).
• Lanifibranor (pan-PPAR agonist): Improved both inflammation and scarring (16).
• Cilofexor (FXR agonist): Reduced liver fat and fibrosis in trials (17).

🧬 While these drugs may have value, they come with high costs, limited long-term safety data, and narrow mechanisms. The IOM approach is broader, safer, and more sustainable:

✅ Non-drug orthomolecular therapies:

• High-dose antioxidants (vitamin C, NAC, ALA, glutathione)
• Mitochondrial and liver detox support
• Nutritional repletion (magnesium, vitamin D3, taurine, tyrosine)
• Anti-inflammatory diets and extended fasting

✳️ Author's Note: A Personal Story from the Pandemic

During the COVID-19 pandemic, the mother of a close friend-Professor F, a U.S.-based academic-was admitted to the ICU in China with acute hepatic failure. The hospital issued a critical condition notice (病危通知书), and her prognosis appeared grim.

Professor F urgently requested my consultation. In a rare and remarkable moment of cooperation, the ICU physician accepted my Integrative Orthomolecular protocol: high-dose intravenous vitamin C (HDIVC), glutathione, B vitamins, and alpha-lipoic acid. These therapies were administered alongside supportive care.

Meanwhile, Professor F navigated intense travel restrictions: flying to Guangzhou, completing two weeks of quarantine, then continuing to her hometown under another week of isolation-all to be with her mother.

The outcome: Her mother stabilized, was discharged from the ICU, and eventually returned home. To this day, she continues maintenance vitamin C therapy-and remains well. Professor F often tells me how grateful she is that she was able to see her mother again-thanks, in part, to the timely use of high-dose orthomolecular support.

✳️ Clinical Proof: Case Report of Cirrhosis Reversal

This article accompanies an OMNS case report by Drs. Aarti Midha and Pankaj Verma, titled:

"Nutritional and Antioxidant Therapy Reverses Opioid Dependence and Liver Cirrhosis"

In that report, a young man with confirmed cirrhosis experienced documented fibrosis reversal-without liver-targeting drugs-through orthomolecular interventions including:

• Glutathione
• Vitamin C
• Taurine
• Probiotics
• Detox and dietary therapy

📌 This real-world case demonstrates what science is pointing to: Restore the terrain, and healing happens.

📊 Summary Table

🧠 IOM Takeaway

From the integrative orthomolecular perspective, cirrhosis isn't always the end. It's a warning sign that the body's biological terrain has collapsed-due to toxins, nutrient loss, insulin resistance, oxidative stress, and mitochondrial failure.

But terrain collapse is reversible.

✅ With the right tools-nutrition, detox, fasting, and targeted supplementation-we can shift the narrative from "damage control" to genuine regeneration.

📚 References

1. Jung YK, Yim HJ. Reversal of liver cirrhosis: current evidence and expectations. Korean J Intern Med. 2017 Mar;32(2):213-28.

2. Yoo HW, Park JY, Kim SG, Jung YK, Lee SH, Kim MY, et al. Regression of liver fibrosis and hepatocellular carcinoma development after HCV eradication with oral antiviral agents. Sci Rep. 2022 Jan 7;12(1):193.

3. Piedade J, Pereira G, Guimarães L, Duarte J, Victor L, Baldin C, et al. Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes. Sci Rep. 2021 Jun 3;11(1):11681.

4. Berenguer J, Aldámiz-Echevarría T, Hontañón V, Fanciulli C, Quereda C, Busca C, et al. Clinical outcomes and prognostic factors after HCV clearance with DAA in HIV/HCV-coinfected patients with advanced fibrosis/cirrhosis. Hepatology. 2025 Jan;81(1):238.

5. Elzawawy M, Nomrosy RE, Hassanein S. The role of fibroscan in assessment of liver cirrhosis in patients with chronic liver disease. Menoufia Medical Journal. 2018 Jun 1;31(2):520-4.

6. Fernandez M, Trépo E, Degré D, Gustot T, Verset L, Demetter P, et al. Transient elastography using Fibroscan is the most reliable noninvasive method for the diagnosis of advanced fibrosis and cirrhosis in alcoholic liver disease. Eur J Gastroenterol Hepatol. 2015 Sep;27(9):1074-9.

7. Ganne-Carrié N, Ziol M, de Ledinghen V, Douvin C, Marcellin P, Castera L, et al. Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases. Hepatology. 2006 Dec;44(6):1511-7.

8. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized Controlled Trial Testing the Effects of Weight Loss on Nonalcoholic Steatohepatitis (NASH). Hepatology. 2010 Jan;51(1):121-9.

9. Sanyal AJ, Newsome PN, Kliers I, Østergaard LH, Long MT, Kjær MS, et al. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis. N Engl J Med. 2025 Jun 5;392(21):2089-99.

10. Loomba R, Hartman ML, Lawitz EJ, Vuppalanchi R, Boursier J, Bugianesi E, et al. Tirzepatide for Metabolic Dysfunction-Associated Steatohepatitis with Liver Fibrosis. New England Journal of Medicine. 2024 Jul 24;391(4):299-310.

11. Harrison SA, Bedossa P, Guy CD, Schattenberg JM, Loomba R, Taub R, et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med. 2024 Feb 8;390(6):497-509.

12. Harrison SA, Frias JP, Lucas KJ, Reiss G, Neff G, Bollepalli S, et al. Safety and Efficacy of Efruxifermin in Combination With a GLP-1 Receptor Agonist in Patients With NASH/MASH and Type 2 Diabetes in a Randomized Phase 2 Study. Clin Gastroenterol Hepatol. 2025 Jan;23(1):103-13.

13. Harrison SA, Frias JP, Lucas KJ, Reiss G, Neff G, Bollepalli S, et al. Safety and Efficacy of Efruxifermin in Combination With a GLP-1 Receptor Agonist in Patients With NASH/MASH and Type 2 Diabetes in a Randomized Phase 2 Study. Clin Gastroenterol Hepatol. 2025 Jan;23(1):103-13.

14. Harrison SA, Frias JP, Neff G, Abrams GA, Lucas KJ, Sanchez W, et al. Safety and efficacy of once-weekly efruxifermin versus placebo in non-alcoholic steatohepatitis (HARMONY): a multicentre, randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Gastroenterol Hepatol. 2023 Dec;8(12):1080-93.

15. Lawitz EJ, Shevell DE, Tirucherai GS, Du S, Chen W, Kavita U, et al. BMS-986263 in patients with advanced hepatic fibrosis: 36-week results from a randomized, placebo-controlled phase 2 trial. Hepatology. 2022 Apr;75(4):912-23.

16. Nathani RR, Bansal MB. Update on Clinical Trials for Nonalcoholic Steatohepatitis. Gastroenterol Hepatol (N Y). 2023 Jul;19(7):371-81.

17. Patel K, Harrison SA, Elkhashab M, Trotter JF, Herring R, Rojter SE, et al. Cilofexor, a Nonsteroidal FXR Agonist, in Patients With Noncirrhotic NASH: A Phase 2 Randomized Controlled Trial. Hepatology. 2020 Jul;72(1):58-71.

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