AskNadia: Insulin Dependent with Hepatitis C Jaundice and Hemochromatosis

My dad has diabetes and takes insulin. Nowadays he has hepatitis c and jaundice but I have observed hyperpigmentation on unexposed areas of skin.  Especially his face. Also, His has mild itching in his arms and bleeding. Is this related to hemochromatosis?

Ahmed E.

 Dear Ahmed:

Your father is lucky to have you as his advocate. His condition sounds complicated for people living with type 1 or Type 2 diabetes.

Hepatitis C, a viral infection, Jaundice, the yellowing of the skin and hemochromatosis, a disease affecting your ability to process iron, are all related. They are a byproduct of a damaged liver with an overwhelming symptom of fatigue, nausea abdominal pain, malaise and jaundice. Some people may be asymptomatic for decades without knowing it.

Over time, a Damaged liver will inflame the organ, compromising the natural production of hormones that help the body maintain a biochemical balance. The word hepatitis is derived from the meaning swelling or inflammation of the liver.

The Function of the Liver

The liver is the second largest organs in the body and serves an essential function. Everything we eat and drink is filtered in the bloodstream and flows through the liver. The liver’s job is to remove toxins from the food we eat, the liquids we drink and the medications we take. The liver releases stored glucose from glucagon when the blood sugar is too low and releases insulin when the blood sugar is too high.

Alcohol, for example, is toxic to our system and the liver removes the toxins from our blood as it filters through the liver. The consumption of food and carbohydrate liquids require hormonal balance. The liver plays a vital role in creating this balance.

The other crucial functions of the liver are to break down fats by producing bile, the waste created in our liver and stored in the gallbladders. Bile helps digest the fats in the bloodstream.

The liver also stores vitamins, produce cholesterol and proteins to assist the body in functioning.  The hormones secreted by the liver are the messengers that are responsible for orchestrating specific bodily functions, Such as metabolism, respiration, glucose and the nervous system. All of these functions require hormones and energy. The liver releases the hormones and glucose to make these connections.

Itchy Skin

Pruritus commonly referred to as “itchy skin” can be a result of the bile build up in the bloodstream. Twenty percent of people with Hepatitis C get jaundice and experience severe itching.

The itching can also be a result of nerve damage from diabetes. Which can happen when the brain erroneously triggers the desire to itch.

The best thing you can do for your father is to help him be comfortable and help him with his diet and symptoms by providing creams that will prevent, heal or reduce itching. Ask his pharmacist which lotion is best for his symptoms.

The diet that the NIH recommends for liver damage is to eat less protein, more carbohydrates, less salt, take vitamins and the medications that are prescribed by his healthcare professional.

Less protein is better because it reduces the toxin build up. More toxins in the bloodstream can be a possible cause for bile to surface to the largest organ, the skin, causing itching. Chronic itching can result in bleeding from scratching. Two prevention methods for scratching is wearing gloves or cutting nails.

Less salt is recommended to limit swelling. Inflammation of the liver can kill blood cells, damaging the liver and affecting the blood flow.

Best to follow the physician’s instruction when taking vitamins’, supplements, and nutraceuticals. Improper use may cause liver damage.


New blood cells die and form every two days. The breakdown of the dying blood cells occurs in the liver. If there is an excess of dead blood cells that are not filtering out of the liver, then there will be a buildup of bilirubin; a green, yellowish substance that makes the skin and eyes yellow.

Jaundice is a result of a damaged liver that is not functioning correctly.


This condition is when the body has an excess of iron and is unable to process it.

There are two types of hemochromatosis. One could have a genetic marker for it resulting in diagnosis, or it can be a consequence of liver damage, a blood transfusion or anemia. Left alone, it can cause other organs to fail.


Whole blood cells are released from the liver. The buildup of iron in the liver can be damaging to your overall health. Excess iron may also be stored in the heart, pancreas joints and skin. An overload of iron in these organs is what can cause organ failure.

The treatment for hemochromatosis is diet and medication. Foods that are not rich in iron and supplements without iron is recommended. Other therapies include a medical device and different types of medication that eliminate the iron from the blood. One is a pump, similar to an insulin pump, providing an infusion for 8-12 hours. Alternatively, the noninvasive treatment for hemochromatosis is medication.

It goes without saying- family support is beneficial. You don’t want your father to feel like you are policing him, give him the tools and support he needs to empower him to be more conformable in his condition.

Common Causes of Hepatitis C

Hepatitis is a viral infection. A significant portion of people living with hepatitis C, like diabetes, are unaware of their condition. The CDC (Center for Disease and Control) estimated that 3.5 Million people have hepatitis and another 850,000 people live with hepatitis B. These statistics are based on what is reported to the CDC through various studies and surveillance reports. It is widely acknowledged by national medical associations and patient groups that the actual number is far higher than what is being reported

Both carriers of hepatitis B & C have shown a correlation between the virus and an increase in liver cancer. Men are more susceptible to dying from liver cancer than their female counterparts. Nevertheless, the rate for women dying from liver cancer is increasing at a higher rate than men.

Medical Transmission for Hepatitis C

In 1989 a test to diagnosis hepatitis C was under development. Several years ago, the CDC established a new guideline, recommending that baby boomers be tested; people born between 1945 and 1965.  It was believed that higher rates of infections occurred in the 1960’s through the 1980’s. Primarily through contact with blood from infected persons. Those included surgeries, transfusions, medical procedures etc.. During the outbreak of AIDS in the 1980’s, universal blood precautions where introduced and continued to be perfected to protect from blood-borne illnesses in medical settings.  The safety blood programs to screen hepatitis C in the national blood supply through blood banks was not firmly in place until the Spring of 1992.

People living with Hepatitis C have an 80% chance of developing chronic infection, and one in four will be at risk for a liver transplant.

The CDC reports, in 2013 more people died from viral hepatitis than all other combined infectious diseases. Since 2014 the death toll has continued to climb more steadily.

 Domestic Transmission

One of the most common ways to get Hepatitis C today is by sharing needles and syringes.

Nationally, we do not have consistent strict regulations in salons or with tattoo parlors. Adults and children who choose piercings and tattoos should become aware of the hygiene standards or regulations in their State. The State of California passed AB300, the safe tattooing and piercing act placing a high standard of regulation to promote safety and to stop the spread of blood-borne diseases in this industry.

Sharing a sowing kit needle or tweezers to remove a splinter, using another person toothbrush, razor blade, tweezers, nail clippers or getting a manicure and pedicure can also put you at risk.

Some medications cure Hepatitis C. However; there are no cures for chronic Hepatitis B at this point. Continued research is ongoing in finding a cure. Fortunately, since the early 1980’s vaccine developments for hepatitis B has been very robust. Today we have a well-established national public health immunization and national awareness program in the arsenal to prevent the spread of hepatitis B.

What Can You Do to Help Your Father to Regain His Strength and Quality of Life?

Assist him in; eating a diet that supports liver health, exercise, reduce stress, ensure proper hygiene and wear clothing that is less restrictive.

Taking short walks will build up his stamina and doing yoga or Tai Chi exercises to strengthen his core could help if permissible by his healthcare professional.

Although your father does not have Hepatitis A or B, a brief mention is necessary to note for all other readers.

Hepatitis B

Hepatitis B is not curable. However, treatment is available to manage it.

The vaccine is now mandatory for children entering elementary school as prevention from contracting it.

New incidences of hepatitis B and C, it is dramatically impacted by the national opioid crisis in the United States.

Hepatitis A

The hepatitis A virus is more related to hygiene where a small amount of fecal matter can be life-threatening. Food can carry the virus.

Hepatitis A outbreaks can also be found in poorly run nursing homes, hospitals and clinics.

Unlike the B & C virus, hepatitis A if diagnosed and treated early can prevent a life threatening condition.


William Remak


Mayo Clinic

Itch and Liver

Diet & Liver Disease

Hepatitis C kills American

Viral Hepatitis in The U.S.





Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.

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