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FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, July 28, 2025

Nutritional and Antioxidant Therapy Reverses Opioid Dependence and Liver Cirrhosis: A Case Report

By Aarti Midha, M.D., and Pankaj Verma, M.D.


✒️ Editor's Note

This case report has been edited for clarity, readability, and accessibility for Orthomolecular Medicine News Service (OMNS) readers. The original, full-length clinical version can be downloaded separately. [Download Full Clinical Version]


🔹 Key Highlights

Opioid withdrawal completed in 30 days using integrative nutritional protocols-without relapse.

Liver fibrosis reversed over six months, documented by FibroScan.

✅ Addressed gut-liver-brain axis dysfunction with probiotics, antifungals, and dietary changes.

✅ Corrected deficiencies in taurine, tyrosine, vitamin D3, and magnesium.

Reduced oxidative stress with NAC, alpha-lipoic acid, vitamin C, and glutathione.

✅ Used low-dose medications (metformin, pregabalin, clonidine) to support the transition.

✅ Demonstrates a safe, effective orthomolecular alternative to drug-centered treatment.


🔬 Background

Conventional medicine often isolates liver disease from psychiatric conditions like opioid dependence. But both disorders share root causes and common mechanisms-namely micronutrient deficiency, oxidative stress, gut dysbiosis, and neurotransmitter imbalances. This case report illustrates the reversal of both conditions using a structured integrative plan based on orthomolecular principles.


🧠 Case Overview

A young man from Punjab presented in 2022 with:

  • 1-year dependence on 10-12 tablets/day of buprenorphine
  • Obesity, chronic constipation, flat affect, and motor slowing
  • Parkinsonian symptoms and fungal skin infections
  • Confirmed liver cirrhosis via FibroScan
  • Lab findings: low vitamin D3, taurine, and tyrosine

🛠️ Treatment Strategy

  1. Diet and Lifestyle
    • Gluten-free, casein-free diet
    • Antioxidant-rich, anti-inflammatory meal plan
  2. Core Nutritional Support
    • N-acetylcysteine (NAC): 600 mg BID
    • Alpha-lipoic acid: 300 mg BID
    • Magnesium citrate: 300-600 mg/day
    • Vitamin D3: 5,000 IU/day
    • Taurine: 4 g/day (initial), tapered to 3 g/day
    • L-tyrosine: 500 mg/day
    • Probiotics: multi-strain, daily
  3. Medications
    • Metformin: 500-1000 mg/day
    • Fluconazole: 150 mg weekly
    • Clonidine: 0.1 mg BID
    • Pregabalin: 75 mg BID
  4. IV Therapies
    • Vitamin C: 5,000-10,000 mg, twice weekly
    • Glutathione: 600-1200 mg, twice weekly
  5. Additional Measures
    • Ayurvedic liver decoction
    • Short-term laxative support (discontinued after bowel normalization)

📈 Outcomes

  • 🧪 Complete opioid detox in 30 days, without complications
  • 🧬 Liver fibrosis regression confirmed by imaging
  • 😌 Improved mood, energy, psychomotor function
  • 👪 Family reported restoration of daily function and social engagement

🧩 Discussion

Gut-Liver-Brain Axis

Gut dysbiosis fuels systemic inflammation in both cirrhosis and addiction. Probiotics, antifungals, and a clean diet improved microbiome balance and reduced endotoxemia.

Antioxidant Defense

Chronic opioid use and liver disease both generate intense oxidative stress. NAC, ALA, vitamin C, and glutathione collectively reduced free radical damage and improved hepatic function.

Amino Acid and Neurotransmitter Support

Taurine and tyrosine replenishment helped normalize mood and energy. These amino acids are essential for neural stability and liver regeneration.

Metabolic Regulation

Metformin improved insulin resistance. Clonidine and pregabalin reduced sympathetic overdrive, easing withdrawal and supporting neurotransmitter balance.


🧠 Conclusion

This case shows how integrative orthomolecular medicine-by addressing micronutrient depletion, gut dysbiosis, oxidative stress, and neurochemical imbalances-can reverse complex, comorbid conditions previously considered intractable. It highlights a non-pharmacological pathway to healing, and a model for future clinical strategies.


👩‍⚕️ About the Authors

Aarti Midha, M.D. is a psychiatrist and board-certified anti-aging medicine specialist from Jaipur, India. She specializes in metabolic and nutritional psychiatry.

Pankaj Verma, M.D. is an internal medicine consultant focused on integrative liver, diabetes, and metabolic care.



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Editorial Review Board:

Jennifer L. Aliano, M.S., L.Ac., C.C.N. (USA)
Albert G. B. Amoa, MB.Ch.B, Ph.D. (Ghana)
Seth Ayettey, M.B., Ch.B., Ph.D. (Ghana)
Ilyès Baghli, M.D. (Algeria)
Greg Beattie, Author (Australia)
Barry Breger, M.D. (Canada)
Ian Brighthope, MBBS, FACNEM (Australia)
Gilbert Henri Crussol, D.M.D. (Spain)
Carolyn Dean, M.D., N.D. (USA)
Ian Dettman, Ph.D. (Australia)
Susan R. Downs, M.D., M.P.H. (USA)
Ron Ehrlich, B.D.S. (Australia)
Hugo Galindo, M.D. (Colombia)
Gary S. Goldman, Ph.D. (USA)
William B. Grant, Ph.D. (USA)
Claus Hancke, MD, FACAM (Denmark)
Patrick Holford, BSc (United Kingdom)
Ron Hunninghake, M.D. (USA)
Bo H. Jonsson, M.D., Ph.D. (Sweden)
Dwight Kalita, Ph.D. (USA)
Felix I. D. Konotey-Ahulu, M.D., FRCP (Ghana)
Peter H. Lauda, M.D. (Austria)
Fabrice Leu, N.D., (Switzerland)
Alan Lien, Ph.D. (Taiwan)
Homer Lim, M.D. (Philippines)
Stuart Lindsey, Pharm.D. (USA)
Pedro Gonzalez Lombana, M.D., Ph.D. (Colombia)
Diana MacKay (Gifford-Jones), M.P.P. (Canada)
Victor A. Marcial-Vega, M.D. (Puerto Rico)
Juan Manuel Martinez, M.D. (Colombia)
Mignonne Mary, M.D. (USA)
Dr.Aarti Midha M.D., ABAARM (India)
Jorge R. Miranda-Massari, Pharm.D. (Puerto Rico)
Karin Munsterhjelm-Ahumada, M.D. (Finland)
Sarah Myhill, MB, BS (United Kingdom)
Tahar Naili, M.D. (Algeria)
Zhiwei Ning, M.D., Ph.D. (China)
Zhiyong Peng, M.D. (China)
Pawel Pludowski, M.D. (Poland)
Isabella Akyinbah Quakyi, Ph.D. (Ghana)
Selvam Rengasamy, MBBS, FRCOG (Malaysia)
Jeffrey A. Ruterbusch, D.O. (USA)
Gert E. Schuitemaker, Ph.D. (Netherlands)
Thomas N. Seyfried, Ph.D. (USA)
Han Ping Shi, M.D., Ph.D. (China)
T.E. Gabriel Stewart, M.B.B.CH. (Ireland)
Jagan Nathan Vamanan, M.D. (India)
Dr. Sunil Wimalawansa, M.D., Ph.D. (Sri Lanka)

Andrew W. Saul, Ph.D. (USA), Founding Editor
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