Milk Thistle for liver protection?

[Jenise]

I've seen the claims in health food stores, which unfortunately have the fanatical look of most claims in health food stores, which means that I got curious enough to buy a bottle but felt stupid for having done so by the time I got home so a bottle of milk thistle pills sits on a counter, untouched.

So I was more than a little interested when Jancis Robinson told Charlie Rose (thanks, Bob Ross, for the link/post) that she's a fan. She takes it prior to occasions on which she knows she's going to drink a lot. Perhaps she even takes it all the time and just loads up extra on those occasions, but no mistake, she said "Milk thistle is my friend."

Do others use it, and does anyone who frequents her site know more about her regimen? Those of us who have a glass or two with dinner daily might be wise to do something more than just drink water.

I don't use it but I am a big fan of dandelion greens. They are very good liver cleansers. They are also very bitter but I dress them with a goat cheese-buttermilk dressing and throw some tomatoes in if I have them. Either the red or green variety is fine. YUM, YUM.

Dressing:

Goat cheese
Buttermilk
s&p
garlic powder
thyme (dried or fresh)
Sour cream or Mayo (optional)

Use whatever quantities you like until you get the consistency you like. This is much more fun than taking a pill.

Gastroenterologists frequently recommend milk thistle. Carole does not recommend it, but she does not discourage patients from taking it. It is not a panacea, but it does have its place, similar to saw palmetto for prostates. Here is a blurb from one medical journal:

SUMMARY — Historically, milk thistle was used as a digestive tonic; a general tonic for the spleen, stomach and liver; for the gallbladder; to promote bile flow; and as a stimulant for milk flow in nursing mothers. Milk thistle appears to supply important compounds for hepatic detoxification reactions (including drug metabolism) and to block the hepatotoxic effects of some compounds. It has also been used in a variety of liver disorders.

PHARMACOLOGY — The activity of milk thistle is reported to be derived from silymarin, which is composed of three primary flavonoids (silybin, silydianin, and silychristin). Silymarin reportedly alters the composition of hepatocytes, limiting entry of hepatotoxins, and stimulates protein synthesis as well as hepatic regeneration. Silymarin increases hepatic glutathione by over 35%. Glutathione is an important antioxidant in detoxification reactions, acting as an important sulfhydryl donor. Milk thistle is also reported to inhibit inflammatory effects of leukotrienes which could contribute to hepatic damage. Milk thistle is reported to be hepatoprotective against psychotropics (eg, phenothiazines, butyrophenones), ethanol, acetaminophen, and other drugs that modify hepatic function (Morazzoni, 1995).

Another blurb:

Silybum marianum (milk thistle), given alone or in combination with traditional therapy has limited scientifically proven value, although it is commonly used and probably safe [102]. Because it has active properties, it continues to be studied. (See "Emerging therapies for hepatic fibrosis").

And for balance, a negative or neutral blurb:

Silymarin — Silymarin (silybum marianum) is a natural component of milk thistle, which has exhibited promising anti-fibrotic activity in experimental liver injury and is widely used as a non-prescription agent in patients with chronic liver disease, particularly those with HCV. Based upon its structure, silymarin belongs to a group of flavonoid compounds, the other members of which include quercetin, baicalin, and baicalein (see below). These flavonoids have drawn increasing attention because of their antifibrogenic properties [23]. Silymarin functions as an antioxidant and may decrease hepatic injury via cytoprotection and inhibition of Kupffer cell function. Despite its theoretical benefit, a systematic review that included 14 studies found no clear evidence showing a reduction in mortality, improvement in liver histology, or biochemical markers of liver function in patients with chronic liver disease [24]. Similar conclusions were reached in an evidence report on the efficacy of milk thistle in liver disease performed through the Agency for Healthcare Research and Quality (http://www.ahrq.gov).

I guess everyone has to decide for themselves if the value is real or not. I have seen patients liver enzymes improve with milk thistle, but it is anecdotal.

[Robin Garr]

Do others use it, and does anyone who frequents her site know more about her regimen? Those of us who have a glass or two with dinner daily might be wise to do something more than just drink water.

Google "milk thistle quack" and you'll get an awful lot of reputable-looking sites that enumerate it among useless herb remedies.

Here's one:
http://www.quackwatch.org/01QuackeryRel ... herbs.html

Jenise, Jancis has a long discussion about milk thistle on the free pages of her site at http://www.jancisrobinson.com/articles/jr400

The article was written in 2002, but she re-confirmed her belief in its efficacy twice this year, at least, on the Purple Pages.

Regards, Bob

I like it, and, just like Robert, I'm also a fan of dandelion greens - as well as the other bitter dandelion-type greens that are so available at Italian grocery stores. I'm not sure if it helps much, but I greatly enjoy the bitter taste and regularly make all-dandelion salads, or sometimes salads using a mixure of the various bitter greens. I figure they say it's good, so it sure as heck can't hurt to eat once a week or so.

Of course, what gets me every time is that people spend good money on poisons to put on their lawns when they could just go outside and pick some lunch (though with all the pollution we are dealing with, that is more along the lines of figurative, rather than literal, advice). To my thinking, the "lowly" dandelion isn't lowly at all, but noble and health-giving.

Google "milk thistle quack" and you'll get an awful lot of reputable-looking sites that enumerate it among useless herb remedies.

Here's one:
http://www.quackwatch.org/01QuackeryRel ... herbs.html

Certainly, the herbal treatment industry could do with some regulation. I know pharmacists get concerned that patients often don't tell them they're taking herbal supplements that could react with prescriptions.

However, when pill-pushing doctors call herbalists quacks, I wonder if that isn't the pot and the kettle. Many prescription drugs have dangerous side-effects (just look at all the drugs pulled off the shelves in the last couple years).

I would think some herbs do have very beneficial uses in health care. However, without having been subject to the same kind of research and trials as drugs, they still lack credibility.

[Robin Garr]

Certainly, the herbal treatment industry could do with some regulation. ... However, when pill-pushing doctors call herbalists quacks, I wonder if that isn't the pot and the kettle.

Mike, you'll get no argument out of me there! If there is a Hell, I think there's a special spot reserved in it for Big Pharma execs ... and I can hardly wait to line up for opening night of Michael Moore's <i>Sicko</i> this year.

But that being said, there's a long and sordid history of people dying because they tried to self-treat ailments with quack herbal medicine remedies until it was too late.

I can hardly wait to line up for opening night of Michael Moore's Sicko

Can I go too? Ya danged pinko ridge runner....

However, when pill-pushing doctors call herbalists quacks, I wonder if that isn't the pot and the kettle. Many prescription drugs have dangerous side-effects (just look at all the drugs pulled off the shelves in the last couple years).

ALL prescription drugs have potential dangerous side-effects. People want 100% safety and correctness in medicine and that is not going to happen. This is what a few greedy lawyers prey on -- they have driven several good drugs off of the market and have jacked up health care costs across the board. Penicillin probably kills more people every year than any drug, but it is not a target of lawyers, and it is still on the market.

Many herbal medicines have documented evidence of efficacy. Many are also dangerous to your health, such as ephedra. People should not assume that because it is a "natural" herb that it is safe to take. They need to research the data.

[Robin Garr]

Can I go too? Ya danged pinko ridge runner....

Sure, you snaggle-toothed old hillbilly!

Darn, Neil grubbed all the thistles and dandelions out of the lawn in the weekend! We could have harvested them instead!!!

I think if you find something that works for you, then stick by it. I still find water is very good for cleaning out the system.

"This is what a few greedy lawyers prey on -- they have driven several good drugs off of the market ..."

Randy, I'm not interested in debating the issue, but as an attorney who did a great deal of defense work for doctors, and for pharmaceutical and medical device companies, I'd be interested in the identity of any good drugs that were driven off the market by lawyers.

We tried several times to develop the argument that costs of litigation wefre determinative, but always found on analysis that the risk/benefit analysis always favored withdrawal of specific drugs for medical and business reasons without considering litigation costs at all.

It would be very helpful to the defense if that case could be made.

Regards, Bob

I can hardly wait to line up for opening night of Michael Moore's Sicko

Can I go too? Ya danged pinko ridge runner....

Count me in, too!

I can name one very valuable one right off of the bat -- Lotronex. This drug is used for IBS and is one of the few medications that really works. A few docs misused the drug, caused ischemic colitis in a few patients, and the lawyers started in with the class action lawsuits. The company removed the drug from the market, which caused a hue and cry from patients and gastroenterologists. Believe it or not, the company put the drug back out, but restricted it to gastroenterologists.

Fen/Phen is another, but it will take me more time and space than I have right now.

Just because a small percentage of patients have problems with a drug, or because careless physicians do not monitor their patients properly, does not mean that a drug is "bad." They all have side effects. They all will cause problems in a small subset of people.

Count me in, too!

Why is it that Michael Moore never travels to Texas?

Glaxo-Wellcome withdrew Lotronex from the market because, it said, the FDA ordered it to do so. The FDA said it was willing to negotiate limitations on sales but that Glaxo-Wellcome initially refused to do so.

Eventually Glaxo-Wellcome and the FDA reached an agreement on re-launching the product. It's very hard to prove that product liability lawsuits influenced the FDA, and Glaxo-Wellcome is certainly selling the product with the new, more restrictive labelling.

As you suggest, the Fen-phen story is much more complicated, but again the FDA was instrumental in increasing warnings, etc. A basic problem with Fen-phen was the relatively small benefit for large numbers of people and a severed risk (unpredictable according to the FDA scientists) for a small number of people.

I agree, of course, that there are always risks and benefits for any medicine.

Neither of these cases were determined by the class litigations. It's better, I think, to argue that beneficial drugs are not launched at all because of fears of litigation -- but that too is very hard to prove.

Certainly, the herbal treatment industry could do with some regulation.

I have been told by doctors who are otherwise open-minded about herbal medications that the greatest problem is that, because they are not regulated, you have no way of knowing for sure what dosage you're taking. The bottle might say ### milligrams, but there's no way to verify it.

Still, I may have to give Milk Thistle a try, given that it's apparently harmless. Even if it's only a placebo effect, if it does the trick, that would be fine with me.

I still find water is very good for cleaning out the system.

And very effective and practical !
Your liver will LOVE you for it.

Count me in, too!

Why is it that Michael Moore never travels to Texas?

He actually did a screening of Farenheit 9/11 in Crawford, TX just outside the Bush ranch. I love it!

I still find water is very good for cleaning out the system.

And very effective and practical !
Your liver will LOVE you for it.

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