Milk Thistle benefits

http://www.hepatitis-central.com/mt/archives/2008/08/hep_c_quality_o.html

FYI....This link  from Hepatitis C Central explains the advantages of taking Milk Thistle for anyone with Hep C, including taking it during treatment.  I just wanted to pass this on if any of you are currently NOT taking this supplement.  I have been taking this for years and am convinced that it has helped me.
I hope this helps someone out there!

[coeric]

thanks for posting the link

i believe willing was talking a while back about legalon-sil which is an intravenous preparation of milk thistle.   i think he might have been suggesting it might be useful for those of us that did not get SVR with the current SOC including those of us that fail with the new PIs.  so i did a quick google search.

i was interested to read that legalon-sil reduces core and NS5A proteins in vitro in this article.  looks like it would be a great adjunct to the PIs
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072633/

here is another article that shows a remarkable decline in HCV RNA following dosing with legalon-sil in a single transplant patient.
http://www.natap.org/2011/HCV/021611_06.htm

unfortunately we cannot use this in the US for hepatitis although the FDA does allow special use for mushroom poisoning.

[Magnum]

Although both my GI and Hepatologist say there's no real proof of benefits, they also said "it can't hurt". In Europe, they've been taking it for many years and believe in its benefits. I've been taking it for about 6 years on a daily basis at 1000mg.

Magnum

[coeric]

Mag, are you taking milk thistle during treatment?  i have read posts from folks that said their doc told them not to take milk thistle on treatment, although i really don't understand the rational for stopping.
eric

[Magnum]

Funny you should mention that. Just the other day I was thinking that in Aug., when I start my triple therapy, I wanted to ask him if I should keep taking supplements.

What are they???  Milk Thistle = 1000mg daily. Vitamin C = 500mg. daily. Alpha Lipoic Acid 200mg = 3 times weekly. Vitamin D-3 = 2000mg. daily. Pure Alaskan Fish Oil with Omega-3 = 1000mg. daily. Multiple Vitamins (minus iron) = once daily.

In my opinion, I would like to stop after being cured, with the exception of the multi-vitamins. Let me add that the Gastro recommended the Alpha Lipoic Acid (which Hep C robs the body of) and the Fish Oil (which is supposed to suppress Fatty Liver). As the shards of Hep C intrude into a healthy liver, another thing to remember is diet. I eliminated fast foods, salt, sugar, fats, meat, any shell fish (oysters, mussels, shrimp, lobsters, clams, etc.) due to the potential mercury poisoning and other polluters in the ocean and last but not least, ex-girlfriends...

Magnum

[coeric]

ex-girlfriends - thanks for the laugh my friend.

it is tempting to think that milk thistle might have a synergistic effect with the PI since the link http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072633/  states that it reduces NS5A proteins. but that study used legalon sil, an intravenous preparation.  with our puny little oral does we probably cannot get serum levels close to an IV dose.  

in the link elpasolady posted from the HaltC study, quality of life seemed to improve with those taking milk thistle. but of course you wonder about what else the study participants were doing. maybe avoiding ex-girlfriends.

time to go watch fireworks.
may we all get independence from HCV
eric

[copyman]

Yes they have been using it in Europe for years. Actually the best milk thistle you can get is certified from Europe. Life extension sells it.

[Bali05]

In Europe they conducted trials with MT and it did not show any effect against HCV when taken orally so far. There is still a trial going on where they upped the dosage but so far that does
not look very promising.
Taken by IV (legalon-sil) on the other hand was very effective in reducing viral load at least
temporarily. It acts like a natural PI. Under the right circumstances legalon-sil is promising
problem is it is very expensive , requires weeks of clinic stay , ea infusion is several hours,
only approved in Austria so far  for proven previous non-responders.

[mlkinmb]

I was told that I should take MT over 6 months ago. I buy a concentrated extract 1000mg from WallyWorld. It suggests one, two to four times daily, I've just been taking 3 at a time once a day. Over a 4 month period my VL did not drop, it increased by 1.5mil.+. I have to wonder if it does anything really, perhaps it may help preventing more liver damage?

[elpasolady]

My Gastro told me i should definitely keep taking my supplements during treatment, which include Milk Thistle as well as the Alpha R Lipoic Acid. My personal criteria is that I research the company making these supplements and get the purest, best quality product I can buy. They are NOT all made equally, the same as the vitamins we take. Many may not be familiar with the Alpha R Lipoic Acid so I posted below the benefits.....

The Alpha R Lipoic Acid is described as follows:

Alpha R-Lipoic Acid benefits.....
Universal Antioxidant - Both water and fat soluble
Regenerates Antioxidants
Boosts Glutathione
Supports Normal Liver Enzymes Levels
Powerful Scavenger of Dangerous Free Radicals
Increases Energy
Anti-Aging
Strengthens Memory & Supports Healthy Brain Function

Glutathione is the important factor here. It is composed of three amino acids ( glutamine, cysteine, and glycine)  It is considered to be the body's  master antioxidant, which is why it is so important for your liver.  Many physicians would consider glutathione to be the single most important nutrient for proper liver health and promote cellular health.  I suggest you do research on it if you are interested. You can also get Glutathione from foods such as watermelon, grapefruit,strawberries, oranges, cantalope, peaches, avocadoes, asparagus, potatoes, acorn squash, tomatoes, broccoli, okra, zucchini and spinach.

My feeling is that my body needs all the help it can get to get better and as long as these supplements are not harmful, I'm all over them!

Here is a link containing an article  from Hepatits- Central talking about glutathione.

http://www.hepatitis-central.com/mt/archives/2007/07/hcv_and_the_bod.html

[Bali05]

"perhaps it may help preventing more liver damage?"

When you read the results from HALT-C you will see
it did NOT reduce ALT which is a marker for hepatocellular
damage.Makes you wonder if the results of that study regarding
MT are not just one giant placebo effect.
BTW, nothing wrong with a good placebo effect.

[James10500]

From the article;

When comparing silymarin users to non-silymarin users in the HALT-C trial, the following was discovered:

1. No beneficial effect of silymarin was found on ALT levels (serum alanine aminotransferases) – an enzyme often elevated with liver injury.

2. No beneficial effect of silymarin was found on Hepatitis C virus RNA levels.


Quality of life improvements are psychosomatic .......imho

[elpasolady]

There will be more studies and debates on this subject, now and in the future, for sure!
In my personal experience, however, once I started taking Milk Thistle several years ago, my ALT and AST levels have been in the normal range, with the exception of one time.  Prior to Milk Thistle, they were always above the normal range, albeit not by alot. My VL, however, has risen over the years.  In 2006, it was just over 2 mil and now it is 7mil.

So, in IMHO, I don't see any harm in taking these supplements.  Even though they are not a cure for hep c, I will NOT say they don't help our livers in some way, shape or form, especially before our livers suffer severe damage? How will we ever know if we would be worse off if we had never taken them? For ME, it is a no brainer.
All the best !

[elpasolady]

Also, the main reason I posted this was because of the benefits of taking Silymarin ( Milk Thistle) during treatment, not that it would replace treatment. What James did not post were the findings right under the two he listed, which are as follows...The last paragraph is important!!

3. Those on silymarin showed significantly fewer liver-related symptoms than non-users.

4. Those on silymarin scored higher on quality-of-life parameters than non-users.

5. After adjusting for age, race, education, alcohol consumption, exercise, body mass index and smoking, silymarin users showed significantly LESS  fatigue, nausea, liver pain, anorexia, muscle and joint pain, and improvements in general health over non-users.

Confirming that silymarin has little direct effect on the Hepatitis C virus, the qualitative values generally used to evaluate virus severity were similar in silymarin users and non-users.

However, there were other observable benefits to the silymarin users. By reducing the severity of common Hepatitis C symptoms and interferon side effects, silymarin use demonstrated an obvious advantage to people managing this virus.

[willbb]

The use of MT has been discussed here many times....The experienced Hepa I asked  if MT was useful or useless when treating...said    "We Don"t Know"

For what it"s worth .I have taken 1000mg/ day  for many years ..however stopped when on tx.

Will

[James10500]

Right like I said it's psychosomatic.  The "real" numbers say it doesn't help.  The subjective questions say it does.

To each there own, the goal is SVR and for that ML does nothing.  But if it makes you happy by all means take it!

[James10500]

As there is no edit feature I have to add this post.

Nicole Cutler I'd not a doctor, and I'm fairly suspicious of anything she writes, seems to be motivated by the ads on here site.  Why doesn't she just post a link to the study ?

Here's what HALT- C actually said, scroll down to page 4ish.  They say exactly what my doc (Everson google him) who does HALT-C studies said.  Problem is you don't what is in those capsules, because there are no regulations of the supplement industry.

http://www.haltctrial.org/newsletter/Jan2007newsletter.pdf

[aj7538]

My dr suggested mt with vitamin e. He said it would not cure yep c but would. Slow progression of disesase aj7538

[Boobert]

I've been taking it for over 9 years now with a few others. My GI at the begining had just said it wouldn't hurt but now after all these years and my lab reports he is now suggesting MT to other patients. He truley believes it has helped manage my AST/ALT in the normal levels. I KNOW it has. I also take Sam-e, R-liopic acid,Nac,Vitamin E,Selenium,Glutathione,B12, and D.I believe it is definitely helping and don't really care what the skeptics have to say.

[kutza4]

thanks for the info on Rliopic acid...i'll look into it....i do eat alot of kal nutr. yeast  which has a lot of ammino acids...but i'm with you on the mt ..i take mt and other supp.  and when i go off them i'm back to being sick 4-5 days a month completely bedridden...mt works for me...extract and 1200mg caps...good health to you

[elpasolady]

@boobert...Are you saying that you take a supplement that is solely gluthathione?  If so, where do you get it from?  The reason I take the lipoic acid is really only for the glutathione.

@kutza4 ... You are welcome.  good health to you TOO!

[Magnum]

An interesting change appeared in all four (quarterly) blood works taken over the past year, the ALT and AST have been consistently lower than in the previous 9 years. Why? Good question. What have I done different than the Milk Thistle I've been taking for 6 years? Grapefruit Juice... I buy the Simply Grapefruit at Wal-Mart and drink a glass a day. I understand it has great benefits from the statement below. Keep in mind both ALT and AST were over 100 in every blood work for the past 9 years, with the exception of the past (10th) year. Now, they have been as low as 58 & 82 respectively. Could this statement below be the catalyst?

"Since HCV does not integrate its genetic material into the DNA of infected cells the way HIV does, totally clearing the virus is possible if new cells were not being infected. Therefore, interfering with the transport of HCV out of cells holds a great deal of therapeutic promise.

Scientists found that by blocking vLDL with a compound in grapefruit, Hepatitis C lost its vehicle and thus was stopped from expansion. Grapefruit's bitter taste is caused by the presence of the flavonoid naringin, which is metabolized into naringenin, an antioxidant known to reduce the secretion of vLDL from liver cells. The Massachusetts investigators confirmed that naringenin reduces the secretion of Hepatitis C from infected cells".

Another Grapefruit Advantage

Although focusing on a different component of the grapefruit, previous research supports the hepatic potential of grapefruit. Phytonutrients in grapefruit, called limonoids, inhibit tumor formation by promoting the formation of glutathione-S-transferase, a detoxifying enzyme. This enzyme sparks a reaction in the liver that helps to make toxic compounds more water soluble for excretion from the body.

Since those with chronic Hepatitis C are at a greater risk for developing cancer of the liver, inhibiting tumor formation is especially important. By helping the liver clear out cancer-causing toxins, limonoids’ promotion of detoxification enzymes is a simple way to ward off the development of cancer”...

There are cautions about grapefruit and certain medicines. This is the ONLY thing I’ve added to my supplement regiment in the past year or more. Could this be the catalyst for keeping my ALT and AST below 100 in every blood work? What else?

Read it all here: http://www.hepatitis-central.com/mt/archives/2008/02/what_you_need_t.html

Magnum

[Boobert]

Jarrow fomulas 500mg Glutathine

[penn1023]

What brands are you using in your supplement regimen?

[nygirl7]

I'm pretty sure Dr. J said not to take it and he was the lead investigator of HALT-C - but not to take it during treatment. And I know years ago we were told no grapefruit - look how things change........

[Magnum]

Vitamin C 500mg. daily = Kirkland (Costco)
Mature Multi Vitamins (one daily) = Kirkland
Pure Alaska Omega-3 Wild Alaskan Salmon Oil = PharmaPure Nutritionals
Concentrated Extract Milk Thistle 1000mg. daily = Spring Valley
Alpha Lipoic Acid 200mg 3 X weekly = Spring Valley
High Potency Vitamin D-3 2000iu daily = Spring Valley

Those are dosages and manufacturers brand...

Magnum

[penn1023]

Thanks Magnum
I heard it's good to take buffered C. Also, someone told me that the ALA has to be from a pure European source. I found out that Bluebonnet brand is from Germany. Most others are from China. I am thinking about going on low dose naltrexone to lower my viral load in addition to a good supplement regimen.

[Susan_1a_CC]

FWIW, it's my understanding that ALA is the precurser of glutathione and it is cheaper than glutathione.  

[James10500]

Someone please post a clinical study that says taking ML during tx increases SVR.  Taking unregulated herbs while on tx...because you "think" it will help, maybe not so smart.

I wanted those meds in my liver around my liver as long as possible.  Taking an herb that artificially increases the livers ability to clean, sounds risky.

So on this thread we have two of the countries leading hepatologists Deb's Dr. J, and my doc Everson telling people don't take it during tx.  And armchair docs on a forum saying go for it.

[cheesenrice]

they have done clinical trials with silymarin - it does have antiviral properties - the injectable form is far more effective than the pills - there is no proof that it benefits or hinders inf/riba tx

[James10500]

I said SVR.

hmmm take the advise of a leading hepatologist or some anonymous person off the internet, let me think.  After much consideration I'll stick with Everson's advice, thanks though.

[Susan_1a_CC]

I don't think that there is any clinical proof that ML aids in achieving SVR.

I take a number of supplements all of which were medically okayed prior to starting the trial I am in.  The only thing that I was told not to take were corticosteriods.  I took supplements before tx and I was glad to take them during tx in order to offer my liver what support I could.  As far as meds staying in the liver as long as possible - I am reminded of when I read so much on here that one needed to take riba w/ a high fat food.  I tried that and didn't do well - the study nurse assured me that the riba dosage was based on a normal diet.

It's tricky making one's way through tx and can be even tougher if we read about something here and suddenly think that we aren't doing all we can to help ourselves.  One of the great things about this forum is how quickly one gets called to substantiate medical claims.  I sure learned that early on ;).

[cheesenrice]

hmmm thats what i was told by - u guessed it - another leading hepatologist

[cheesenrice]

go figure huh - or is your leading hepa more leading than mine - lol
yeah you said svr - thing is you have to tx to accomplish that

[James10500]

I did tx, thanks for the great advice.

Yes silymarin injectables have show to have anti viral properties.  But never have been proven to lower VL as far as I know, please supply a study that says it does.  By the way where do you go for silymarin drips,or injections ? #pointless

[roostermom]

I am something of a vitamin junky and never get the colds and bugs that go around my home and office. One of the things I have been taking daily is milk thistle. I just started my second round of trt this week, and my gastro guy said to stop the milk thistle during treatment - something about not wanting the liver taxed my too many things blasting it at once (my words and interpretation, not theirs).

[Bali05]

"the liver taxed by too many things blasting it at once "

There is definately truth to that. It is not just about if any particular supplement
has shown any benefit but it is also very much about dosages like everything else.
Too much of anything can harm you.
My motto on tx and now post is  "In case of a dought through it out "

Good luck with your second round.

b

[roostermom]

Thanks much Bali05

[cheesenrice]

the fact that its labeled as an antiviral and a protease inhibitor proves it - granted its not as effective treating with soc - i guess you didnt bother exploring the links provided at the beginning of this thread that will address your skepticism so i wont waste my time doing so - also again its liver friendly and tx friendly

id worry more about the air we breathe and the food we eat taxing the liver

injectable extract has saved more than a few peoples lives after ingesting toxic mushrooms - aka fulminant hepatitis always fatal until now

[James10500]

It does NOT have an effect on VL, and it does NOT help liver enzymes. The article says that.  

I'm sure the "people who ate bad mushrooms" forum would appreciate your information.  But as far as killing the HCV virus it does nothing.  If people think it does them good go for it.  My only point is the HALT-C article by Cutler the OP posted states

1. No beneficial effect of silymarin was found on ALT levels (serum alanine aminotransferases) – an enzyme often elevated with liver injury.

2. No beneficial effect of silymarin was found on Hepatitis C virus RNA levels.

[Bali05]

Rest assured I am very much aware of the latest research on Silymarin taken orally
or by IV as Legalon-Sil. Most of those studies take place in Europe and I get quaterly
updates. As a matter of fact this year`s March issue of the German Liver Magazine
"Lebenszeichen" (sign of life) has 3 big double page spreads about Silymarin and its
efficacy for NASH ,primary biliary cirrhosis, autoimmune hepatitis , akute viral hepatitis,
Hep B , Hep C , mega dosis of Silymarin orally , Silibin IV  (legalon-sil) for Hep C and as
rescue therapy for slow or non responders as well as Silibin IVs as a lead in for
SOC and prevention therapy of reinfection after transplant.

b

[cheesenrice]

1. alt levels mean nothing
2.they didnt dose high enough in halt c - dont base opinions on 1 study - like anything else
3.read coerics links
4. nevermind ill do it 4 u
5.Legalon-SIL downregulates HCV RNA as well as HCV core and NS5A proteins in CON1 cells

from Jules: many studies in the past few years conducted by Peter Ferenci have shown IV silibin to have significant antiviral efficacy against HCV (see link below). So for patients who are peg/rbv nonresponders and for that matter responders as well IV silibin should be researched in combination with telaprevir and boceprevir as it might have a particular benefit for prior null responders and partial responders and perhaps most importantly for patients who are contraindicated for peg/rbv but could combine IV silibin with an HCV protease.



LS downregulated HCV RNA (core region) in a dose-dependent and also a time-dependent manner in CON1 cells. The HCV RNA (core region) level was decreased 21% following 6 h treatment with LS 200 μmol/L compared with the DMSO control (P < 0.05, Figure ​Figure2A).2A). HCV RNA (core region) levels were further decreased after 24 h treatment by both LS 50 μmol/L (55% decrease, P < 0.05) and 200 μmol/L (88% decrease, P < 0.01) when compared with vehicle (DMSO) control (Figure ​(Figure2A).2A). The HCV RNA (NS5A region) level was also decreased 43% following 6 h treatment with LS 200 μmol/L compared with DMSO control (P < 0.01 Figure ​Figure2B),2B), and was also further decreased after 24 h treatment by both LS 50 μmol/L (62% decrease, P < 0.01) and 200 μmol/L (87% decrease, P < 0.01) (Figure ​(Figure2B).2B). LS 200 μmol/L also downregulated HCV core (by 57%) and NS5A protein (by 49%) after 24 h of treatment although this was statistically significant only for HCV core protein, P < 0.05). This effect was more pronounced following 48 h of treatment: LS 200 μmol/L decreased HCV NS5A protein expression by 65% (P < 0.05), while LS significantly decreased HCV core protein expression in a dose-dependent manner (52% reduction at 50 μmol/L and 85% reduction at 200 μmol/L P < 0.01) (Figure ​(Figure33).

[Bali05]

Old news !
Read my post above Silibin IVs are only approved in Austia in combination with SOC
for proven previous non responders , require several weeks of clinic stay , many hrs of IV per day
and are very expensive.

b

[cheesenrice]

but you can get it in the usa - although the benefits are greater with injectable - oral still works and its relatively inexpensive

i read your post - sounds like an endorsment to me ---" Silymarin and its efficacy for NASH ,primary biliary cirrhosis, autoimmune hepatitis , akute viral hepatitis, Hep B , Hep C , mega dosis of Silymarin orally , Silibin IV  (legalon-sil) for Hep C and as rescue therapy for slow or non responders as well as Silibin IVs as a lead in for SOC and prevention therapy of reinfection after transplant."

there are many trials ongoing with it - there are many other conditions not mentioned in your post like diabetes and iron overload that respond to its use --- so its good for you - it doesnt hinder tx but actually helps it - and theres no known proof showing not to take it during tx - just because a dr doesnt recommend it means nothing to anybody but him - some say no to it because of overtaxing the liver - ha - then they turn around and start prescribing all kinds of meds for sides complications etc

[James10500]

Are you treating now ?

[willing]

silimaryin/silibinin are a very interesting class of compounds with promising anti-fibrotic, anti-carcinogenic and HCV-RNA suppressive properties. However, as far HCV patients it's important to not confuse in-vitro results, intravenous in-vivo and oral in-vivo.  

The promising  in vivo results on HCV RNA suppression have *only* been observed with IV-SIL, which as Bali points out is a heavy-duty drug whose administration  involves hours a day hooked up to a drip IV. IV-SIL, which is water soluble is also chemically distinct from the compound available as an oral supplement, which is not.

A recent study investigating multiple oral doses of silimaryn (using the high-quality Legalon variant made by Madaus ) found "no clinically meaningful reductions from baseline serum transaminases or HCV RNA titer" notwithstanding dosage as high as 2.1g a day.  See

http://www.ncbi.nlm.nih.gov/pubmed/19841158

Note in particular the lack of effect on HCV RNA VL documented in Figure 3. The IV-SIL results *are* very promising, but you just can't get there by taking oral supplements,

[cheesenrice]

im not treating now - ive tried peg intron pegasys and infergen - i had about 2 yrs documented svr with peg intron but the virus came back - then tried pegasys which resulted in a very slow response and was switched to infergen daily but experienced breakthrough - gasto sent me to transplant center - hepatologist there at first said no more inf / riba - meld ~ 12 - on 2nd visit he seemed open to 3x tx - i feel i have to try 3x but i dont want to fail - i dont think i can "afford"
to fail - i also have fatty liver disease and hard to control diabetes - thats mostly why i do the milk thistle

ps - thanks all

[Bali05]

Silymarin taken orally at high dosages  causes gastrointestinal problems.
One of the key problems is absorption.
Here is a trial sponsored by NIH looks like they are recruiting
Silymarin @ 280mg or 700mg twice a day  + green tea
http://clinicaltrials.gov/ct2/show/NCT01018615

" i also have fatty liver disease and hard to control diabetes  "
Instead of Silymarin have you tried a lowcarbohydrate diet to better your
diabetes and fatty liver ?

Excessive carbohydrate consumption is one of several characteristics of the American diet that contributes to abnormal lipid profiles and fatty liver disease. If your carbohydrate intake exceeds your energy needs, the excess is converted to triglycerides in your liver through a process called lipogenesis. A 2011 study in "The American Journal of Clinical Nutrition" demonstrated that carbohydrate restriction reduces your liver's storage of triglycerides--and the risk of fatty liver--more effectively than simple caloric restriction

http://www.ajcn.org/content/early/2011/03/02/ajcn.110.007674.abstract

[James10500]

I'm sorry to hear tx didn't work.  And I wish you the best.

[cheesenrice]

thanks guys
yes bali - im a carb watcher - lol - i think my main stumbling block with diet is the exercise part -in the past 6 months or so ive lost quite a bit of weight (50 lbs) and i think its not of my doing - ( cirrhosis ? ) - of course it seems to be muscle more so than fat - i have a bad back and neuropathy and walking is about as much exercise i can tolerate - im grateful i can still do that

[benefitsdonna]

anyone every experience allergice reaction to milk thistle?  I did