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Milk thistle?
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Milk thistle?

Does anyone know if milk thistle is good, bad, or of no effect?  I read somewhere that it is helpful for liver problems so started taking it.  I won't see my dr. for almost three months so can't ask him until then.
39 Comments Post a Comment
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Avatar_m_tn
been taking for 10 years; I think it is a good supplement
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Avatar_f_tn
I agree that it is beneficial in terms of supporting the liver. No way a cure. Fine to take it now but you won't be able to when you start treatment.
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Avatar_f_tn
My Doctor says it may reduce elevated liver enzymes, which is good, because that is from inflammation.  But I dont like the milk thistle that comes in the gelatin capsules, because gelatin is not so healthy for us. I bought a non-alcoholic tincture form of it, which was water soluble. Of course, it never did reduce my elevated liver enzymes.  One month into treatment, my liver enzymes went down to normal, and my Hep C viral load went undetectable, so I prefer the Interferon/Ribavirin method, to the natural methods
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Avatar_m_tn
I buy organic milk thistle seed, whiz it around a Magic Bullet and put it in green smoothies.

They say it's not very water soluble though.
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446474_tn?1404424777
Milk thistle has been proven to have no effect on liver disease. It is another myth that we now have data on. Apparently some are not aware of the study, including doctors. I would recommend hepatitis C treatment to prevent further damage to your liver. It actually works.

AASLD: "Milk Thistle Extract Did Not Improve Liver Inflammation or Quality of Life for Hepatitis C Patients"  Nov 14, 2011

Oral silymarin, an extract from the milk thistle plant, was well-tolerated but did not reduce alanine aminotransferase (ALT) or HCV RNA levels or improve quality of life for hepatitis C patients who did not respond to interferon, researchers reported at the 62nd Annual Meeting of the American Association for the Study of Liver Disease (AASLD 2011) last month in San Francisco.

Interferon-based therapy for chronic hepatitis C virus (HCV) infection is not always effective, and even if it is, liver damage may persist. Patient and providers have explored numerous alternative and complementary therapies for liver disease, with milk thistle (Silybum marianum) among the most common. Silymarin is a mix of milk thistle flavonoids (including silybin A and B) with anti-oxidant, anti-inflammatory, immunomodulatory, and antiviral properties in vitro.

In the present study -- funded by the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Center for Complementary and Alternative Medicine (NCCAM) -- Michael Fried from the University of North Carolina Liver Center and colleagues evaluated oral silymarin in hepatitis C patients who did not achieve sustained virological response to interferon-based therapy.

A total of 154 adult participants at 4 U.S. centers were enrolled; a majority were men, about 75% were white, and the median age was 54 years. Most (about 90%) had hard-to-treat HCV genotype 1 and 40% had liver cirrhosis, but people with decompensated cirrhosis, moderate or worse steatosis (liver fat accumulation), and HIV or hepatitis B coinfection were excluded. At baseline they had elevated ALT (> 65 IU/L or 1.5 x upper limit of normal; median 106 IU/L), a biomarker of liver inflammation.

Participants were randomly assigned to receive 420 mg or 700 mg of Legalon brand silymarin 3-times-daily (3 to 5 times higher than the doses typically used) or placebo or 24 weeks.

Results

138 out of 154 enrolled participants completed the study.

Adherence was good, with more than 90% reporting that they took silymarin as directed at least 80% of the time.

Although ALT levels declined somewhat more in the 420 mg and 700 mg silymarin groups compared with the placebo group (-4.3, -14.4, and -11.3 IU/L, respectively), the difference did not reach statistical significance (P = 0.75).

At 24 weeks, only 2 people (4%) each in the 420 mg and 700 mg silymarin groups saw their ALT level fall to 45 IU/L or lower compared, with 1 (2%) in the placebo group.

1 person (2%) in the 420 mg silymarin group and 2 (4%) in the 700 mg group saw their ALT decrease by at least 50% to < 65 IU/L, compared with 2 (4%) in the placebo group.

HCV RNA viral load did not change significantly in any group (+0.07, -0.03, and +0.04, respectively).

Quality of life measures and symptom scores (including CES-D, SF-36, and CLDQ) were not significantly different across groups.

Silymarin was well-tolerated, with mostly mild-to-moderate adverse events that were similar across groups.

The investigators concluded that although it was well-tolerated, higher than usual oral doses of silymarin "did not significantly reduce serum ALT levels more than placebo in participants with HCV infection who previously failed interferon-based therapy."

In response to a question about whether even higher doses might have an effect, given the need for alternatives in areas of the world that have no access to new HCV drugs, Fried replied that higher doses would necessitate too great a pill burden -- even the higher dose used here required 5 capsules 3-timesdaily -- and attempts to boost silymarin with other botanicals were unsuccessful.

Investigator affiliations: UNC Liver Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Thomas Jefferson University, Philadelphia, PA; Beth Israel Deaconess Medical Center, Boston, MA; University of Pittsburgh, Pittsburgh, PA; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC; NIDDK, National Institutes of Health, Bethesda, MD; NCCAM, National Institutes of Health, Bethesda, MD; University of Pennsylvania, Philadelphia, PA.

12/6/11

Reference

MW Fried, VJ Navarro, NH Afdhal, et al. A Randomized, Placebo-Controlled Trial of Oral Silymarin (Milk Thistle) For Chronic Hepatitis C: Final Results of the SYNCH Multicenter Study. 62nd Annual Meeting of the American Association for the Study of Liver Disease (AASLD 2011). San Francisco, November 4-8. 2011. Abstract 228.

Cheers!

Hector
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Avatar_m_tn
I'm with Hector, my thoughts are the only effect Milk Thistle will have is in your wallet.... I was told "don't waste your money" on it.

Best to you
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1748829_tn?1338040641
It actually made me feel better before treatment but i wasn't taking it to cure Geo c because it can't do that. And I had a link but now I can't find it that supported that it helps the liver pass toxins quicker so its no wonder drug but for some people can speed up the time toxins sit inthere liver
Crud I wish I had the link to make my point or half a brain since its all fogged up.I don't know if it will do you any good but it did make me personally feel better but I also started trying to take better care if myself at the time. So who knows but I had a link and ill shut up the useless ramble now.
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446474_tn?1404424777
I would suggest going shopping at your favorite store instead of buying Milk Thistle. It has a better placebo effect and it just plain makes you happy.  ;-)
Also you are helping the economy at the same time.

Serious, think about doing treatment. It actually works for many people.

Cheers!
Hector

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1840891_tn?1383280315
Thank you Hector, for once again providing a straight answer with excellent background info.  I did ask my hepatologist many years ago, but at the time the answer wasn't very clear. He thought it probably wouldn't help but also wouldn't do any harm, so I  ended up taking it for years because there were no other tx options for me at that time. I don't think it helped, other than allowing me to feel like I was trying something. I appreciated that feeling but I don't think it was worth as much as the herb cost over the years!
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446474_tn?1404424777
Always glad to share with a fellow Bay Area person.

Cheers!
Hector "in the city by the Bay". SF
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901131_tn?1293748153
My Doctor supports it, I've been taking it for 10 years and believe it has helped keep things in check. That study was a joke, if anything it won't hurt you. To each his own.
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179856_tn?1333550962
No Boobert, the sad truth is it does nothing and is a waste of money.

Milk thistle has been proven to have no effect on liver disease. It is another myth that we now have data on. Apparently some are not aware of the study, including doctors. I would recommend hepatitis C treatment to prevent further damage to your liver. It actually works.

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Avatar_f_tn
I was taking Milk Thistle last year religiously because I didn't know any better.  So I had been taking it for about 3 months and my ALT/AST shot up to around 200.  Then I read on the forum from all these warriors that it did absolutely nothing to help so I quit!  So I would recommend you save your money and buy some popsicles instead.  

Have a great day!
Jules
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1494170_tn?1361754460
right or wrong, I like the Popsicle theory!  
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Avatar_m_tn
Seem like the MT debate has gone on since the "big bang" and it also seems there is no concordance either in the medical community. I asked two experienced Hepa's whether or not there was any benefit and was told by one   "I Don't know"  and the other one said "probably not"  If I had asked a third.possibly he would have said "sure it helps"

I don't believe the study was a joke ,not one to think any study involving 150 people is a joke , however  I guess being there is no study data that says it is harmful possibly we take it as a hopeful prelude to tx.

BTW..I have taken it for years and have minimal liver damage. has it helped ..no clue..guess it hasn't hurt..
Best..
Will
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163305_tn?1333672171
Milk thistle has been used for centuries in Europe for the liver
Some view it as protective.
Will it do anything to stop your hep C ? No.
Will it harm you  ? No.

I often wonder about research, who it is funded by and what results are desired by those doing the research.
There has been a concerted effort to discredit the herbal industry which causes me to be skeptical.

On the other hand, there's the question of freshness and quality and what happens during processing.
Perhaps fresh milk thistle does more good  then the supplemental varieties?
You could buy the seed and make tea.

While pondering upon the reason so many people seem to be wheat intolerant these days, I stumbled into the fact that almost all wheat and gluten products consumed in the US these days are from a GMO variety made by Monsanto.
Are people allergic to wheat and gluten or the added modifications from Monsanto ?

If you choose to use herbs, try to get the freshest variety possible.
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Avatar_m_tn
"....Thanks to 1994's Hatch Act, the Dietary Supplement Health and Education Act (DSHEA), pushed through Congress and released upon a then-unprotesting public by Utah's Sen. Orrin Hatch (R-UT), substances which may be benign, toxic, and everything in between, as long as they are sold as "dietary nutritional supplements," get a virtual free pass.

The supplement manufacturer can make "structure-function" claims, such as "supports sexual health," but not health claims. Such assertions must clarify that the substance is not FDA approved "to diagnose, treat, cure or prevent any disease."

Part of the law mandates that ingredients brought to market after 1994, so-called "novel" ingredients -- and only those -- be shown to have passed safety tests.

Older ingredients got "grandfathered" in without the need to be proven either safe or effective.

How is that working out? There have been approximately 51,000 new ingredients brought to market since DSHEA passed, of which about 0.3% -- that's not a misprint, 170 out of 51,000 -- have documented safety tests.

Who cares? "Why worry?," perhaps under the delusion that some substance termed "natural" must be safe, seems to be the governing mantra of the American consumer on this subject, since about 100 million of us spend, at last tally, over $28 billion per year on these products -- vitamins, minerals, potions, herbals, biologicals, who-knows-what.

If a shopper has a question about the efficacy or danger of a supplement, they may simply ask the health-food store employee......"

http://www.medpagetoday.com/Columns/At-Large/31494?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g235671d0r&userid=235671&email=***@****%CE%BC_id=
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Avatar_f_tn
Interesting discussion, and a thank you to Hector, for "telling it like it is".
     I have to admit, I used to be one of those people, who thought I could "cure"my Hep C, with alternative medicines, and yeah, I have drawers and drawers full of these expensive supplements, etc. Needless to say, I make a very low working wage, as well.
   I remember last year, reading a personal story, on the internet, about Milk Thistle, which was from the wife of a man, who had Hep C. It went something like this: "My husband had very good luck, keeping his liver enzymes from being elevated, by using Milk Thistle. Unfortunately, he ended up getting liver cancer"
    This story kind of summed up Milk Thistle for me: people need to go get treated, and stop wasting their money.  Companies are profiting on our pain!
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979080_tn?1323437239
I know one thing for sure regarding MT.
If you take too much of it it has a laxative effect...., lol .

b
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Avatar_f_tn
So strange, I was trying to get my ALT/AST down below 400, in order to get into this Research Study, for Hep C.
   So I started taking tons of Milk Thistle, the capsules, and the tincture, all in a weeks time, and it had the exact opposite effect on me: I have never been so sick or constipated, in my entire life, lol
   Maybe it was just the stress of it all, but they never did let me into that study, which I ended up being glad about, I'm doing fine, just doing the triple tx, with my Doctor!
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979080_tn?1323437239
well , it had that effect on me some time ago but it is also known
to be upsetting to the gastro track in large doses.
This is one reason why in studies they were limited in terms of dosage.
The active compound Silibin in MT if adminstered by IV definately
showed strong antiviral activity. It is actually approved for that use in
Austria .We been posting about this and a lot can be found in the archives.
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Avatar_f_tn
I had also read about mega doses of vitamin C, administered by I.V., as having some antiviral promise.
   When-ever I feel like my immune system is low, I usually do take about 1000 mgs of the chewable vitamin C. But this practice could be dangerous for someone who had iron-overload, from the Hep C, because vitamin C helps iron to be absorbed. That kind of freaked me out, but when I had my biopsy, I didn't have that problem, thankfully.
   I think the bottom line is: I wasted alot of years, trying to "cure myself"...my liver enzymes have always been elevated, which shows that my immune system was always trying to fight it, as well. My immune system tends to attack any virus I get, quickly.
   My Doctor said this kind of immune system can cause liver damage quicker then if it didn't attack the virus at all, and just let my body live with the virus. But that my immune system also reacted well to the Interferon/Riba, so I am so glad I decided to get into treatment!
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979080_tn?1323437239
Vit C can maybe indirectly help your immune system but that`s about it.
Silibin by IV has shown such a strong antiviral effect it has been called
a natural PI. Problems is the effects of it are mostly temporary.

I did those VitC IVs when I was still trying to get a handle on my infection
alternatively. The result was enzymes stayed the same but VL went up..lol.
You certainly get a different perspective on things once you reach SVR
and you are on your way there.

Cheers
b
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1280753_tn?1367761532
i took MT for 6 months prior to treatment. i think i felt better. but i stopped when i treated. looking back i think i just wanted to do something to help my situation; i felt like i was doing something positive...if it makes you feel better, than do it and forget about all the mumbo jumbo about MT....we all know there is only one way to successfully treat HCV. good luck
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1652596_tn?1342015226
my doctor said NO to milk thistle while on treatment.  good luck to you.  belle
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Avatar_f_tn
my doctor said ok to milk thistle, but only 175 mg, or 1 pill a day. She ran all my other supplements, and took about half of them away...But, she said the milk thistle is very good. Wish all of them would get on the same page about it. I know we all react differently, and I just can't wait to see my reactions. Starting triple threat, as I call it, on Wednesday. I have been on this site, and you all have such good info, I had many questions when I saw my dr Thursday. Good luck. Maggie
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Avatar_m_tn
My Dr.'s said ok to the Milk thistle also Ive been taking it for about three yrs.I read that it was tested in Germany for ten years not to treat hep c   But it did keep the inflammation down
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1652596_tn?1342015226
maybe my doctor said no because i'm in a clinical trial.  there were 3 groups.    i won't know which group i'm in until the end of the study.  my study nurse is pretty sure i'm in group 1 with the PI.  i have 4 1/2 weeks out of 48 to go.  take care.  belle
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2105146_tn?1334597383
OK, I have read or skimmed over most of these comments.  I never intended milk thistle as a substitute to treatment.  I haven't even had a liver biopsy yet,and I can't make a decision about treatment before that.  So milk thistle is for while I wait.  
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1748829_tn?1338040641
I never said MT would heal you but I did say it might make u feel better everyone is different. But if you want to heal your hep c take the treatment for that obviously.
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Avatar_m_tn
SAM-e is a much better supplement costs a bit more, but is a strong liver protectant i take it all the time. Also aids in mood.
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Avatar_m_tn
why the treament ruined my life amost killed me and still having sidez years later, if someone wants to do it another why, good thing. The treatment is poison getting ready to be pulled off too i bet, there coming out with non interferon treatment studies right now, so don't tell someone to do treatment, unless you know for a fact it will work in them and you can't make that promise, i know alot of ppl on disability because of treatment. I collapsed at the 10month mark unalbe to move, walk or talk. This stuff is serious business. I don't blame anyone for finding a better way, im just waiting for the class action lawsuit to come out, cause  ill be on board.
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1747881_tn?1358189534
"there coming out with non interferon treatment studies right now, so don't tell someone to do treatment"

Hmmm, that is a nice thought, however the projected release for the non interferon tx is 3-5 yrs, interferon has saved many lives and with the  current treatment availible SVR rates are around 75% for all genotypes, for some like me who were diagnosed with borderline cirrhosis, waiting is not a luxury I could afford and treatment looked a whole lot more promising that waiting to advance cirrhosis and possibly on to ESLD, I'm sorry that you are having long term effects but there are many who treat, reach SVR and continue on with there lives without long term problems.

Are you SVR ?

Have a great day
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1280753_tn?1367761532
you hit the nail on the head HPG, the only treatment that cures us is proven. sure there are risks, but there are calculated risks that each of us take daily. i responded to treatment and then relapsed in a few months. i am going to treat again with interferon, ribaviron and incivek. it's been 4 months since i treated and i feel great. sure there are a few sides left e.g. joint pain and a small rash, but they pale in comparison to the alternative. i am probably stage 4 (i still can't get a straight answer to that) so i don't have time to wait for new drugs to be approved.

the point is this; if Interferon was not available to me i might be known as "the former" uncledudeness. i think "almost" everyone would agree that would suk.

i feel for the people that have lingering side effects from treatment, but "the good of many, outweigh the good of a few"....i think i heard that in a star trek episode.

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2029713_tn?1373044704
I treated with interferon/ribavirin in 1999. It didn't work but I had absolutely no lasting side effects. Any sides I did have were gone within a few months of ending treatment.
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1491755_tn?1333204962
My Doc (Everson) said save your money go out to lunch once a month.
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Avatar_m_tn
probably good advice.  
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Avatar_m_tn
I treated in 1992 and thought I had no sides.  I did not, however, correlate psoriatic arthritis, foot pain, swollen toes and ongoing dry skin that arose shortly following that treatment with the treatment.

I think too that my psyche / personality went a little flat post-1992 (I just lost a bit of my enthusiasm), and I blamed it on other things.  

I only correlated these things after treating again in 2008 and getting pretty much hammered with same symptoms only far worse.

The point is that sometimes when people say "no sides" it might be "no sides that they have connected to treatment"  or "sides that aren't so problematic that they are really noticed."  

Perhaps a repeat treater will think on this subject a bit.  Subtle effects first time around may mean strong effects second time.
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Avatar_m_tn
The cited milk thistle study focused on only one liver enzyme (why not others?) and gave no numbers, just the conclusion that the difference wasn't "significant."

here's his abstract

What's the definition of "significant?"  

Who paid Dr. Fried?  Who was he speaking to?  Who funds his lab and staff at UNC-Chapel Hill?

Don't know the answers to these questions.  They might be relevant, though.

Also, for some very contra views of milk thistle see, e.g.:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851903/?tool=pubmed

http://www.ncbi.nlm.nih.gov/pubmed/17201169

Here's another article authored in part by Fried wherein they acknowledge some hepatoprotective effects (I think):

http://www.ncbi.nlm.nih.gov/pubmed/18566043?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum


here's one says "good for liver injury, but not viral hepatitis":

http://www.ncbi.nlm.nih.gov/pubmed/11520257
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