Hi, I am not sure about "the best" but I use a tincture a couple times a week. The tincture is preserved in alcohol of some kind but it is only a dropper. I also buy the stuff at walmart.
I don't remember if you are treating but You are not supposed to take it while on TX
Is there a reason that you want to take milk thistle during treatement? Did your hepatologist say this was okay?
My understanding is that most doctors don't mind if you take milk thistle off treatment but that there's disagreement among even very knowledgeable hepatologists about whether it's okay to take during treatment. Some say okay, some say no.
I can think of one good study that shows the benefit of it off treatment but I don't know if there's ever been a good one to show the possibly negative interaction during treatment. For that reason, I myself wouldn't tamper with things but just simply stick to the prescribed meds and roll with them; I do recall, though, that some members' docs thought it was okay to take during tx. What if milk thistle somehow inhibits the meds' actions? Although I doubt this, the fact that no study (that I'm aware of) investigates this, was enough for me to have steered clear of it during tx. And that's what I'd advise you to do, unless your own hepatologist recommends otherwise.
The other concern I have is that milk thistle in North America is unregulated, unlike places like Germany and Switzerland, so you have no idea of the purity or contamination of the product you purchase. The contaminants themselves could be harmful to your liver.
Here's a study about milk thistle:
Conclusions: The data indicate that Silymarin exerts anti-inflammatory and antiviral effects, and suggest that complementary and alternative medicine-based approaches may assist in the management of patients with chronic hepatitis C.
Inhibition of T-cell inflammatory cytokines, hepatocyte NF-kappaB signaling, and HCV infection by standardized silymarin.
Polyak SJ, Morishima C, Shuhart MC, Wang CC, Liu Y, Lee DY.
Department of Laboratory Medicine, University of Washington, Seattle, Washington; Department of Microbiology, University of Washington, Seattle, Washington; Department of Pathobiology, University of Washington, Seattle, Washington.
Background & Aims: Chronic hepatitis C is a serious global medical problem necessitating effective treatment. Because standard of care with pegylated interferon plus ribavirin therapy is costly, has significant side effects, and fails to cure about half of all infections, many patients seek complementary and alternative medicine to improve their health, such as Silymarin, derived from milk thistle (Silybum marianum). Milk thistle's clinical benefits for chronic hepatitis C are unsettled due to variability in standardization of the herbal product. Methods: In the current study, we focused on the anti-inflammatory and antiviral properties of a standardized Silymarin extract (MK-001). Results: MK-001 inhibited expression of tumor necrosis factor-alpha in anti-CD3 stimulated human peripheral blood mononuclear cells and nuclear factor kappa B-dependent transcription in human hepatoma Huh7 cells. Moreover, MK-001 dose dependently inhibited infection of Huh7 and Huh7.5.1 cells by JFH-1 virus. MK-001 displayed both prophylactic and therapeutic effects against HCV infection, and when combined with interferon-alpha, inhibited HCV replication more than interferon-alpha alone. Commercial preparations of Silymarin also displayed antiviral activity, although the effects were not as potent as MK-001. Antiviral effects of the extract were attributable in part to induction of Stat1 phosphorylation, while interferon-independent mechanisms were suggested when the extract was biochemically fractionated by high-performance liquid chromatography. Silybin A, silybin B, and isosilybin A, isosilybin B elicited the strongest anti-NF-kappaB and anti-HCV actions. These effects were independent of MK-001-induced cytotoxicity. Conclusions: The data indicate that Silymarin exerts anti-inflammatory and antiviral effects, and suggest that complementary and alternative medicine-based approaches may assist in the management of patients with chronic hepatitis C.
Hope this helps,
HR (hepatologist researcher) told us not to take anti-inflammatory supplements while on TX because there was a chance it could slow down the dendretic (sp?) cell response and you wouldn't want that while treating. The only one that he cited that was an exception was polyenelphosphatidyl choline. Unless they've done research to prove otherwise, I wouldn't take. it. As the wife of a 3 time non responder...it isn't worth the chance if it could disrupt your TX response in any way. It has been quite some time since HR explained it but I don't know that I would chance it with anything that has anti- inflammatory properties. Susan's article above says milk thistle exerts anti-inflam. and anti-viral effects.
I use the products from life extension.
here is a link for the milk thistle I use:
You can read more about it with that link but here is a brief description:
Mega Silymarin with Isosilybin B is the first milk thistle extract to contain standardized, premium-quality potencies of silymarin, silibinin and isosilybin B, providing the full spectrum of milk thistle compounds that promote a healthy liver and prostate.23-27
The botanical extract in Mega Silymarin is a triple standardized milk thistle extract. In addition to an optimal 80% standardization of the main active compounds, silymarin flavonolignans, Mega Silymarin is further standardized to two highly active isomers—silibinin and isosilybin B. Most premium milk thistle extracts are devoid of or lack consistent amounts of the most active flavonolignan isomer isosilybin B