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January 17, 2006
Conclusions About Milk Thistle
A May 2005 review of clinical studies which casts doubt on milk thistle's value
has recently been re-released into the press. Alternatively, an extensive amount
of research supports the continued usage of this herb at higher dosages.
Researchers of the Cochrane Review examined 13 randomized, clinical trials
assessing the impact of silymarin (the extract of milk thistle) on liver
disease. It is important to note that a current search of silymarin clinical
studies on Medline.com results in 846 entries. According to the National
Institutes of Health and hundreds of in-vitro studies, silymarin demonstrates a
marked hepato-protective effect. In addition to concluding that milk thistle is
perfectly safe, the researchers in this Cochrane Collection Review also concede
that studies using higher dosages are required to accurately determine
silymarin's effect on liver function.
Those concerned with optimal liver protection should look for the following
characteristics in a quality milk thistle product:
* A high dosage
* A delivery system which enhances absorption
* Use of the most beneficial constituent of silymarin
Medical researchers concur that silybin, which comprises 50 percent of
silymarin, is responsible for the majority of milk thistle's liver-protective
qualities. While the standard dose of silymarin is 420 mg per day, higher
dosages of the more specific form, silybin, demonstrate correspondingly higher
levels of liver protection. Furthermore, when silybin is in a phytosome complex,
liver cells can absorb 8 to 10 times more than a standard preparation. The daily
recommended dosage of UltraThistle provides 1,080 mg of silybin phytosome, far
exceeding the levels of bio-available milk thistle used in this scientific
review. For more information on UltraThistle, visit www.UltraThistle.com.
The article below urges researchers to conduct studies with higher dosages of
milk thistle extract.
Milk Thistle Does Not Lower Mortality in Liver Diseases, Best Studies Find
By Lise Stevens, Contributing Writer
Health Behavior News Service
Milk thistle, a widely used alternative medicine, is not proven effective in
lowering mortality in alcoholic or hepatitis B or C liver disease, according to
a systematic review of current evidence.
While some studies found that liver-related mortality may be significantly
reduced in patients treated with milk thistle, these findings were not
duplicated in the higher quality clinical trials.
However, milk thistle was found safe to use with no serious side effects and
with participants perceiving improvement in symptoms - although no more than
with placebo.
Dr. Andrea Rambaldi, visiting researcher at the of the Centre for Clinical
Intervention Research at Copenhagen University Hospital, led a team that
reviewed 13 randomized clinical trials involving 915 patients who were treated
with milk thistle or its extracts.
Participants had acute or chronic alcoholic liver cirrhosis, liver fibrosis,
hepatitis and/or steatosis, and viral-induced liver disease (hepatitis B and/or
hepatitis C). Patients with rarer specific forms of liver disease were excluded.
All the trials compared the efficacy of milk thistle or any milk thistle
constituent versus placebo or no intervention in patients with liver disease.
"There is no evidence supporting or refuting milk thistle for alcoholic and/or
hepatitis B or C virus liver diseases," the authors found.
The review appears in the most recent issue of The Cochrane Library, a
publication of The Cochrane Collaboration, an international organization that
evaluates medical research. Systematic reviews draw evidence-based conclusions
about medical practice after considering both the content and quality of
existing medical trials on a topic.
According to the Centers for Disease Control and Prevention, 170 million people
worldwide are infected with hepatitis C, and 2 billion are infected with
hepatitis B. While a vaccine exists to prevent hepatitis B, there is no vaccine
for hepatitis C.
Although the virus can be cleared in a handful of patients, many strains are
resistant to treatment. Drug therapies that focus on long-term suppression of
the virus are expensive, and many patients develop a resistance. The current
gold standard treatment, which combines injections of interferon and ribavirin,
has serious side effects and is hard for patients to tolerate.
With lack of effective treatment for liver disease, researchers have been
looking for alternative therapies that curb symptoms with minimum adverse
effects on patients.
Milk thistle and its extracts have been used since the time of ancient Greece
for medicinal purposes, are currently widely used in Europe for liver disease,
and are readily available in the United States at alternative medicine outlets
and outdoor markets.
G. Thomas Strickland, M.D., Ph.D., professor at the University of Maryland
School of Medicine, has been studying the role of silymarin, an extract of milk
thistle, in preventing complications of chronic hepatitis virus infection.
Strickland says that the exact mechanism of action of silymarin is unclear.
A problem with current trials, according to Dr. Strickland, is that the dose of
silymarin administered, typically 140 mg three times daily, is too low. "I would
certainly double it," he says, "especially since at the current dose we're not
seeing any improvement in acute viral or chronic hepatitis, and we've shown that
silymarin is totally safe."
" The problem is, there is no cure for viral hepatitis except bed rest and diet,
and treatments like silymarin are worth pursuing," Strickland says, calling for
more research funding.
" We should consider doing randomized clinical trials with higher doses of
silymarin," Dr. Rambaldi concurs.
According to the National Center for Complementary and Alternative Medicine , a
part of the National Institutes of Health, studies in laboratory animals suggest
that silymarin may benefit the liver by promoting the growth of certain types of
liver cells, demonstrating a protective effect, fighting oxidation (a chemical
process that damages cells) and inhibiting inflammation.
In their review, Dr. Rambaldi and colleagues conclude, "Milk thistle could
potentially affect alcoholic and/or hepatitis B or C virus liver diseases.
Therefore, large-scale randomized clinical trials on milk thistle for alcoholic
and/or hepatitis B or C liver diseases versus placebo may be needed."
- Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic and/or
hepatitis B or C virus liver diseases. The Cochrane Database of Systematic
Reviews 2005, Issue 2.
Posted by Editors at January 17, 2006 04:37 PM
http://hepatitis-central.com/mt/archives/2006/01/conclusions_abo.html