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Liver protective benefits and safety for complimentary medications

Digestion, General | May 17, 2016 | Author: The Super Pharmacist

general, Digestion

Liver protective benefits and safety for complimentary medications

There are a range of widely available complementary and alternative medicines (CAM) that supposedly offer protective benefits in regards to the liver, or in easing the symptoms of people living with some form of liver disease.

At present, healthcare professionals are not clear on the role and place of some therapies in managing liver disease because they have not been researched or examined under replicable, controlled research conditions. As with many CAMs, there remains a possibility that taking them may have a negative health impact due to not being sure of their impact, as well as how much active ingredients are given to patients (or how pure they are).

This is a result of traditional medicines or CAMs being exempt from the strict regulatory framework that medical drugs must pass through in order to be approved for market – as such, providers of CAMs do not have to prove the effectiveness of the solutions that are being offered. As such, any material which extols the benefits of alternative medicine must be tempered by the knowledge that such claims are rarely based in some form of scientific research.

As most of the products that are offered are processed by the liver, there remains a possibility that some may be toxic to people with liver problems, potentially damaging the liver and making patients ill (1). As such, the use of any remedy, or the intention to use such remedies, is usually best done following a detailed discussion with a doctor.

What complementary products are considered to have liver protective benefits?

Milk Thistle

Milk thistle (Silybum marianum) is a commonly purchased over-the-counter supplement. A small number of laboratory based studies have shown that the active components of the herb (silymarin) have a positive effect on liver cells (2), but there are no studies evidencing its effectiveness outside of a laboratory conditions either in the treatment of liver disease or as a preventative CAM that improves liver function (3). It is not licensed as a medicine and here is not currently enough evidence to prove or disprove any beneficial effects it may have on the liver. There is a small and growing body of evidence that suggests milk thistle may have properties that cause blood sugar levels to lower: as such, individuals with diabetes may stand to gain from it therapeutically (4). However, at present this remains a contentious matter between researchers and health professionals, underlining the need for more research and well designed clinical trials to ascertain the true value of milk thistle as a treatment option.

Globe Artichoke

Globe artichoke leaves are regularly marketed as having both a protective and restorative function in regards to the liver, with its main benefits considered to be its choloretic (encouraging the formation of bile) and cholagogue (promoting the flow of bile) properties. Due to these properties, it is often offered as a remedy for difficulty in digesting fats, increasing levels of blood cholestrol, and gallstones. There are no formal studies to suggest that it is beneficial to health, although there is a single case study, published in France in 2007, suggesting that the ingestion of artichoke extracts (Hepanephrol) was directly responsible for a number of acute hepatic injuries (5).

Bupleurum

Bupleurum is a large genus of plants, typically covering approximately 190 different species. It has been used in Traditional Chinese Medicine (TCM) for thousands of years for various illnesses and ailments such as infections with fever, indigestion, irritability, liver stagnation and liver disease. The only evidence that is currently available regarding the use of bupleurum concerns the potential threat it poses in regards to increasing the risk of liver damage rather than improving its function – a study conducted in Taiwan in 2011 found that the prescription of bupleurum in Hepatitis B (HBV) positive patients may increase their risk of liver damage and loss of liver function (6).

Glutathione

Glutathione is an antioxidant that is commonly found in plants, animals and fungi, and its role is to prevent damage to cellular components caused by other products in the body such as free radicals, peroxide, lipid peroxides and heavy metals (7). There is some encouraging research that suggests glutathione does have a positive benefit, particularly in regards to diminishing hepatic injury. However, the large majority of this research has been carried out on animals such as rats and rabbits (8), and similar studies in human populations that aimed to build on the positive findings in animals produced largely inconclusive results (8). Much of the literature focuses on the role of glutathione in mitigating the damaging effects of paracetamol overdose, although again the majority of the research in this area has been conducted on mice (9).

Curcumin

Curcumin, a substance found inside turmeric (best known as a spice), has been used in many countries for thousands of years due to a belief in its anti-inflammatory and antioxidant properties. As with glutathione, the large majority of research does highlight curcumin as having a positive protective effect against ethanol-induced hepatosteatosis and liver injury, but the action is only ever clearly present in animal populations (10). Although such results demonstrate that curcumin may have a potential therapeutic benefit for humans in protecting against chronic alcohol-induced liver injury and atherosclerosis, there is not enough research to reinforce this hypothesis.

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REFERENCES:

  1. Mukai H, Watanabe T, Ando M, Katsumata N (2006) An alternative medicine, Agaricus blazei, may have induced severe hepatic dysfunction in cancer patients Jpn J Clin Oncol 36(12):808-10
  2. Wu JP, Tsai CC, Yeh YL, Lin YM et al (2015) Silymarin accelerates liver regeneration after partial hepatectomy Ev Base Comp Alt Med doi: 10.1155/2015/603529
  3. Aller R, Izaola O, Gomez S, Tafur C et al (2015) Effect of silymarin plus vitamin E in patients with non-alcoholic fatty liver disease: a randomized clinical pilot study Eur Rev Med Pharm Sci 19(16):3118-24
  4. Kazazis CE, Evangelopoulos AA, Kollas A, Vallianou NG (2014) The therapeutic potential of milk thistle in diabetes Rev Diab Stud 11(2):167-74
  5. Sinayoko L, Mennecier D, El Jahir Y, Corberand D, Harnois F, Thiolet C, Farret O (2007) Acute hepatic injury secondary to ingestion of artichoke extracts (Hepanephrol) Gastro Clin Biol 31(11):1039-40
  6. Lee CH, Wang JD, Chen PC (2011) Risk of liver injury associated with Chinese herbal products containing Radux bupleuri in 639,779 patients with HBV infection PLoS One DOI: 10.1371/journal.pone.0016064
  7. Pompella A, Visvikis A, Paolicchi A, Tata V, Casini AF (2003). The changing faces of glutathione, a cellular protagonist Biochemical Pharmacology 66 (8): 1499–503
  8. Hong RW, Rounds JD, Helton WS, Robinson MK, Wilmore DW (1992) Glutamine preserves liver glutathione after lethal hepatic injury Ann Surg 215(2):114-119
  9. Masubuchi Y, Nakayama J, Sadakata Y (2011) Protective effects of exogenous glutathione and related thiol compounds against drug-induced livery injury Biol Pharm Bull 34(3):366-70
  10. Varatharajalu R, Garige M, Leckey LC, Reyes-Gordillo K, Shah R, Lakshman MR (2016) Protective Role of Dietary Curcumin in the Prevention of the Oxidative Stress Induced by Chronic Alcohol with respect to Hepatic Injury and Antiatherogenic Markers Oxid Med Cell Longev doi: 10.1155/2016/5017460
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