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Liver Support: Milk Thistle

Diabetes, General | February 15, 2015 | Author: The Super Pharmacist

general, liver

Liver Support: Milk Thistle

Milk thistle is a fairly well researched herbal treatment option for persons with liver concerns. It has a known active component, silymarin, which has been consistently demonstrated to be an effective supporter of healthy liver function and protector of the overall health of the liver. The clinical evidence for its effectiveness is in fact so well established that milk thistle extract has been a commonly accepted herbal treatment for a variety of liver-related health conditions, including chronic hepatitis, alcohol-related liver disease, and cirrhosis of the liver, as well as associated diseases including Type 2 diabetes and diabetic nephropathy.

Natural history of milk thistle

The milk thistle plant (S. marianum) is a member of the Aster family, and is native to Southern Europe and the Middle East, although it is now found worldwide. The plant produces small, hard seeds that are the source of herbal extracts for liver support, and they have been used in this capacity for over 2,000 years. The seeds of milk thistle contain up to six percent silymarin, while the extract can contain up to eighty percent. Silymarin was not understood to be the active compound in milk thistle extract until 1968, when it was discovered to be the bioflavonoid complex responsible for the extract’s liver support benefit.

Benefits of milk thistle 

The health benefits provided by milk thistle extract and silymarin have several bioactive ways in which they function to protect and support a healthy liver. These include direct cell protection, supporting antioxidant activity, boosting anti-fibrotic activity, and assisting in cell regeneration.

BenefitsĀ of milk thistleĀ Direct cell protection

The bioflavonoid complex that constitutes silymarin binds to the outside of liver cells, where they prevent the ability of certain toxins to enter and neutralize the activity of toxins already in the liver. In doing so, silymarin helps protect the liver from the toxic effects of a number of compounds, including alcohol, acetaminophen, and tetrachloride. These compounds are directly implicated in a number of liver diseases.

Supports antioxidant activity

Silymarin has been shown in a number of studies to be correlated with an increased production of antioxidant levels in general. Among these, the levels of glutathione and superoxide dismutase have been shown to be particularly susceptible to silymarin consumption. Antioxidants help repair damaged cells and support the body’s ability to flush toxins from the body.

Boosts anti-fibrotic activity

Fibrotic activity is the result of inflammation of the liver, most commonly caused by alcohol abuse or chronic viral hepatitis. Silymarin has been demonstrated to prevent fibrotic activity, which slows the kind of liver damage that would otherwise eventually lead to chronic liver disease and cirrhosis.

Assists in cell regeneration

Liver cells are damaged by chronic hepatitis, abuse of alcohol, and certain prescription drugs including antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs) and cholesterol medications. Silymarin has been shown to help regenerate liver cells, which can counteract the effects of this damage.

Supports detoxification programs

Supports detoxification programsSilymarin is an excellent source of detoxifying the liver. In a study published in Biochemical Pharmacology, researchers described the results of research that showed silymarin promoted bile production.

Bile is critical for carrying toxins to the intestines where they can be flushed from the body.

This activity, combined with the compound’s support of antioxidant production, makes it an excellent focal point for cleansing the liver.

Evidence-based clinical applications

Since its discovery as the active compound in milk thistle seeds that supported liver health, silymarin has been extensively studied to determine its clinical applications. While research into its potential uses is far from complete, it has been extensively established as an effective treatment for a number of diseases.

Cirrhosis of the liver

A number of studies have shown that there are benefits for orally administering milk thistle extract to prevent and treat cirrhosis. These studies found that regular administration of the extract improved liver function and decreased mortality rates among patients with liver disease.

Chronic liver disease

Severe alcohol abuse and viral infections may both cause chronic liver disease. In several studies of patients with chronic liver disease other than cirrhosis, similar results were reported, with experimental groups demonstrating improved liver function compared to controls.

Type 2 diabetes

Milk thistle extract has been shown to improve blood glucose levels for patients with Type 2 diabetes, both in groups that did and did not have associated chronic liver disease.

Diabetic nephropathy

A number of biomarkers found in blood and urine samples are associated with progression of diabetic nephropathy; one study found that milk thistle extract was associated with improved levels of these markers. The researchers concluded that this may indicate that milk thistle could slow the progression of the disease.

Viral hepatitis

Research is not yet robust to support the application of milk thistle extract in reducing liver inflammation associated with viral infections, but a review of literature conducted in 2007 found that more high-quality studies were needed.

Safety of milk thistle extract

Clinical studies into the effects of milk thistle extract for these and other health conditions consistently report no serious adverse effects related to silymarin. Overall, milk thistle extract is generally considered to be a safe supplemental therapy.

A review of clinical trials evaluating the safety of milk thistle that was published in the journal Integrative cancer therapies in 2007 found that “Milk thistle extracts are known to be safe and well tolerated, and toxic or adverse effects observed in the reviewed clinical trials seem to be minimal” (Tamayo 2007). The authors went on to report that the “future of milk thistle research is promising, and high-quality randomised clinical trials on milk thistle versus placebo may be needed to further demonstrate the safety and efficacy of this herb.”

While patients should always take any nutritional supplement such as milk thistle under the guidance of a physician, silymarin and milk thistle extract are generally very safe for consumption and will likely have multiple clinical applications for the diseases discussed here, along with potential other ones as well.

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References

Abenavoli, L., Capasso, R., Milic, N., & Capasso, F. (2010). Milk thistle in liver diseases: past, present, future. Phytotherapy Research24(10), 1423-1432.

Das, S. K., & Vasudevan, D. M. (2006). Protective effects of silymarin, a milk thistle (Silybium marianum) derivative on ethanol-induced oxidative stress in liver. Indian Journal of Biochemistry and Biophysics43(5), 306.

Flora, K., Hahn, M., Rosen, H., & Benner, K. (1998). Milk thistle (Silybum marianum) for the therapy of liver disease. The American journal of gastroenterology93(2), 139-143.

Greenlee, H., Abascal, K., Yarnell, E., Ladas, E. (2007). Clinical Applications of Silybum marianum in Oncology. Integrative Cancer Therapies 6(2): 158–65.

Jacobs, B. P., Dennehy, C., Ramirez, G., Sapp, J., & Lawrence, V. A. (2002). Milk thistle for the treatment of liver disease: a systematic review and meta-analysis. The American journal of medicine113(6), 506-515.

Kidd, P., & Head, K. (2005). A review of the bioavailability and clinical efficacy of milk thistle phytosome: a silybin-phosphatidylcholine complex (Siliphos).Alternative medicine review: a journal of clinical therapeutic10(3), 193-203.

Kroll, D. J., Shaw, H. S., Oberlies, N. H. (2007). Milk Thistle Nomenclature: Why It Matters in Cancer Research and Pharmacokinetic Studies. Integrative Cancer Therapies 6(2): 110–9.

Rainone, F. (2005). Milk thistle. American family physician, 72(7), 1285-1288.

Rambaldi, A., Jacobs, B. P., & Gluud, C. (2007). Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev4.

Tamayo, C., & Diamond, S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative cancer therapies6(2), 146-157.

Venkataramanan, R., Ramachandran, V., Komoroski, B. J., Zhang, S., Schiff, P. L., & Strom, S. C. (2000). Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug metabolism and disposition28(11), 1270-1273.

Vessal, G., Akmali, M., Najafi, P., Moein, M. R., & Sagheb, M. M. (2010). Silymarin and milk thistle extract may prevent the progression of diabetic nephropathy in streptozotocin-induced diabetic rats. Renal failure32(6), 733-739.

Wang L, Waltenberger B, Pferschy-Wenzig EM, et al. (July 2014). "Natural product agonists of peroxisome proliferator-activated receptor gamma (PPARγ): a review".Biochemical Pharmacology.

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