Use of Milk Thistle in Treating Hepatitis

Milk Thistle has been used to treat acute and chronic viral hepatitis, alcoholic liver disease, and  toxin-induced liver diseases. The active complex of  Milk Thistle is a lipophilic extract from the seeds of the plant and is composed of 3 isomer flavonolignans (silybin, silydianin, silychristin) collectively known as silymarin. Silymarin may protect the liver against damage from toxic chemicals by blocking toxins from entering the cell or by moving toxins out of the cell before damage begins. The German Commission E (an official government agency similar to the US FDA) approved the use of silymarin as a treatment for toxic liver disease and a supportive treatment for chronic inflammatory liver illness and cirrhosis of the liver.

Milk Thistle Benefits and High Liver Enzymes

Milk Thistle  has antioxidant and anti-inflammatory effects, and it may help the liver repair itself by growing new cells. Silymarin 420 mg/day was shown to improve indices of liver function in patients with liver disease of various aetiology, including those exposed to toxic levels of toluene or xylene. In animals, silymarin reduces liver injury caused by acetaminophen, carbon tetrachloride, alcohol, phenylhydrazine, Amanita phalloides, radiation and iron overload. Lately it was showed that high-dosage silibinin infusion therapy could substantially decrease the number of hepatitis C viruses after 4-week application. Silymarin was also shown to reduce liver toxicity associated with chemotherapy in children with acute lymphoblastic leukemia and cisplatin-induced nephrotoxicity.

In the 1970’s, two German research group proved through clinical studies that 70 percent of people suffering from chronic liver diseases had a vastly improved chance of recovery when given between 210 -420 milligrams of silymarin daily over periods ranging from 6 weeks to 2 years. In a study, reported in 1993, 10 participants with chronic hepatitis were assigned to the treatment group and 10 others were assigned to the placebo group. The treatment group received 240 milligrams of silybin, (a component of silymarin), 2 times a day for 1 week. The results of tests  demonstrated important improvement in the treatment group. A small study presented at the 2008 European “Association for the Study of the Liver conference” showed that silymarin might decrease levels of the hepatitis C virus in patients who didn’t respond to standard therapy.

LiverIn a study conducted in Iran, the scientists treated 55 patients with active and chronic cases of hepatitis C infections with 630 mg a day of silymarin for 24 weeks. After 24 weeks of therapy, the ALT liver enzyme levels decreased down from an average of 108 U/L to an average of 70, and AST levels decreased from an average of 99 U/L to an average of 60. Quality of life scores improved substantially and of the 55 patients treated, 9 had HCV-negative RNA levels after the therapy. In a 6-month double-blind study of 36 patients with chronic alcoholic liver illness, the group given silymarin (Legalon) showed normalization of their bilirubin, aspartate transaminase and alanine transaminase serum levels. In different study, 106 patients with mild acute and subacute liver illness characterized by elevated serum transaminase levels were randomized to receive silymarin or placebo. Of the 97 patients who completed the 4-week study, there was a statistically considerable greater decrease in transaminase levels in the silymarin group.

A clinical trial of 16 patients who didn’t respond to ribavirin and interferon therapy, silymarin important reduced the viral load of hepatitis C.  In 7 of the patient the virus decreased to undetectable levels after 14 days of treatment. Silibinin, reduced hepatitis C virus levels in people awaiting liver transplantation in a pilot study, which may help reduce the risk of HCV recurrence in the new liver, Spanish scientists reported in the March 2013 “Journal of Hepatology“. In this study included 14 hepatitis C patients awaiting liver transplants. Within this group, 11 patient were randomly assigned to receive silibinin while 3 patient received placebo.Therapy was used for a maximum of 21 days prior to transplantation and 7 days after the procedure. Among patients who received therapy for more than 14 days pre-transplant, HCV viral load decreased substantially more in the silibinin group compared with the placebo group. During the post-transplant period, viral load levels were consistently and substantially lower in the silibinin group.

Some studies indicate silymarin slows the progression of cirrhosis. In one study, examined the effects of silymarin on 170 patients, 91 of them alcoholics with liver cirrhosis. Participants received 140 mg silymarin 3 times a day for 41 months. The four-year survival rate was 58% in the Milk Thistle group and 39 % in the placebo group. In a comment of previous clincial studies with human subjects, reported in the Forschung Komplementmedicine in 2008, the writers concluded that milk thistle is a positive option as a general supportive supplement for the liver and in treatment of cirrhosis.

Silymarin has been used to treat Amanita phalloides mushroom poisoning. In animal studies, Milk Thistle (silymarin) given within 10 minutes after amanita toxin ingestion completely counteracted the toxic effects, and if given within 24 hours of toxin ingestion silymarin prevented death and significantly reduced liver damage. In a group of 49 patients with Amanita phalloides poisoning, physicians rated the results “spectacular” and  “amazing” after patients were given injections (20 mg/kg daily) of silybin. All of the patients survived, even though they were treated 24 to 36 hours after poisoning, when liver damage had already occurred. The death rate in emergency rooms from Amanita phalloides mushroom poisoning is usually 30 to 40 %.

Liver-damage, can occur from a number of toxins, including alcohol and drugs such as acetaminophen. A 1998 study found that silymarin may protect the liver from toxicity from taking acetaminophen, phenothiazines and dilantin. Acetaminophen (Tylenol) overdose is the leading cause of acute liver failure in the world. Using acetaminophen with alcohol increases the likelihood of toxicity. Milk thistle (silymarin) enters the liver cells and prevents those cells from absorbing toxins. Silymarin may protect the liver from toxic chemicals and have been tested for their potential to make chemotherapy more effective or less toxic. There is one case report describing the use of milk thistle in a patient  with promyelocytic leukemia who required breaks in chemotherapy due to abnormal liver enzyme levels. During four months of therapy with milk thistle, the patient had normal liver enzyme levels and was able to undergo chemotherapy without breaks.

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