Tuesday, March 09, 2010

Milk thistle for liver protection

I had a patient in yesterday whose medical records show a long history of elevated liver function tests. These enzymes, namely aspartate aminotransferase (ALT) and alanine transaminase (AST), are part of routine blood test panels often ordered to screen for disease. Normally present in liver cells, elevated levels in the blood can indicate disruption of the cells by inflammation or disease. Even minor elevations are taken seriously if they persist over time as progressive destruction of the liver from hepatitis or other disease can occur without major changes in the transaminase values.

Further testing indicated she might be suffering from auto-immune liver disease wherein a misguided immune response against one's own tissue can cause damage to the organ. She wondered what she could do to promote liver health while pursuing a definitive diagnosis with a specialist. I recommended milk thistle only to read the following today on the Consumer Lab web-site.

Consumer Lab is an independent organization that tests nutritional supplements for quality, assuring that these products are pure, contain what they claim, and are free of contamination. The nominal yearly subscription fee is well worthwhile if you are a fan, as am I, of supplements. One of their recent reviews covered milk thistle.

Only one brand was found on testing to contain the amount of active ingredient indicated on the label. Furthermore, the evidence that milk thistle changed the course of chronic liver disease caused by hepatitis or alcohol was weak. The research suggesting that the herbal preparation protects against liver toxicity from acetaminaphen and anti-seizure meds was stronger. The active ingredient in milk thistle--silibinin--has been the subject of recent cancer research and seems to have some promise as a chemotherapeutic agent.

I don't feel quite so enthusiastic about my recommendation now. If you're considering milk thistle supplements, have a look at the ConsumerLab site to choose the best brand.


Cat said...

Ahhhhh - so glad to see you are posting again. I, and my friends, really appreciate your blog.


Mauigirl said...

Interesting. My husband and I have taken milk thistle for years since we enjoy our alcohol! (I stopped a few years ago when I quit drinking but now that I've taken it up again was thinking I should start taking milk thistle again). I wonder which brand had the active ingredient it is supposed to have? I think we get Nature's Bounty or is it Nature Made? Or did one just buy the other? Hard to keep up...maybe I should subscribe to this site.

femail doc said...

Cat: I'm glad to be back. Was a bit dispirited and lethargic from life and winter, now ready to take up the keyboard again. How nice of you to take the time to comment!

MG: I once had a consult with a doctor of pharmacology about all my supplements--she recommended milk thistle. Can't hurt, might help, why not?

Anonymous said...

Was she tested for Alpha 1 Antitrypsine?