RSS feedDuring a recent question and answer session at a public lecture, I was asked “What supplements or herbs should I consume to protect my liver?”. Milk thistle (Silybum marianum), Chinese herbs and cutting out all meat products were just a few suggested by the audience.
Extract of milk thistle has been used as a traditional herbal remedy for almost 2000 years. Nowadays, many people take it as a ‘liver tonic’ – protection against liver toxins and amelioration of the deleterious effects of chronic liver diseases. The commercial milk thistle product is termed silymarin. It is not a single pure substance but a complex of at least 7 flavonolignans and 1 flavonoid that comprises 65 – 80% of milk thistle extract. From silymarin, a semipurified fraction of silibinin is obtained. Once thought to be a single compound, it is now recognized as a 1:1 mixture of 2 diasteroisomers, silybin A and silybin B. In the last 5 – 10 years, experimental and clinical studies have looked at the effects of milk thistle in liver disease, hepatitis C, diabetes, hypercholesterolaemia and HIV. Some interesting and potentially positive effects have been observed but a definite beneficial effect has yet to be proven. The fact that milk thistle extract is not a single compound but a complex mixture of compounds makes it more difficult for the scientists to tease out which is the truly active ingredient. Perhaps it might be a combination of the components in specific proportions that confers a protective effect. Until we know for sure it is difficult to give concrete advice on its use.
Taking milk thistle and other natural health products (NHPs) [garlic, vitamin C, milk Echinacea species, goldenseal and fish oil are a few examples] is almost second nature to most individuals. Perhaps their use is more so in individuals with chronic illnesses as an attempt to improve their general health or a means to help stave off the unrelenting assault of the underlying disease process. Taking NHPs can interfere with the availability of other medicines in your body. For those with a chronic illness, the NHPs circulating in your body can increase or decrease the availability / concentration of the medicine circulating in your body. For example, concurrent use of NHPs with anti-retroviral (ARV) drugs is common among HIV infected individuals. Limited studies have found that intake of garlic and vitamin C results in reductions in ARV concentrations. The intake of milk thistle, Echinacea species and goldenseal causes an increase in the ARV concentrations (but by a non-clinically important amount). The reason why NHPs can potentially be problematic is because they can induce or inhibit the cytochrome P450 enzymes in the liver. The cytochrome P 450 enzyme system is involved in the regulation of the amount of drugs available in the body.
Most people feel that taking a supplement is being proactive in looking after their health. If the health supplement, like milk thistle, does not have significant side-effects, then consuming it for its potential health effects may have no deleterious consequences and, just maybe, may be of some benefit. However, if we have poor lifestyle habits, such as eating too much, not exercising regularly, or drinking significant amounts of alcohol, it is unlikely that any amount of milk thistle, Chinese herbs, sushi or NHPs will stop our health from deteriorating.
Your body is not unlike a motorcar. Every weekend, it is not uncommon to see a proud car owner spending several hours washing and polishing his car. The intention is to keep it gleaming and by so doing maintain its market value. The same applies to your body. If you eat the right food, exercise regularly and maintain a normal body weight, your body will ‘run’ in tip top condition and maintain its ‘value’ – with or without NHPs. I guess popping an NHP pill daily takes less effort. Indeed, it is human nature that we will always choose the easiest option but remember the saying – there is no such thing as a free lunch in life. If you want a healthy body, look after it. Start with a healthy lifestyle!
