Constituents of Milk Thistle.
Milk Thistle contains a bitter principle, antioxidant properties, essential oil, polyacetylenes, tyramine, histamine, and flavolignans collectively referring to Silymarin. These are silybin, silychristin, and silydianin.
How Milk Thistle Affects the Liver.
It is thought that silymarin works in three different ways. Firstly, it strengthens the outer membranes of the liver cells, therefore preventing the penetration of liver damaging poisons and substances. Silymarin is also a powerful antioxidant that offers the liver cells protection against chemicals that are formed by the use of high fat diets, smoking and other substances such as alcohol abuse. It is also thought that the antioxidant affect of the silymarin is ten times more powerful than that of Vitamin E. Michael Castleman in his article entitled "Milk Thistle: Nature's Liver Protector" writes, "The best known antioxidants are Vitamin A (beta-carotene), Vitamin C, Vitamin E, and the mineral selenium. However, in the liver, silymarin [milk thistle extract] is more than 10 times as potent an antioxidant as Vitamin E." (11). It is also thought that silymarin inhibits the action of the enzyme largely responsible for causing inflammation in hepatitis. Milk thistle may also have positive effects on the blood and immune system due to it's action of decreasing basophilic histamine release, and increasing of T-lymphocytes as well as reducing immunoglobulins. It is also thought that silymarin may decrease cholesterol and HDL levels.
Milk Thistle and Liver Function Test.
Many studies have shown the qualities of Milk thistle in its use as a medicine, with more recent studies showing how good herbal medicine is when it is compared to the limited medicine of the medical establishment when it comes to treating liver problems. On the one hand, unless your liver function test shows that it is abnormal, they will say that there is nothing wrong with the liver while you are manifesting symptoms such as skin disease, constipation, low blood sugar, heartburn, indigestion and food allergies. On the other hand, the liver function test is showing that it is abnormal, they will tell you they can not do anything for you. This is the wonders of modern medicine.
Milk thistle when used properly is excellent in this situation. The liver, through our lifestyles of stress, drinking of alcohol to the excess, smoking, incorrect diet, and the taking of powerful synthetic medication, gets over worked. The chemical Silymarin counteracts against this helping to produce a normal liver function. Studies have shown that those taking synthetic drugs and also having a abnormal liver function test were helped by taking an extract of Milk thistle. Michael Castleman comments on this stating, "In one study, 66 women taking anticonvulsant or psychiatric medications showed abnormal liver-function tests. They began taking silymarin [milk thistle extract] in addition to their medication, and 52 of them showed significant improvements in liver function." (12).
Milk Thistle and Carbon Tetrachloride.
A number of studies have shown that Milk thistle is an effective remedy in protecting the liver against hepatotoxins such as carbon tetrachloride, thioacetamide, a-amanitin, and the death cap mushroom Amanita phalloides.
Poisons such as carbon tetrachloride are ingested by over 25,000 children under the age of 5 in the United States, but most of the deaths that occur as a result of accidental poisonings occur in the teenage years. Tests carried out on rats where carbon tetrachloride induced liver damage was present showed that Milk thistle extract had a protective effect.
Of the many symptoms that carbon tetrachloride produces, one is Central Nervous System depression that produces sleep. This is used to assess the extent of the damage to the liver and also the effectiveness of the protection of drugs used to treat the liver. David Hoffmann writes concerning the effect an extract of silymarin has on such subjects, "a reduction of the prolongation of hexobarbital sleeping time produced by carbon tetrachloride. This is a common method for assessing protective effects on the liver against the effects of chemical toxins." (13). If there is an increase in sleeping time the implication is that the livers ability to metabolize the hexobarbital is somewhat impaired. Tests show that carbon tetrachloride poisoning increases the sleep time, but significantly silymarin reduces this sleep time by up to 60%. suggesting that there is liver protection from the toxin while the Milk thistle is being used. David Hoffmann writes, "When Milk Thistle is added the increase in sleeping time normally produced by the carbon tetrachloride is reduced by up to 60%, suggesting that the herb is protecting liver function from the toxin." (14).
Other studies have shown that carbon tetrachloride also raises the serum levels of enzymes such as glutamic oxaloacetic transminase (G.O.T), glutamic pyruvic transaminase (G.P.T) and also sorbitol dehyrogenase (S.D.H). It was found that under treatment with silymarin these increases were significantly diminished. Rudolf Weiss comments on the aspect of serum tolerance and transaminase activities in relation to the use of Milk thistle and silymarin, saying,"… and serum tolerance and transaminase activities became normal." (15).
Milk Thistle and Hepatitis.
Hepatitis is generally put into three categories, A, B, and C, defined by the Merck manual as "An inflammatory process in the liver characterized by diffuse or patchy hepatocellular necrosis affecting all acini." (16). Sometimes these progress to what is known as Chronic Hepatitis lasting for more than six months, defined once again by the Merck manual as, "A spectrum of disorders merging between acute hepatitis and cirrhosis." (16). This disorder often results in liver failure or cirrhosis, or sometimes it results in both. Modern medicine deals with acute hepatitis by doing nothing at all apart from telling the patient to reduce their alcohol intake and get rest if they feel the need. Chronic hepatitis is treated by the use of corticosteroid therapy, but this can make the situation worse as they are contra-indicated in most types of hepatitis.
Studies show that with taking Milk thistle the affect of hepatitis is greatly reduced and that the affects of the virus are removed much quicker than any thing that modern medicine can do for the disorder. One such study suggests that taking Milk thistle reduced the recovery time by nearly 30% compared to what modern medicine can do. Michael Castleman writes concerning this study, "77 people with hepatitis were divided into two groups, one treated with silymarin [milk thistle extract], the other with a placebo. Average recovery time for the placebo-takers was 43 days, but those who took silymarin [milk thistle extract] recovered in an average of just 29 days." (18).
Other studies show that in cases of chronic hepatitis of all types, silymarin helps with general symptoms in relation to the gastrointestinal tract, improved appetite, less discomfort and an overall improvement in well being and physical performance. Rudolf Weiss comments on the efficacy of silymarin, "there is an improvement in the general condition within the first two weeks of treatment, particularly where gastrointestinal symptoms are concerned, there being a reduction of meteorism and relief of the tension or pressure felt in the right epigastrium." (19). Whilst Milk thistle has an affect on the symptoms of hepatitis, it will if given early enough prevent any damage to the liver cells by the virus. This is achieved by the silymarin acting on the membranes of the liver cells in a way that prevents the entry of the virus toxins and other compounds, thus limiting the damage to the cells. Rudolf Weiss makes an excellent point in relation to this and the use of silymarin, "A good result can thus be achieved at the acute stage of hepatitis, preventing necrotic changes and making the condition less severe. This explains why the symptomatic response has always been so good. The protective effect on the cell membranes cannot reverse the whole process in chronic forms of hepatitis caused by toxins, but it can often prevent further deterioration." (20).
From this we can safely say that in all cases of disease where the liver is involved, whether it be skin disease, cancer, hepatitis or just cleansing the body, Milk thistle will offer protection during the breakdown of toxins present in the liver and the body.
Milk Thistle and Death Cap Mushroom Poisoning.
Death cap mushroom causes many deaths every year with about half of all the reported cases proving fatal. It is hard to distinguish from other such wild mushrooms hence the large number in need for treatment. The standard medical treatment for the poison of this fungus is not particularly effective, with activated charcoal being the main form. It takes only a handful of the mushrooms, around 50 grams, to kill an adult, and even less for a child.
The toxins produced by the fungus have a special affinity with the liver. It manifests itself with symptoms that occur in two separate stages. During the first stage there is nausea, vomiting and abdominal pain which then subside for around 24 hours only for the second stage to bring more serious problems for the liver and kidneys, due to the highly poisonous amatoxins. Help in the form of silymarin can be given in between the two stages after the stomach contents have been emptied, for which, Lobelia tincture will be of great help. According to Rudolf Weiss it is silibinin, the principle component of silymarin that is the effective remedy, with the clinical progress being satisfactory and further liver destruction being prevented. He writes, "The next and crucial step is to make use of the latent period, i.e. temporary improvement after the first stage, to prevent damage to the liver and kidneys. Silibinin, the principal component of silymarin, has proved highly effective for this." (21). He then proceeds to explain how the silibinin works in the prevention of further damage to the cells of the liver. He writes "It occupies the receptors on the cell membranes preventing amatoxins from entering." (22).
Treatment for Death cap mushroom poisoning has to be given within 48 hours to stop any damage to the liver and in the case of using silibinin or silymarin administered by the mouth the dose has to be relatively high. Again Rudolf Weiss writes "If silibinin cannot be obtained in time, silymarin is given by mouth in relatively high doses. If silibinin or silymarin is given within 48 hours of the fungus having been ingested, clinical progress may be expected to be satisfactory. If treatment is delayed by more than 48 hours, toxic liver damage leading to coma is highly likely to develop. Even at this stage, silibinin will in most cases prevent further destruction of liver cells and the resulting coma." (23).
In Germany a company called Madaus produces a silymarin product that is in a solution that can be injected into the blood stream to achieve faster results. This is based on the assumption that because flavonoids do not dissolve well in water other means are needed to get at the properties in the Milk thistle. The Flavonoids dissolve well in 75% alcohol, so presumably there was not enough money in producing an alcoholic extract for the purpose of administration by mouth as this is much stronger than a infusion or decoction. Rudolf Weiss states, "Silymarin does not dissolve well in water, but it has now proved possible to make silibinin water-soluble, producing a solution that can be injected, to achieve rapid action (produced by Madaus in ampoules containing 50mg)." (24).
Milk Thistle and Cirrhosis.
In the United States, cirrhosis is the third leading cause of death in the 45 to 65 age group, and in most cases they are secondary to chronic alcohol abuse. In some cases cirrhosis is as a result of chronic hepatitis. As we have seen earlier, Milk thistle is of help in the treatment of hepatitis, but those who are unfortunate to miss out on treatment with Milk thistle and have progressed to cirrhosis there is hope in using an extract of Milk thistle.
In general, modern medical treatment of cirrhosis extends to that of being supportive, the withdrawal of toxic agents and drugs, the attention to nutrition which may involve vitamin and mineral supplements, and the treatment of complications at the time they arise.
In 1989 the Journal of Hepatology published a study carried out on 170 people with advanced alcoholic cirrhosis that is often a fatal condition. The 170 people were separated into two groups, one taking 200 mg three times per day of Milk thistle extract of which 140 mg was of silymarin extract, and the other group received a inactive placebo. Michael Castleman comments on the study, "Both groups were followed for four years. During that time, the death rate in the placebo group was about 60 percent, but among those taking silymarin [milk thistle extract], only 40 percent died, a highly statistically significant difference." (25).
Other studies in regard to Milk thistle and cirrhosis have shown similar benefits for those who are suffering. Clinical trials have replicated the laboratory studies in that they show the livers ability to reverse many disorders that affect the organ through the stimulation of hepatocytes to replace diseased tissue. David Hoffmann writes, "Milk Thistle arrests the course of these diseases as well as stimulating hepatocyte regeneration. Over time, complete restoration of the liver is possible, with regeneration at four times the normal rate." (26).
Milk Thistle and Gallstones.
In the United States, 20% of the population over the age 65 have gallstones and of these, over 500,000 undergo a cholecystectomy each year. They occur more in women, those who are obese, and those that have a family history of gallstones or those who follow the typical Western diet. The major component of most gallstones is cholesterol to which a diet high in animal and saturated fats is a major contributor. In most cases the medical professions answer for those who are manifesting symptoms of gallstones is to remove the gallbladder, there is an answer in herbal medicine. Apart from using the gallbladder cleanse of apple juice and olive oil to remove the gallstones, the use of a Milk thistle extract as a preventative is of great help. It is suggested by Michael Castleman that a low fat, low cholesterol diet helps prevent gallstones and so does Milk thistle extract. He writes, "In one study, people with gallstones were given 420 mg of silymarin [milk thistle extract] a day. Without diet changes, after several weeks, they showed significant reductions in the cholesterol concentration of their bile, which minimized the risk of stone formation." (27).