Milk Thistle: need some case studies 
Author Message
 Milk Thistle: need some case studies

I am looking for some actual case studies of milk thistle and the
treatment of elevated liver enzymes.  My Doctor is impressed with the
results I have had with the milk thistle and has asked me for some
good case studies done on the herb.  Good scientific studies

I have searched Medline, but as a nonpaying member I can only get
abstracts.

Thanks for the help

Surfing the internet from the Florida Keys
Visit my Web site
http://www.***.com/ ~mikegetz/index.html



Sun, 24 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies


Quote:
> I am looking for some actual case studies of milk thistle and the
> treatment of elevated liver enzymes.  My Doctor is impressed with the
> results I have had with the milk thistle and has asked me for some
> good case studies done on the herb.  Good scientific studies

> I have searched Medline, but as a nonpaying member I can only get
> abstracts.

> Thanks for the help

> Surfing the internet from the Florida Keys
> Visit my Web site
> Http://www.bridge.net/~mikegetz/index.html

  I'm not sure there are any U.S. studies on milk thistle, but certainly
could be wrong.  There are all kinds of information on this drug
in Germany, but our medical folks are rather snotty about anything
that is NIH [Not invented here].  I'm sorry I don't have anything
to give you, but I do remember several posts that stated it's major
advantage was NOT for people with hepatitis. It's primary use
in Europe is for non viral liver problems.  If I am wrong,
I hope someone will give us better information.  Sorry,
I can't tell you anything more about it. I don't have Hep, but
do take it daily.  My wife, Wilda, does have HEP C, and she
also takes it.  But does it help?  Who knows? Here is part of a
post I found in my Milk Thistle folder:

There is a booklet by Christopher Hobbs called, "Milk Thistle The
Liver Herb."  You can find it at a health cooking.net">food store or Whole
Foods Market (Mrs. Gooches).  All the studies showed favorable
results.

But, of course this isn't the scientific information you are looking
for.  Anybody?

       KOKO   [ Keep on keeping on ]    Hop



Sun, 24 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies

Quote:
> I am looking for some actual case studies of milk thistle and the
> treatment of elevated liver enzymes.  My Doctor is impressed with the
> results I have had with the milk thistle and has asked me for some
> good case studies done on the herb.  Good scientific studies

> I have searched Medline, but as a nonpaying member I can only get
> abstracts.

OK, you can do with this as you will...
I think I might have something else, I'll see if I can track it down.

  - Grumpy

- - - - - - - - - - - - - - - CUT HERE - - - - - - - - - - - - - - - - - -

Title: [Results of a double blind study on the effect of silymarin in the
treatment of acute viral hepatitis, carried out at two medical centres
(author's transl)]
Author: Magliulo E; Gagliardi B; Fiori GP; Issue/Part/Supplement: 28-29
Source:  Med Klin
Date of Pub: 1978 Jul 14  Volume: 73 Pagination: 1060-5

Abstract: In a double blind study carried out under standard conditions at
two treatment centers silymarin, 2 sugar-coated tablets 70 mg three times
daily, showed a definite therapeutic influence on the characteristic
increased serum levels of bilirubin, GOT and GPT associated with acute viral
hepatitis. The above mentioned values in 28 patients treated with silymarin
were compared with those in 29 patients treated with placebo. The laboratory
parameters in the silymarin group regressed more than in the placebo group
after the 5th day of treatment. The number of patients having attained
normal values after 3 weeks' treatment was higher in the silymarin group
than in the placebo group. A statistical comparison revealed a difference
between bilirubin and GOT values in the placebo and silymarin groups and a
definite trend in the regression of GPT values in
favour of silymarin. The course of the immune reaction in HBS Ag patients
was not influenced by silymarin. As already proved by other investigators,
the use of silymarin in acute viral hepatitis can lead to an accelerated
regression in pathological values, thus indicating its use in the treatment
of this liver disease.

Abstract By: Author
Transliterated/Vernacular Title: Zur Wirkung von Silymarin bei der
Behandlung der akuten Virushepatitis.
Ergebnis einer an zwei medizinischen Zentren durchgefhrten Doppelblindstudie.

- - - - - - - - - - - - - - - CUT HERE - - - - - - - - - - - - - - - - - -



Sun, 24 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies

Quote:
> I am looking for some actual case studies of milk thistle and the
> treatment of elevated liver enzymes.  My Doctor is impressed with the
> results I have had with the milk thistle and has asked me for some
> good case studies done on the herb.  Good scientific studies

Hepatology 1997 Sep;26(3):643-649

Silymarin retards collagen accumulation in early and advanced biliary
fibrosis secondary to complete bile duct obliteration in rats.

Boigk G, Stroedter L, Herbst H, Waldschmidt J, Riecken EO, Schuppan D

Department of Gastroenterology and Hepatology, Klinikum Benjamin Franklin,
Free University of Berlin,
Germany.

Silymarin (SIL), a standardized plant extract containing about 60%
polyphenole silibinin, is used as a hepatoprotective agent. Its
antifibrotic potential in chronic liver diseases has not been explored.
Therefore, we
applied SIL to {*filter*} Wistar rats that were subjected to complete bile duct
occlusion (BDO) by injection of sodium amidotrizoate (Ethibloc). This
treatment induces progressive portal fibrosis without significant
inflammation. Rats
with sham-operation that received SIL at 50 mg/kg/d (n = 10) and rats with
BDO alone (n = 20) served as controls, whereas groups of 20 animals were
fed SIL at a dose of 25 and 50 mg/kg/d during weeks 1 through 6 or doses
of
50 mg/kg/d during weeks 4 through 6 of BDO. Animals were sacrificed after 6
weeks for determination of {*filter*} chemistries, total and relative liver
collagen (as hydroxyproline [HYP]), and the serum aminoterminal propeptide
of procollagen type III (PIIINP). BDO in untreated rats caused an almost
ninefold increase in total liver collagen (16.1 +/- 3.1 vs. 1.8 +/- 0.4 mg
HYP, P < .001). SIL at 50 mg/kg/d reduced total HYP by 30% to 35%, either
when given from week 1 through 6 or from week 4 through 6 after BDO (10.6
+/-
2.7 and 10.2 +/- 3.9 mg HYP, both P <.01 vs. BDO alone), whereas 25
mg/kg/d were ineffective. Because SIL at 50 mg/kg/d also reduced the
collagen
content per gram of liver tissue, it acted as a true antifibrotic agent.
The single value of PIIINP at killing paralleled the antifibrotic activity
of SIL with 11.6 +/- 3.8 and 9.9 +/- 3.7 vs. 15.3 +/- 5.2 microg/L in both
high-dose groups (P < .05 and P < .01, respectively, vs. rats with BDO
alone). Except for a decreased alkaline phosphatase and a lower
histological fibrosis score in the groups that received SIL,
clinical-chemical parameters were not different among all groups with BDO.
We therefore conclude that 1) BDO with Ethibloc is a suitable model to
test for pure antifibrotic {*filter*} because it induces progressive rat
secondary biliary fibrosis without major inflammation; 2) {*filter*}SIL can
ameliorate hepatic collagen accumulation even in advanced (biliary)
fibrosis; and 3) PIIINP appears to be a suitable serum marker to monitor
the inhibition of hepatic fibrogenesis in this model of biliary fibrosis.



Mon, 25 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies

You asked about Milk Thisle - Here you go:

Silymarin/Milk ThistleLiver Medication

(Special thanks to Mark Kuebel for his invaluable help in researching and
writing this Information Sheet)

What Is It?
Silymarin is a generic term for extract from the mature fruits of Silybum
marianum (sometimes Carduus marianus), a species of thistle commonly known
as milk thistle. It grows tall in waste places and along roadsides in
disturbed soil or other similar patches of soil. Although a native of
Europe, silymarin has naturalized on all continents. The seed extract
targets the liver with its medical properties but also shows some activity
in the {*filter*}, stomach and intestines. This extract is made of four related
molecules (all flavonoids) and other nonactive substances. Silibinin is
thought to be the most active of these molecules and is the most abundant
(Madaus, 1989; Valenzuela, 1985).

Are There Deficiencies in HIV Infection?
Not applicable.

Studies (Laboratory, Animal, Human)
Silymarin has been extremely well researched in Europe over the past 30
years, as well as by a Chilean team in Santiago. Extensive testing of both
animals and humans, as well as standard pharmaceutical assays, have
characterized this medication quite fully (Muzes, 1991). All four active
compounds found in silymarin are flavonoids with typical phenolic
structures that possess free radical-scavenging properties. To be more
precise, the phenol group has the addition of lignan precursor structures.
Therefore, they are more properly characterized as flavonolignans.

Silymarin has a strong affinity for quenching hydroxyl (OH) species, while
having a limited ability to scavenge superoxide (O2-) and peroxide (H202)
(Mira, 1994). These are the three most common pro-oxidant species found in
biological systems. This antioxidant property allows silymarin to act on
numerous pathways in the liver and accounts for its many protective and
detoxifying functions. Unlike most flavonoid antioxidants, silibinin does
not remain in {*filter*} plasma, but is transported into cells, though with an
affinity for liver, intestinal, and stomach tissues. Silymarin is only
slightly soluble in water. Its found in nuclear membranes, the plasmalemma
(cell membranes) and the cytoplasm (the fluid inside cells) (Bartholomaeus,
1994) and is primarily excreted by bile, although a relatively small amount
is excreted by the kidneys.

Silibinin is also known as silibin, silybin or silybinin.  The convention
adopted here mimics the most common use in the literature: silibinin. Also
note that the physiological effect of the three remaining compounds in
silymarin are rather ineffectual: isosilibinin occurs in very small
amounts; silidianin is extensively metabolized; and silicristin is poorly
absorbed by the gastrointestinal tract (Weyhenmeyer, 1992).

HIV, even from the first few weeks of infection, has a pronounced effect on
the concentration of cellular glutathione (GSH). This is thought to occur
as a result of the oxidative effect of HIV itself and the inhibition of GSH
production in the bodys cells by an unknown mechanism. Glutathione is
considered one of the most important molecules for elimination of
cytotoxicity in humans (Campos, 1989). Fortunately, silymarins affinity
for liver tissue has been shown to substitute for depleted GSH in
hepatocytes (liver cells), providing free radical scavenging, especially
hydroxyl radicals. Acetaminophen (Tylenol, paracetamol) is known to deplete
hepatocytes of GSH by suppressing its biosynthesis and generating oxidative
stress. It has been used as a model in rat liver studies, showing that
although silymarin cannot prevent necrosis from overdose of acetaminophen,
it does prevent lipid peroxidation of hepatocyte cell membranes and keeps
intracellular GSH levels and plasma liver enzyme levels near normal. This
scavenging prevents glutathione from leaking into capillaries, thus greatly
lessening liver damage (Muriel, 1992).

Silymarin has been extensively studied in humans and rats with {*filter*}ic
liver disease (chronic {*filter*} abuse causes liver cirrhosis, fatty
degeneration and necrosis). The silymarin-treated group in a double-blind
study of patients who abused {*filter*} showed improved morphological and
physiological markers (Salmi, 1982). Studies have shown that oxidative
stress caused by the byproducts of {*filter*} metabolism contributes
substantially to liver disease (Comoglio, 1995). These metabolically
produced oxidants also cause damage outside the liver. Silymarin was shown
to maintain superoxide di{*filter*}ase and glutathione activity in erythrocytes
normally destroyed by {*filter*}-related metabolites (Altorjay, 1992; Muzes,
1991). In a large, double-blind study of 170 cirrhotic patients, long-term
silymarin supplementation significantly reduced mortalitywith no reports
of side effects. This study was done with low-dose Legalon?, 70 mg capsules
3 times per day (Ferenci, 1989).

Silymarin is noted for its ability to prevent lipid peroxidation in
hepatocytes (Campos, 1989; Muriel, 1992). This mechanism keeps amatoxins
out of hepatocytes in mushroom poisoning and other forms of liver
poisoning. Silymarin protects and counteracts toxins that can be scavenged
from hepatocytes (Hobbs, 1992). This same antioxidant property has been
noted when silymarin was tested for efficacy in antiulceration studies
(Alarcon de la Strada, 1992). Free radical damage of lipids in a cells
plasmalemma causes leaky membranes, and a myriad of imbalances result from
which cells may or may not recover. In a recent study using silibinin
dihemisuccinate (SDH), a water-soluble lab product from silibinin, very low
concentrations of SDH are needed to inhibit lipid peroxidation in rat liver
microsomes, and its ability to scavenge hydroxyl radicals compares to that
of some anti-inflammatory {*filter*} (Mira, 1994). Using several different
hepatotoxins, the silibinin conjugatesilipideprevented lipid peroxidation
through its antioxidant effect. This is thought to be silibinins primary
mechanism of action in hepatoprotection (Carini, 1992).

Silymarins specific affinity for the liver is partially explained by its
enterohepatic circulation. As silymarin is absorbed by the intestinal
tract, it passes directly into the liver via normal portal circulation
where it is taken up by hepatocytes (liver cells) and excreted into bile.
The silymarin contained in bile is then reabsorbed after biliary secretion
to the intestines. So it basically makes a big loop from intestines to
liver to gall bladder (bile) back into the duodenum (intestine). Only a
small portion of silymarin<10%is excreted by the kidneys in the form of
residual silymarin in plasma. This enterohepatic circulation is thought to
be the reason silymarin does not express its antioxidant properties on
other organs like the lungs, kidneys or spleen, because it is constantly
recirculated into the liver (Valenzuela, 1989). In the case of
alphaamanitin and phalloidin, the most potent toxins from the mushroom
Amanita phalloides circulate through the same enterohepatic pathway, which
makes its effect more insidious. Fortunately, silymarin noncompetitively
inhibits these amatoxins from destroying hepatocytes and causing liver
failure and death.

As noted above, silymarin promotes liver regeneration. One of the ways it
has been shown to do this involves the cells genetic machinery. DNAthe
spiral staircase-shaped molecules that direct the production of new
proteinsrequires a great deal of other proteins to operate. When the cell
is told that a new protein needs to be made, it starts the process by
creating a more "readable" template of the DNA called a messenger RNA
(mRNA). This mRNA leaves the nucleus and heads out into the cytoplasm of
the cell where it hooks up with an organ that looks like folded draperies
called the endoplasmic reticulum. But for this RNA to be produced in the
first place, another protein enzymecalled the nuclear enzyme Polymerase
Ais needed. This specifically promotes the production of RNA from nuclear
DNA. Silymarin enhances the activity of this polymerase, causing increased
synthesis of ribosomal RNA (rRNA)one of the other forms RNA comes in that
is used in the process of creating new proteins that serve as an anchor for
the mRNA. An excessive quantity of ribosome formation pushes the cell to
produce proteins as the cellular count of ribosomes increases
simultaneously with protein synthesis capacity (Sonnenbichler 1986, 1984;
Machicao, 1977). Alpha-amanitin effectively shuts down the liver by binding
to Polymerase A and preventing protein synthesis. Because of enterohepatic
circulation of alpha-amanitin (in the intestines and liver), the liver is
barraged by the poison and crippled. If the dose is high enough (about 50+
grams of fungus), it will shut down the liver, causing death (Hruby, 1983).
Silymarin is antagonistic to alpha-amanitin and blocks it from binding to
Polymerase A, preventing destruction of this enzyme. It was also noted that
silibinin changes the membrane integrity of hepatocytes, making penetration
of the cells by the poison more difficult. Silymarin is antagonistic to
lanthanide poisoning, carbon tetrachloride, galactosamine, the hepatotoxic
virus FU3 and other toxins (Hobbs, 1992).

A conjugate form of silymarin called silipide is being developed and tested
in labs. This form is absorbed much better (90% absorption) than the
standardized extract or tincture, but has yet to prove bioavailable. It is
a conjugate of silibinin with phosphatidylcholine and is much more
lipophilic than silibinin. Studies have shown silipide is efficacious
(Comoglio, 1995), but the extent of its value is still not determined
(Gatti, 1994) and the standardized extracts have not been proven to be
inferior in their bioactivity (Weyhenmeyer, 1992). No pricing data on the
cost of silipide was available.

What Does Silymarin Do? How Does It Work in HIV Infection?
Silymarins ...

read more »



Mon, 25 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies

Ron......thanks for sharing this very informative article.

Gayla



Tue, 26 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies


Quote:
>You asked about Milk Thisle - Here you go:

Excellent report on the Milk Thistle
You desceve an A+
Thanks
Mike Getz
Surfing the internet from the Florida Keys
Visit my Web site
Http://www.bridge.net/~mikegetz/index.html


Tue, 26 Sep 2000 03:00:00 GMT
 Milk Thistle: need some case studies

Thanks to everyone for their submissions on this one. We have been looking for
more detailed info to share with doctors in our area. This was really a help.

The only thing bad about common sense is it ain't common!



Tue, 03 Oct 2000 03:00:00 GMT
 
 [ 8 post ] 

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