INTRODUCTION OF SILYMARIN – BOTANICAL:
The active components in Milk Thistle are its flavonoids, collectively called silymarin; and the majority of Milk Thistle-related research has been conducted on this component.
Silymarin has long been recognized for its ability to benefit people with liver disorders. Other research has suggested that it may be more effective for hepatitis B as opposed to hepatitis C. One study in 1998 demonstrated that it has the ability to block fibrosis, a process that contributes to the eventual development of cirrhosis in persons with inflammatory liver conditions secondary to alcohol abuse or hepatitis.
Milk thistle also provides liver protection by stabilizing liver cell membranes. It alters the structure of the outer cell membrane in such a way as to prevent the penetration of the liver by toxins into interior of the cell. Milk Thistle also increases the regenerative ability of the liver and the formation of new liver cells. Further studies concluded that other actions of silymarin include preventing the recirculation of toxins and regeneration of damaged liver cells. Other studies indicate the silymarin in milk thistle has anticancer effects, and data suggests that milk thistle may prevent liver damage from liver poisoning prescription medications.
THE USE OF SILYMARIN IN THE TREATMENT OF LIVER DISEASE:
The high prevalence of liver diseases such as chronic hepatitis and cirrhosis underscores the need for efficient and cost-effective treatments. The potential benefit of silymarin (extracted from the seeds of Silybum marianum or milk thistle) in the treatment of liver diseases remains a controversial issue. Therefore, the objective of this review is to assess the clinical efficacy and safety of silymarin by application of systematic approach. 525 references were found in the databases, of which 84 papers were retained for closer examination and 36 were deemed suitable for detailed analysis. Silymarin has metabolic and cell-regulating effects at concentrations found in clinical conditions, namely carrier-mediated regulation of cell membrane permeability, inhibition of the 5-lipoxygenase pathway, scavenging of reactive oxygen species (ROS) of the R-OH type and action on DNA-expression, for example, via suppression of nuclear factor (NF)-kappaB. Pooled data from case record studies involving 452 patients with Amanita phalloides poisoning show a highly significant difference in mortality in favour of silibinin [the main isomer contained in silymarin] (mortality 9.8% vs 18.3% with standard treatment; p < 0.01). The available trials in patients with toxic (e.g. solvents) or iatrogenic (e.g. antispychotic or tacrine) liver diseases, which are mostly outdated and underpowered, do not enable any valid conclusions to be drawn on the value of silymarin. The exception is an improved clinical tolerance of tacrine. In spite of some positive results in patients with acute viral hepatitis, no formally valid conclusion can be drawn regarding the value of silymarin in the treatment of these infections. Although there were no clinical end-points in the four trials considered in patients with alcoholic liver disease, histological findings were reported as improved in two out of two trials, improvement of prothrombin time was significant (two trials pooled) and liver transaminase levels were consistently lower in the silymarin-treated groups. Therefore, silymarin may be of use as an adjuvant in the therapy of alcoholic liver disease. Analysis was performed on five trials with a total of 602 patients with liver cirrhosis. The evidence shows that, compared with placebo, silymarin produces a nonsignificant reduction of total mortality by -4.2% [odds ratio (OR) 0.75 (0.5 – 1.1)]; but that, on the other hand, the use of silymarin leads to a significant reduction in liver-related mortality of-7% [OR: 0.54 (0.3 – 0.9); p < 0.01]. An individual trial reported a reduction in the number of patients with encephalopathy of -8.7% (p = 0.06). In one study of patients with cirrhosis-related diabetes mellitus, the insulin requirement was reduced by -25% (p < 0.01). We conclude that available evidence suggests that silymarin may play a role in the therapy of (alcoholic) liver cirrhosis. Silymarin is has a good safety record and only rare case reports of gastrointestinal disturbances and allergic skin rashes have been published. This review does not aim to replace future prospective trials aiming to provide the ‘final’ evidence of the efficacy of silymarin.
- Effects of Silymarin:
Clinical trials have shown that silymarin exerts hepatoprotective effects in acute viral hepatitis, poisoning by A phalloides, toxic hepatitis produced by psychotropic agents and alcohol-related liver disease, including cirrhosis, at daily doses ranging from 280 to 800mg, equivalent to 400 to 1140mg of standardised extract. Hepatoprotection has been documented by improvement in liver function tests; moreover, treatment with silymarin was associated with an increase in survival in a placebo-controlled clinical trial in alcoholic liver disease.
Pharmacokinetic studies have shown that silymarin is absorbed by the oral route and that it distributes into the alimentary tract (liver, stomach, intestine, pancreas). It is mainly excreted as metabolites in the bile, and is subject to enterohepatic circulation. Toxicity is very low, the oral 50% lethal dose being 10 000 mg/kg in rats and the maximum tolerated dose being 300 mg/kg in dogs. Moreover, silymarin is devoid of embryotoxic potential.
In conclusion, silymarin is a well tolerated and effective antidote for use in hepatotoxicity produced by a number of toxins, including A phalloides, ethanol and psychotropic drugs. Numerous experimental studies suggest that it acts as a free radical scavenger, with other liver-specific properties that make it a unique hepatoprotective agent.
Taking silymarin together with an antihistamine may improve symptoms from allergies better than the antihistamine alone, according to Medline Plus. Studies in animals indicate that milk thistle may protect the liver from toxins, but in human studies the results show conflicting evidence, according to a review of the research on New York University’s Langone Medical Center website. The most promising benefit is for treating alcoholic hepatitis and reducing the death rate from cirrhosis, but more studies are needed to verify milk thistle’s role. Silymarin had a moderate anti-inflammatory effect in patients with chronic hepatitis C, reported a study in the July 2013 issue of the “Journal of Viral Hepatitis.”
- Function; Why it is Recommended?
Milk Thistle Extract is many times more potent in antioxidant activity than vitamin E.
The plant contains B-sistosterol and is the main ingredient in Take Control and Benecol. It thus lowers cholesterol. It has been shown in studies to be effective in treating arteriosclerosis.
Silymarin is considered a liver protectant, a choleretic (moving bile), and a liver-specific antioxidant. It is also known to be protective of the liver by increasing its ability to detoxify numerous toxic substances, including pesticides and heavy metals (lead, mercury, cadmium, arsenic, etc.). In numerous clinical studies, silymarin has been shown to have positive effects in treating virtually every type of liver disease including cirrhosis, hepatitis, jaundice, and chemical- or alcohol-induced fatty liver. Milk thistle facilitates liver cell regeneration and can protect the liver from toxic damage.
Many people take milk thistle regularly to protect their livers from the effects of alcohol, heavy metals and drugs, and as needed after exposure to solvents, pesticides, bacteria from food poisoning or other toxins. Studies since the 1930s, conducted mainly in Germany, researched that the silymarin found in the herb works to stabilize liver cell membranes and act as an antioxidant to protect liver cells from free radical damage. It also helps regenerate healthy liver cells and boost the organ’s ability to filter toxins from the blood.
Most recently researchers found that the antioxidant activity of a milk thistle seed extract reduced the liver damage typically seen in patients who take prescription anti-psychotic drugs for extended periods and particularly in death cap mushroom poisoning. Silymarin has been shown to prevent and even reverse the toxic affect of mushroom (Amanita phalloides) poisoning, which can cause death within 24 hours. It is able to do this by specifically blocking the receptor for these toxins.