Hepatitis disease - Milk thistle no better than placebo

Author

Milk thistle no better than placebo

Waterspider

2005-05-05, 5:58 pm

Milk thistle does not reduce deaths from liver diseases, best studies
find
03 May 2005

Milk thistle, a widely used alternative medicine, is not proven
effective in lowering mortality in alcoholic or hepatitis B or C liver
disease, according to a systematic review of current evidence.

While some studies found that liver-related mortality may be
significantly reduced in patients treated with milk thistle, these findings
were not duplicated in the higher quality clinical trials.

However, milk thistle was found safe to us with no serious side
effects and with participants perceiving improvement in symptoms -- although
no more than with placebo.

Dr. Andrea Rambaldi, visiting researcher at the of the Centre for
Clinical Intervention Research at Copenhagen university Hospital, led a team
that reviewed 13 randomized clinical trials involving 915 patients who were
treated with milk thistle or its extracts.

Participants had acute or chronic alcoholic liver cirrhosis, liver
fibrosis, hepatitis and/or steatosis, and viral-induced liver disease
(hepatitis B and/or hepatitis C). Patients with rarer specific forms of
liver disease were excluded.

All the trials compared the efficacy of milk thistle or any milk
thistle constituent versus placebo or no intervention in patients with liver
disease. "There is no evidence supporting or refuting milk thistle for
alcoholic and/or hepatitis B or C virus liver diseases," the authors found.

The review appears in the most recent issue of The Cochrane Library, a
publication of The Cochrane Collaboration, an international organization
that evaluates medical research. Systematic reviews draw evidence-based
conclusions about medical practice after considering both the content and
quality of existing medical trials on a topic.

According to the Centers for Disease Control and Prevention, 170
million people worldwide are infected with hepatitis C, and 2 billion are
infected with hepatitis B.

While a vaccine exists to prevent hepatitis B, there is no vaccine for
hepatitis C.

Although the virus can be cleared in a handful of patients, many
strains are resistant to treatment. Drug therapies that focus on long-term
suppression of the virus are expensive, and many patients develop a
resistance. The current gold standard treatment, which combines injections
of interferon and ribavirin, has serious side effects and is hard for
patients to tolerate.

With lack of effective treatment for liver disease, researchers have
been looking for alternative therapies that curb symptoms with minimum
adverse effects on patients. Milk thistle and its extracts have been used
since the time of ancient Greece for medicinal purposes, are currently
widely used in Europe for liver disease, and are readily available in the
United States at alternative medicine outlets and outdoor markets.

G. Thomas Strickland, M.D., Ph.D., professor at the university of
Maryland School of Medicine, has been studying the role of silymarin, an
extract of milk thistle, in preventing complications of chronic hepatitis
virus infection. Strickland says that the exact mechanism of action of
silymarin is unclear.

A problem with current trials, according to Dr. Strickland, is that
the dose of silymarin administered, typically 140 mg three times daily, is
too low. "I would certainly double it," he says, "especially since at the
current dose we're not seeing any improvement in acute viral or chronic
hepatitis, and we've shown that silymarin is totally safe."

"The problem is, there is no cure for viral hepatitis except bed rest
and diet, and treatments like silymarin are worth pursuing," Strickland
says, calling for more research funding.

"We should consider doing randomized clinical trials with higher doses
of silymarin," Dr. Rambaldi concurs.

According to the National Center for Complementary and Alternative
Medicine , a part of the National Institutes of Health, studies in
laboratory animals suggest that silymarin may benefit the liver by promoting
the growth of certain types of liver cells, demonstrating a protective
effect, fighting oxidation (a chemical process that damages cells) and
inhibiting inflammation.

In their review, Dr. Rambaldi and colleagues conclude, "Milk thistle
could potentially affect alcoholic and/or hepatitis B or C virus liver
diseases. Therefore, large-scale randomized clinical trials on milk thistle
for alcoholic and/or hepatitis B or C liver diseases versus placebo may be
needed."

By Lise Stevens, Contributing Writer
Health Behavior News Service

FOR MORE INFORMATION Health Behavior News Service: (202) 387-2829 or
www.hbns.org.

Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic
and/or hepatitis B or C virus liver diseases. The Cochrane Database of
Systematic Reviews 2005, Issue 2.

The Cochrane Collaboration is an international nonprofit, independent
organization that produces and disseminates systematic reviews of health
care interventions and promotes the search for evidence in the form of
clinical trials and other studies of interventions. Visit
http://www.cochrane.org for more information.

Professeur Von TwoSteps OA.

2005-05-06, 9:18 am

From : "Waterspider" <waterspider@moonshine.net>
Message-ID : <ZGvee.42444$HR1.20081@clgrps12>

>However, milk thistle was found safe to us with no serious side effects

There has never been any worthwhile clinical environmental toxicology study
conducted to establish that claim

Therefore Waterspout, *I* shall reserve my opinion

Waterspider

2005-05-06, 5:57 pm

"Professeur Von TwoSteps OA." <.@.> wrote in message
news:19472096.1291ca0@news.bumsport.edu...
> From : "Waterspider" <waterspider@moonshine.net>
> Message-ID : <ZGvee.42444$HR1.20081@clgrps12>
>
> There has never been any worthwhile clinical environmental toxicology
> study
> conducted to establish that claim
> Therefore Waterspout, *I* shall reserve my opinion
>
Did you read this part too? "There is no evidence supporting or refuting
milk thistle for
alcoholic and/or hepatitis B or C virus liver diseases," the authors found.
So it looks like they are reserving their opinion too, as should we all.
WS