Milk Thistle Promotes Liver DetoxificationJanuary 2019
By Shirley Dannon
The liver is a primary defense against daily toxins.
People used to think that the main threat to their liver was alcohol.
Today’s nemesis is obesity. The result is an epidemic crisis of non-alcoholic fatty liver disease (NAFLD).1
Liver-related deaths jumped 65% between 1999 and 2016.2,3
Milk thistle extract has demonstrated benefits for non-alcoholic fatty liver disease, alcoholic liver disease, and cirrhosis.4-7
When standardized extracts of milk thistle are combined with a phospholipid delivery system, absorption is significantly enhanced.
The public tends to assume that liver disease affects only those who have abused alcohol.
What few people know is that as many as 30% of all adults suffer from non-alcoholic fatty liver disease, mostly caused by obesity.
There has been an almost two-fold increase in non-alcoholic fatty liver disease since 1991. 1
Those whose diets consist of junk food and drinking sodas are falling victim to non-alcoholic fatty liver disease at alarming rates.8
The liver is one of the largest and most important organs in the body. It is susceptible to many sources of damage. These can include fatty liver disease infections, metabolic insults, and toxic poisonings including alcohol abuse.
Milk thistle extract has been shown to guard the liver from damage and reduce liver-related mortality.4,9-11
Factors behind Liver Disease
Poor diets, obesity, and other factors can lead to permanent liver damage. Chronic liver injury increases the risk for liver cancer, cirrhosis, and liver failure.
Here are some underlying correctable risk factors of the surging liver disease epidemic:
- Excess alcohol ingestion (especially without accompanying it with antioxidants like n-acetyl-cysteine).12-14
- Excess use of acetaminophen pain-relieving drugs (sometimes sold as Tylenol®).15-17
- Abdominal obesity and excess body weight that contributes to nonalcoholic fatty liver disease.18 Almost 40% of adults are clinically obese according to the Center for Disease Control and Prevention (CDC).1
Considering the critical role of the liver in human health, and the growing incidence of liver disease, researchers have focused on the capacity of milk thistle extract to inhibit the most common causes and pathologies of liver damage.
The Potent Liver-Protection Effects of Milk Thistle Extract
Extracts of milk thistle contain several natural compounds that demonstrate the ability to defend the liver from injury. These compounds offer multiple mechanisms of liver protection, including strong oxidant protection and anti-inflammatory properties.19,20
Here are some brief descriptions of studies looking at how milk thistle extract defends against some of the main drivers of liver disease.
Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease is characterized by the deposition of fatty compounds in the liver. As the name implies, it is not caused by alcohol abuse and can occur even in individuals with little or no alcohol intake.
The prevalence of this disease is increasing, closely following the increases seen in related disorders, such as diabetes, metabolic syndrome, and obesity.1 In fact, non-alcoholic fatty liver disease can occur in up to 90% of obese individuals. 21 Fatty liver disease is on track to soon surpass alcoholism and viral hepatitis as the most common cause of chronic liver disease.
Early in its course, fatty liver disease may go unnoticed. However, it can progress over time to cause significant fibrosis of the liver and ultimately result in liver cancer, cirrhosis, and/or liver failure.
Scientists have demonstrated that, in preclinical models, extracts of milk thistle are capable of changing the abnormal metabolism associated with non-alcoholic fatty liver disease, reducing the accumulation of fatty substances and protecting cells from oxidative damage and death. 22-24
The mechanism of this protection may involve altering gene expression related to lipid metabolism, mitochondrial function, and antioxidant mechanisms.
In multiple studies of humans with fatty liver disease, intake of milk thistle extract has been associated with a reduction in fat deposition and improved enzyme blood markers of liver damage. 25-27
A meta-analysis of eight trials concluded that milk thistle extract effectively lowered liver enzymes, compared to controls, in non-alcoholic fatty liver disease patients.28
In randomized controlled trials, non-alcoholic fatty liver disease subjects treated with milk thistle extract for 48 weeks had markedly less fibrosis than those who received placebo.25,26,29
Alcohol and Other Liver Toxins
The liver is susceptible to an array of dangerous toxins known as hepatotoxins, including Amanita mushrooms, acetaminophen, arsenic, alcohol, and others.5,30,31
Research shows that milk thistle extract prevents liver damage when given before or during the exposure to a liver toxin.9,10,32,33
A common toxic cause of liver injury is alcohol abuse, and it appears to be on the rise, particularly in young adults.2,3 The best prevention of alcoholic liver disease is cessation of alcohol intake, but clinical trials have shown that milk thistle extract can even benefit people who’ve already developed the condition.6,11
One of these trials evaluated three different dose levels and found that the highest doses, 360 mg per day of the milk thistle extract preparation, resulted in the greatest improvement in liver enzyme levels.6 Another study showed that a group of patients with alcohol-induced liver disease who were treated with milk thistle extract showed improvements in liver enzymes and liver pathology.7
New studies show even what some people consider moderate alcohol ingestion can inflict an injurious impact.34 One might consider supplementing with milk thistle extract, n-acetyl-cysteine, vitamins B1, and C before ingesting ethanol.35
Cirrhosis is the end-stage of chronic liver injury. It can occur following years of ongoing liver injury from a number of possible causes, including viral and alcoholic hepatitis.
Cirrhosis is generally considered irreversible. But scientists have observed promising improvements with milk thistle extract in clinical trials.
In one such trial of 60 patients with alcoholic liver cirrhosis, those randomized to receive 450 mg of a milk thistle extract daily benefited from a reduction in a marker of liver fibrosis, along with improvements in oxidant reduction.36
Also, in a study of alcoholic and non-alcoholic patients with cirrhosis, 420 mg of milk thistle extract per day was associated with a higher overall four-year survival. This study showed that 58% of subjects supplementing with milk thistle survived compared to only 39% survival in controls (who did not receive milk thistle extract).4 The greatest clinical improvement was observed in alcoholics.
Among its myriad functions, the liver is crucial for detoxification, purifying the body of various toxic substances. As it performs these functions, the liver is itself prone to injury.
Acting through multiple mechanisms, compounds in milk thistle extract have the ability to protect the liver against toxins and metabolic disorders.
Health-conscious individuals can boost their body’s absorption of these protective compounds by taking standardized extracts of milk thistle that have been made more bioavailable via a phospholipid delivery system.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
- Le MH, Devaki P, Ha NB, et al. Prevalence of non-alcoholic fatty liver disease and risk factors for advanced fibrosis and mortality in the United States. PLoS One. 2017;12(3):e0173499.
- Bakalar N. More Americans are dying of cirrhosis and liver cancer. New York Times. July 23, 2018: D4.
- Tapper EB, Parikh ND. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ. 2018;362:k2817.
- Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol. 1989 Jul;9(1):105-13.
- Federico A, Dallio M, Loguercio C. Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years. Molecules. 2017 Jan 24;22(2).
- Vailati A, Aristia L, Sozze E, et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia. 1993;64(3):219-28.
- Salmi HA, Sarna S. Effect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind controlled study. Scand J Gastroenterol. 1982 Jun;17(4):517-21.
- Yasutake K, Kohjima M, Kotoh K, et al. Dietary habits and behaviors associated with nonalcoholic fatty liver disease. World J Gastroenterol. 2014 Feb 21;20(7):1756-67.
- Enjalbert F, Rapior S, Nouguier-Soule J, et al. Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol. 2002;40(6):715-57.
- Mengs U, Pohl RT, Mitchell T. Legalon(R) SIL: the antidote of choice in patients with acute hepatotoxicity from amatoxin poisoning. Curr Pharm Biotechnol. 2012 Aug;13(10):1964-70.
- Saller R, Brignoli R, Melzer J, et al. An updated systematic review with meta-analysis for the clinical evidence of silymarin. Forsch Komplementmed. 2008 Feb;15(1):9-20.
- Torok NJ. Update on Alcoholic Hepatitis. Biomolecules. 2015 Nov 2;5(4):2978-86.
- Ozaras R, Tahan V, Aydin S, et al. N-acetylcysteine attenuates alcohol-induced oxidative stress in the rat. World J Gastroenterol. 2003 Jan;9(1):125-8.
- Khoshbaten M, Aliasgarzadeh A, Masnadi K, et al. N-acetylcysteine improves liver function in patients with non-alcoholic Fatty liver disease. Hepat Mon. 2010 Winter;10(1):12-6.
- Watkins PB, Kaplowitz N, Slattery JT, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial. JAMA. 2006 Jul 5;296(1):87-93.
- van Mil AH, Janssens AR. [Acetaminophen use by chronic alcohol abusers: a therapeutic dose may be too much for the liver]. Ned Tijdschr Geneeskd. 2001 Sep 29;145(39):1873-6.
- Available at: https://library.lsuhscs.edu/am_rpt/media/files/10232009.pdf. Accessed October 9, 2018.
- Available at: https://www.niddk.nih.gov/about-niddk/research-areas/liver-disease. Accessed October 15, 2018.
- Polyak SJ, Morishima C, Lohmann V, et al. Identification of hepatoprotective flavonolignans from silymarin. Proc Natl Acad Sci U S A. 2010 Mar 30;107(13):5995-9.
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- Brunt EM, Wong VW, Nobili V, et al. Nonalcoholic fatty liver disease. Nat Rev Dis Primers. 2015 Dec 17;1:15080.
- Ni X, Wang H. Silymarin attenuated hepatic steatosis through regulation of lipid metabolism and oxidative stress in a mouse model of nonalcoholic fatty liver disease (NAFLD). Am J Transl Res. 2016;8(2):1073-81.
- Vecchione G, Grasselli E, Cioffi F, et al. The Nutraceutic Silybin Counteracts Excess Lipid Accumulation and Ongoing Oxidative Stress in an In Vitro Model of Non-Alcoholic Fatty Liver Disease Progression. Front Nutr. 2017;4:42.
- Guo Y, Wang S, Wang Y, et al. Silymarin improved diet-induced liver damage and insulin resistance by decreasing inflammation in mice. Pharm Biol. 2016 Dec;54(12):2995-3000.
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- Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med. 2012 May 1;52(9):1658-65.
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- Zhong S, Fan Y, Yan Q, et al. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials. Medicine (Baltimore). 2017 Dec;96(49):e9061.
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