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New Study: A Place for Milk Thistle in Hepatitis C Treatment

Nicole Cutler L.Ac. August 1, 2014

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A newly released study encourages previous non-responders to prep their body with milk thistle prior to beginning Hepatitis C triple therapy.
New Study: A Place for Milk Thistle in Hepatitis C Treatment

Ever since the newer, direct-acting antiviral drugs were FDA-approved in the Spring of 2011, triple therapy has significantly improved the odds of successfully eliminating the Hepatitis C virus. Despite this therapeutic improvement, individuals co-infected with HIV (the virus that causes AIDS) and Hepatitis C are among the most likely to fail treatment. Researchers in Switzerland have found that administering a potent form of milk thistle prior to beginning triple therapy dramatically improves patient outcome.

HIV/Hepatitis C Co-Infection

According to the U.S. Department of Disease Control and Prevention, approximately one quarter of HIV-infected persons in the United States are also infected with Hepatitis C. Both viruses are transmitted via blood-to-blood contact; thus, simultaneous infection with Hepatitis C and HIV is especially common (50 to 90 percent) among HIV-infected drug users.

Unfortunately, Hepatitis C infection frequently leads to rapid progression of liver disease when paired with HIV infection. Hepatitis C treatment in those who are co-infected with Hepatitis C and HIV is complicated by the hepatotoxic and myelosuppressive effects of HIV therapy and HIV infection itself. As such, clinicians are always on the look-out for safe ways to improve the treatment outcome for people co-infected with Hepatitis C and HIV.

Switzerland Research

Researchers from Zurich, Switzerland conducted a pilot study to see if injection of a highly purified form of milk thistle could improve the Hepatitis C treatment outcome in the face of HIV/Hepatitis C co-infection. Because they have only a 30 percent chance of achieving a successful outcome during triple therapy, individuals were targeted who:

  • Had co-infection of Hepatitis C and HIV
  • Had advanced liver fibrosis
  • Were previous non-responders to peginterferon and ribavirin treatment

The Swiss researchers evaluated the efficacy of administering silibinin prior to beginning triple therapy in these difficult to treat patients. The regimen during this trial was:

  • Intravenous silibinin 20/mg/kg per day for two weeks
  • Peginterferon-ribavirin and telaprevir triple therapy for the next 12 weeks
  • Peginterferon-ribavirin dual therapy for the remaining 36 weeks

With an astounding 80 percent success rate, the researchers concluded that leading in with silibinin before triple therapy is a highly effective way to increase the probability of Hepatitis C treatment success in difficult to treat HIV/Hepatitis C-coinfected patients with advanced liver fibrosis and previous failure of peginterferon-ribavirin.

Silibinin

Milk thistle seed extract has been used for centuries to protect and strengthen liver cells. Milk thistle has been shown to:

  • Strengthen the outer walls of liver cells to better resist injury
  • Promote the growth of healthy liver cells
  • Fight oxidation – a process that damages liver cells

Milk thistle extract is composed of silymarins, a group of potent antioxidants that are responsible for milk thistle’s therapeutic properties. Of the silymarins, silybin (also referred to as silibinin) has been shown to be the most effective constituent of silymarin for benefitting liver health. The caveat to silibinin (or any other milk thistle preparation) is its poor bioavailability. This is likely the reason that the Swiss study described above used intravenous silibinin over the oral route.

Luckily, those wanting to capitalize on this study’s results don’t need to find a doctor who will inject silibinin prior to starting triple therapy. When in phytosome form, silibinin absorption when taken orally is up to ten times more absorbable than the standard silibinin preparation.

Some with Hepatitis C who are previous non-responders and co-infected with HIV may be ready to try triple therapy for an improved chance of treatment success. Whether co-infected with HIV or not, being committed to two weeks of silibinin therapy (either intravenous or the oral phytosome form) may play a vital role in preparing the liver for a successful attempt at eliminating Hepatitis C.

http://www.cdc.gov/hepatitis/Populations/hiv.htm, HIV/AIDS and Viral Hepatitis, Retrieved July 13, 2014, US Centers for Disease Control and Prevention, 2014.

http://www.hiv.va.gov/provider/guidelines/hcv-coinfection.asp, Management and Treatment of Hepatitis C Infection in HIV-Infected Adults, Retrieved July 13, 2014, US Department of Veteran Affairs, 2014.

http://www.liversupport.com/wordpress/2013/05/milk-thistle-a-liver-and-skin-protector/, Milk Thistle: A Liver and Skin Protector, Nicole Cutler, L.Ac., Retrieved July 13, 2014, Natural Wellness, 2014.

http://www.ncbi.nlm.nih.gov/pubmed/24894776, Braun, D, et al, Efficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C virus-coinfected patients, HIV Medicine, June 2014.

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  • Angelo

    This is just one study and it was a injectable form. Not even close to an oral even if most of the oral is absorbed. Save your money.

    • marsl

      Most OTC Milk thistle flushes right out of your system You need to take Milk thistle with Phytosome they say it’s absorbed in the body like an injected dose!!! The trademark name is Siliphos (It’s expensive) . Swanson’s vitamins has the best price for it. I took Siliphos and a lot of other liver healthy supplements since I was first dx with hep-c in 2002 1st stage fibrosis I was tested again for my liver this Jan 2015 and my fibrosis NEVER progressed past stage1 I am CERTAIN these liver supplements stopped my fibrosis from progressing (NO the liver supplements DID NOT drop my v/l)…..I am currently on Harvoni…. My Dr. said not to take any supplements until i get off of tx because he does not know if they will effect the strength of Harvoni.

  • trotter

    The FDA finally researched milk thistle about 2 years ago and found it to be as efficient as a placebo, having no effect on Hepatitis C. I know this site sells lots of milk thistle, a big business for desperate Hepatitis C sufferers, many of whom can’t work and have little money.

  • Wild Bill

    Even if you wanted to give the article the benefit of the doubt there is no connection to this “phytosome form” and OTC preparations and dosing.

  • Jack

    Why milk thistle was taken prior to treatment and not also during the treatment?
    I just started a conventional new treatment using combination of Sovaldi and Olysio. My Chinese doctor suggests of using TCM Hepatis C herb regiment with the treatment.
    I am not sure if this is a good idea.
    Is anybody can comment on it?

    • SHEESH

      It says right on your packet from the pharmacy-DO NOT USE MILK THISTLE WHILE ON S/O. DO NOT USE ANY OTHER HERB OR MEDICINE WHILE GETTING TREATMENT WITH S/O.

  • buzz

    I treated My Hep C with Milk Thistle and other ‘natural’ medicines for almost ten years and my oncologist monitored certain blood counts. When the Hep C manifested in to cirrhosis, my hepatologist told me to quit taking all that ‘alternative medicines.’ I obeyed him.

    Yet Wikipedia cites ancient Chinese uses, the Ancient Greeks, etc. What made them relate milk thistle to liver health? And it also cites studies that indicated milk thistle IS beneficial.
    I’m so glad that I will be starting the new, non-chemo treatment soon.

  • marsl

    CanI take Milkthistle whlie on Harvoni I also heard that Quercetin was just as effective as Milk thistle