Fatigue – or how can I boost my energy?

As many as one in five people feel fatigued at any time. If you’ve been feeling exhausted then you’ll want to know: Why am I so tired all the time; how can I get more energy?

Fatigue – what is it?

Fatigue is a symptom of many health conditions and life circumstances. Technically fatigue is one or more of these:

  • Overwhelming exhaustion that lingers beyond a good night’s sleep
  • Sleepiness and a lack of motivation to move about that doesn’t go away if you rest
  • A limiting lack of energy that prevents you from getting normal tasks done
  • Feeling like your muscles are too heavy and moving about takes energy you don’t have
  • Foggy achy head, finding it difficult to think or concentrate
  • Apathy and disinterest – everything feels too much

If you feel like this for more than a few days, for a reason that’s not clear, then you must see your doctor.

Is fatigue common?

Yes! Numerous studies across different populations show fatigue is common. You can find many studies, such as this one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557471/ which illustrate that women tend to report fatigue more than men, and those of lower socioeconomic status also experience more fatigue. Across populations it appears above 20% of people report fatigue. 

What causes fatigue?

Excessive tiredness can be caused by simple or serious health conditions. Common deficiencies of vitamins and minerals have tiredness as a symptom. There are many life circumstances which can leave you feeling exhausted. Let’s look at a few in more detail:

Life Stage : A new baby, a new job, grief or a crisis, moving house, caring responsibilities, overwork, stress at home or in the workplace.

Medical conditions: commonly, as you can see on the NHS website, and the Mayo Clinic , conditions causing fatigue include diabetes, depression, cancer, thyroid, coeliac disease, fibromyalgia, liver problems, MS, hormonal changes, heart disease and sleep apnoea, and so many more. This is why it is so important to receive a diagnosis if you experience fatigue which doesn’t let up over time. 

Deficiencies: Iron deficiency (experienced by many women with heavy or prolonged periods), Vitamin D deficiency (common if you live in the northern hemisphere where we aren’t exposed to strong sunlight which generates vitamin D), magnesium (particularly common in women), and an imbalance in good nutrition generally. Some people have metabolic conditions which prevent them from absorbing nutrients well and this can result in multiple deficiencies.

Poor choice of foods which attack energy levels: Food high in sugar or refined carbohydrates provide instant energy. Your body will then have a crash in blood sugar which will make you feel exhausted. Wholegrains, plant based proteins, and wholefoods containing natural sugars will balance your energy levels and make you feel a whole lot better. A high intake of caffeine may also leave you struggling later in the day. (For more about the pro’s and cons of caffeine read this).

A combination of the above!

Unpicking the causes of your fatigue is really important. You must rule out serious health problems, working with your Dr.

Does Gilbert’s Syndrome cause fatigue?

For people with Gilbert’s Syndrome lack of energy is a really commonly reported symptom. I hear all the time from people desperate with debilitating exhaustion, with energy levels that are unpredictable.

There are a number of reasons why people with Gilbert’s Syndrome may feel exhausted. 

  • Reduced liver function. If you eat highly refined carbohydrates such as white bread or sugary things, your blood sugar will rise and fall a lot. This means the enzyme we’re deficient in cannot work as well as it needs blood sugar. The result is your liver won’t do its cleaning job effectively and certain toxins and bilirubin will build up in your body. Typically feelings of exhaustion, jaundice, itching and nausea are reported. You may feel a bit like you have a persistent hangover.  Of course consuming toxins may add to that effect, eg alcohol.
  • Delayed gastric emptying. Food takes longer to leave your stomach if you have Gilbert’s Syndrome. I’m sure many recognise the abdominal discomfort that entails! This has been linked to fatigue .  It is also worth noting that it is also linked to Chronic Fatigue Syndrome. Which itself has often been linked to Gilbert’s Syndrome.
  • Excess serotonin. People with Gilbert’s Syndrome have defective processing of certain neurotransmitters (chemicals that send messages around the brain and nervous system). This can lead to raised levels of Serotonin for example, which is linked to feelings of lethargy and lack of motivation as well as anxiety.

How do I get more energy?

Assuming you don’t have a particular condition or issue that is causing you to feel exhausted, then there are four simple foundations to build your energy on

  1. Good Nutrition
  2. Exercise 
  3. Good Sleep
  4. Mental resilience

The great thing about these four things is that they support each other. 

Eat well and be properly nourished and you’ll exercise better and get better sleep. Better sleep will help you be mentally resilient and give you more muscle energy for exercise. Exercise will help you be more mentally resilient etc etc 

  1. Good Nutrition. A plant based whole food diet has been overwhelmingly shown to provide you with the most sustained energy, lifespan and wellbeing. Eating a variety of plants, legumes, nuts, seeds and wholegrains will ensure you don’t need any vitamin supplements. With all food patterns you need to make sure you aren’t missing anything out. For vegans that means ensuring you get Vitamin B12. Things that will suck your energy and not enhance your wellbeing include refined sugar, other refined and processed foods. If you want the ultimate nutrition facts then dig in here nutritionfacts.org and buy the book ‘How not to die’ . I offer other thoughts on foods to eat here https://gilbertssyndrome.org.uk/the-liver-diet/ https://gilbertssyndrome.org.uk/detox-diets-and-gilberts-syndrome/ https://gilbertssyndrome.org.uk/sesame-magic-for-your-liver/ The How Not to Die cookbook has lots of tasty recipes and you can see from the reviews that many readers report increased energy.
  2. Exercise should ideally be a mix of activities that raise your heart rate and which challenge your posture and muscles both in terms of flexibility and density. Walking briskly combined with pilates (plenty free videos on youtube) are simple cost free and energising. If you aren’t up to a great deal of exercise, then just start with walking a small distance and build up. Even standing up for a while engages muscles. Adding in exercise is something that needs to become a habit or you won’t stick to it. Stand up whilst you are on the phone or watching a favourite programme, take a 20 minute walk at lunchtime, do squats in the shower or whilst brushing your teeth, dance to a favourite song for 5 minutes when you get home from work. Every bit of movement is helping you stay fit and well.
  3. Good quality sleep is vital. Research shows that our circadian rhythm (our body clock) is really important to when we feel awake and when we sleep well. Just making sure your bedroom is really dark can make a big difference to your body clock. Getting plenty of light in the morning will also help you feel alert and awake during the day and sleep better in the morning. There are lots of ways to deal with bad sleep – which I won’t go into here. It’s enough to say that regular sleep hours in a dark room without interruption are fundamental to good quality sleep. There are many books on the subject. Try the popular ‘Sleep Smarter’ by Shawn Stevenson  
  4. Mental resilience is a quality many of us feel we could develop more. It enables you to put the ups and downs of life into perspective. With mental resilience you will better cope when something bad happens in your day or your life, and will worry less about it. That’s not to say that you shouldn’t worry, be upset, grieve or be without feelings. It means you can do those natural things and then move on in time. If you want to understand more about living without anxiety you can buy ‘The Anxiety Solution’ by Chloe Brotheridge or find resources at www.calmer-you.com and Chloe’s podcast. You can also find out more about mental resilience and ‘grit’ here https://positivepsychology.com/5-ways-develop-grit-resilience/ Another great way to build up your mental resilience is through meditation. If it isn’t something you have considered or have found difficult in the past, then you could try these simple and effective tools from Mind Cards:

If you are doing the right things and are still feeling fatigued then you really need your doctor’s help to look into underlying medical conditions. 

Your personal biology will need a personalised response so that it works the best way it can for you and your circumstances. 

Sometimes this may mean prescription medication or balancing up other elements of your nutrition, supplements or lifestyle. 

Beating fatigue in Gilbert’s Syndrome

So, let’s take a look at what this might mean if you have Gilbert’s Syndrome. As mentioned, there are specific reasons you’ll feel fatigued. Everyone with Gilbert’s Syndrome will have other things going on for them too – other chronic conditions, lifestyle or life stage issues, hormonal changes etc. This means that some things may work some of the time and you may need to adjust because of what is going on for you right now. 

What you put in is key to what you get out

Many people with Gilbert’s Syndrome steer clear of alcohol as it really messes with their wellbeing and energy levels. You may want to consider this for other chemicals and potential toxins to lighten the load on your liver. This would mean a plant based wholefood diet which avoids processed and refined foods. Ideally organic! Particularly good foods include broccoli, nuts and seeds. https://gilbertssyndrome.org.uk/the-liver-diet/ . Keep it low in refined sugar and make sure to include limited good fats of plant origin. 

Drinking plenty of water will also ensure you stay hydrated and support the removal of toxins from your body. 

Eat little and often. For a couple of reasons. 

1) to maintain stable blood sugar levels 

2) with delayed gastric emptying a large meal will make you feel uncomfortable and make it harder to move about. 

This isn’t an excuse to pack in more food, unless that means eating more vegetables! Look at what you would like to eat over the day or week and portion it out. If you do it ahead of time you won’t have to think about it. 

Antidepressants in the form of SSRI’s (Selective Serotonin Reuptake Inhibitors) can help for some people. If you feel your anxiety or low mood are overwhelming then you must speak to your doctor and get their advice and diagnosis. These are also prescribed for IBS (again, something that people with Gilbert’s Syndrome have a high rate of) and may be a useful treatment option to consider – in dialogue with your doctor. This may improve your sleep, mental resilience and energy levels. However, as some people with Gilbert’s Syndrome may have raised levels of serotonin, as mentioned above, then you need to be cautious of side effects. Some brands may work better than others.

Supplements. Extra ingredients that can give you a boost or added support to your system are basically just plants in powdered form in a capsule. Some of the supplements offering additional energy balancing and support include types of ginseng, rhodiola rosea, ashwagandha etc available at Approved Vitamins and have been used safely for thousands of years. I list some supplements you can try in the Resources section. https://gilbertssyndrome.org.uk/resources/

I use rhodiola rosea and ashwagandha and have seen an impressive improvement in my ability to function. I occasionally add in gotu kola towards the end of the week or if I’ve not had a great night’s sleep, or have extra physical or mental demands. It works like a really gentle caffeine that doesn’t have the come-down effects.

Some people find caffeine works well at the right points of the day – find out more about caffeine here and let us know how it makes you feel https://gilbertssyndrome.org.uk/gilberts-syndrome-and-caffeine/

Sleep appears to be a really important factor in feeling well, when you have Gilbert’s Syndrome. A good 8 hours can make a world of difference. Some of the supplements I mention above can help sleep. Follow the suggestions in the four foundations section above. Resist the temptation to lie in bed and doze or rest without sleep. This won’t help you sleep later. Keep bed for specific night time hours if you can, and keep your sleep routine and hours regular. Being active during the day will help you sleep better later.

Anxiety can stop you sleeping and suck your energy whilst awake. If it’s overwhelming then seek help from your Dr. I mention Chloe Brotheridge’s work above, but also Mind and other websites have many pointers for help. Mindfulness is a well founded technique for calming your mind and should guarantee better sleep and more energy. You can find some free apps here. As mentioned above, these are also a really simple and effective tool to help try mediation:

I’d really like to hear what your experience is. If you follow the lifestyle above has it changed your energy levels? I found becoming vegan, eating plant based, adding in supplements and building mental resilience transformed my energy levels. What’s worked for you? Please comment. 

Remember – many people feel fatigued. There are basic principles to seize more energy. Plus – there’s the magic ingredient of you and your physiology to consider. Get medical support where needed, and understand your health conditions. You’ll then be in control of your energy and your life. 

Gilbert’s Syndrome and Caffeine

What does caffeine do for the liver, and what is the relationship between Gilbert’s Syndrome and caffeine? Many studies now combine to illustrate the positive effects of caffeine on a number of aspects of health and wellbeing.

You can help reveal the impact of caffeine on people with Gilbert’s Syndrome. Get a free download here and answer a handful of questions – it will take less than 5 minutes, and you could help us all live better with Gilbert’s Syndrome. Thank you!

Naturally, it’s not a simple picture.  Everyone has a different genetic and metabolic profile (we’re all made differently!). Each individual has a unique way of processing any chemical or food. This can also be impacted by your lifestyle, age and even time of the month. My goal is to help you personalise your nutrition so that you can take the research, advice and your experience and see what works best for you.  

I’ve been through the research and summarize and link to it below. This post also gives you the benefit of looking through the science as it relates to Gilbert’s Syndrome, but ultimately – I am not a doctor, I am not YOUR doctor, and the best expert on you – is YOU. 

That said, let’s look at liver health and caffeine, and particularly Gilbert’s Syndrome and caffeine

As Professor Graeme Alexander President, British Association for the Study of the Liver Consultant Hepatologist at Cambridge University Hospitals and The Royal Free Hospital, London said, in a study published by the British Liver Trust in 2016, “At last, liver physicians have found a lifestyle habit that is good for your liver!’

The report pulls together studies that look at liver diseases which are developed or acquired, not genetic conditions that impact the liver, like Gilbert’s Syndrome. However, it’s worth looking at the conclusions and the basis of the studies to see what we can draw from those. 

The bottom line is that it appears caffeine can slow disease progression, help prevent liver cancer and support the anti-viral functions of the liver. 

Other conditions also show a beneficial impact, such as diabetes and stroke. 

‘eighteen studies involving almost half a million people that show overall that coffee, decaffeinated coffee and tea do slightly reduce risk of diabetes.’

One stunning assertion from a study in the report showed that :

‘Coffee appears to have a significant effect on all-cause mortality. The National Institutes of HealthAmerican Association of Retired Persons Diet and Health Study involving 229,119 men and 173,141 women demonstrated an inverse relationship between coffee consumption and mortality. In other words, coffee drinkers had a reduction in mortality compared with non-coffee drinkers.’

Any old caffeine? 

Some of the questions raised include the benefits of tea (or other caffeinated beverages) versus coffee. It appears that coffee itself contains beneficial compounds (particularly those found in the green beans) that other caffeinated drinks do not. And that decaffeinated coffee can have some benefits associated with coffee drinking. 

How much should I drink?

Rightly cautious advice about drinking too much coffee or consuming too much caffeine is flagged. Too much caffeine can have an adverse effect on other conditions, from pregnancy to conditions where medication might be impacted. The difference between men and women is only really significant if you are taking hormonal supplements or, as mentioned, you are pregnant. A moderate 2 to 3 cups a day is suggested by the report authors. 

One factoid of interest – caffeine metabolisation is twice as fast in smokers as non-smokers.

Coffee Caution

Everybody reacts differently to substances and caffeine is itself quite a powerful stimulant. If you have anxiety or depression then do NOT suddenly start drinking lots of coffee! It raises levels of stress hormones adrenaline and cortisol. Plus, it can raise blood pressure. 

Although coffee can enhance energy and alertness, it can also trigger certain conditions, and decaffeinated coffee might provide some benefits without the downsides for people who react strongly to caffeine. However, as noted in Medical News Today In 2013, a study published in World Journal of Biological Psychiatry suggested that drinking between 2–4 cups of coffee a day may reduce suicide risk in adults.

Caffeine is in fact a psychoactive substance and should not be overused. Most studies suggest that more than 400mg of caffeine a day could have adverse effects (probably more than 4 cups of coffee). Plus, as well as the caution for pregnant women, there is a lack of information about how it can impact the growing, changing and susceptible brains of children and adolescents. 

If you would like to read the studies and explore the associated articles on this, then do read the report. https://britishlivertrust.org.uk/wp-content/uploads/The-health-benefits-of-coffee-BLT-report-June-2016.pdf

You can also watch this video from Dr Greger at nutrition facts (buy his excellent book ‘How Not to Die’ which looks at many health conditions and how to optimise your diet to live longer and better).

Dr Greger rightly raises the fact that people metabolise coffee / caffeine very differently. This different metabolisation can result in very different responses, harms and benefits. 

Gilbert’s Syndrome and Caffeine

In the catchily titled piece of scientific research: Caffeine Clearance in Subjects With Constitutional Unconjugated Hyperbilirubinemia

The abstract concludes: ‘CAF altered kinetics in 27% of GS cases may suggest multiple deficits in the hepatocellular metabolism, thus confirming the heterogeneity of this syndrome.’

Ie. caffeine altered the reaction rates in 27% of Gilbert’s Syndrome cases, suggesting that the liver wasn’t processing as well, demonstrating (once again) that Gilbert’s Syndrome has different elements or characteristics. 

(It didn’t seem to impact bilirubin levels or bile acids, though.)

As with many studies into Gilbert’s Syndrome, the conclusions note that there are in fact differences in how our livers process things. But, as is so often the case, this is not taken further, to examine just what that means to the lifestyle management for someone with Gilbert’s Syndrome. 

The implication here is that people with Gilbert’s Syndrome might find coffee or caffeine impacts them negatively, and I’ve written elsewhere how coffee or caffeine can impact energy levels in a way that you may find unhelpful. Stable energy levels and blood sugar are important for the liver enzymes we are deficient in to work properly. We can also experience anxiety as a symptom. These both suggest we would need to be careful around our coffee / caffeine consumption. 

Of course, energy levels can also be an issue if you have Gilbert’s Syndrome. Fatigue is a common symptom of Gilbert’s Syndrome. It would be great to be able to reach for caffeine as a pick me up, to break through that brain fog and boost your concentration!

What caffeine to try when you have Gilbert’s Syndrome

If you want to try caffeine in a different format to coffee, this myprotein drink includes caffeine plus protein and vitamin B6 which can help supplement energy levels too.

Another option is a green coffee bean supplement, this one has additional ingredients to add to the energy boost.

If you don’t want the caffeine, but want the protective elements of green coffee beans (which appear to have the most beneficial compounds), then try this decaffeineated version.

If you want to explore alternatives to coffee then there are other natural stimulants which are more gentle which may help with your energy levels. I take adaptogens to balance my energy levels, you can find a range of supplements here at Approved Vitamins , such as Ashwagandha and Rhodiola (I only use Viridian Maximum Potency Rhodiola ), plus gotu kola which can provide an extra, but gentle, boost that can help concentration levels when they start to flag. I recently tried this one and it works a treat for giving me a gentle pick me up:

Nature’s Answer, Gotu Kola, 950 mg, 90 Vegetarian Capsules

I personally find coffee or caffeine makes me feel quite unwell. I don’t seem to metabolise it comfortably and it leaves me feeling frazzled and sick. I’d love to hear more about whether you find coffee or caffeine helps you, and what your experiences are with it. Please do comment and share your story here. 

This website is dedicated to helping people like you live better with Gilbert’s Syndrome, I hope you find the information interesting and useful – if you do, please consider donating to keep it going. Because so many people struggle to find help and support to live with Gilbert’s Syndrome, please donate today – THANK YOU!

Helping your liver deal better with toxins

Good news! The detox process of the liver which won’t work as well for people with Gilbert’s Syndrome is called Glucuronidation and this process can be helped with Calcium D-Glucarate, glycine, magnesium, and b vitamins.

  • Calcium D Glucarate can be taken as tablets or capsules, but is also available in apples, brussels sprouts, broccoli, cabbage and bean sprouts.
  • Glycine is an amino acid and in high-protein foods, such as fish, meat, beans, milk, and cheese. Glycine is also available in capsule and powder forms, and as part of many combination amino acid supplements.
  • Spices, nuts, cereals, coffee, cocoa, tea, and vegetables are rich sources of magnesium. Green leafy vegetables such as spinach are also rich in magnesium as they contain chlorophyll. Magnesium supplements are widely available and often with calcium and vitamin c which help its absorption. The best absorbed types of magnesium are citrate and malate, rather than the cheaper form of oxide.
  • B vitamins are available in many different foods (see the NHS website), but the easiest ways of accessing them are through yeast extracts such as Marmite, and fortified cereals.

So why not help yourself and make sure your diet contains a good balance of foods that may help your liver to work better.

Glucuronidation – where Gilbert’s Syndrome works in your liver

Glucuronidation
The UGT enzyme (that people with Gilbert’s Syndrome don’t have so much of) works in one particular part of your liver and is responsible for the part (or pathway) of your liver’s processing called ‘glucuronidation’. Glucuronidation happens when toxins are bound to glucuronic acid which is produced by the liver. Chemicals processed by glucuronidation include common opiate based drugs used in pain relief or during surgery  (Liston, H.; Markowitz, J.; Devane, C. (2001). “Drug glucuronidation in clinical psychopharmacology”. Journal of clinical psychopharmacology). Other things that affect glucuronidation include smoking, obesity, age and gender.

You can find a list of drugs affected here: https://en.wikipedia.org/wiki/Glucuronidation#General_influencing_factors

Some herbal supplements may help glucuronidation (Effects of herbal supplements on drug glucuronidation. Review of clinical, animal, and in vitro studies. March 2011 Mohamed ME, Frye RF.Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida 32610, USA.)The use of herbal supplements has increased steadily over the last decade. Recent surveys show that many people who take herbal supplements also take prescription and nonprescription drugs, increasing the risk for potential herb-drug interactions. In vitro and animal studies indicate that cranberry, gingko biloba, grape seed, green tea, hawthorn, milk thistle, noni, soy, St. John’s wort, and valerian are rich in phytochemicals that can modulate UGT enzymes. However, the IN VIVO consequences of these interactions are not well understood. Only three clinical studies have investigated the effects of herbal supplements on drugs cleared primarily through UGT enzymes. The need for further research to determine the clinical consequences of the described interactions is highlighted.

Essential for Glucuronidation are the nutrients L-glutamine, aspartic acid, iron, magnesium, B3 (niacin) and B6. Thyroid should also be adequate. Cruciferous vegetables (cauliflower, cabbage, cress, bok choy, broccoli and similar green leaf vegetables) are helpful. Glucuronidation efficiency can be improved by calcium-d-glucarate. However, you have to start very gradually with the calcium-d-glucarate, and be very consistent.

You can find out more about glucuronidation here https://youarethehealer.org/health-conditions/optizmize-your-health/detox-biotransformation-pathways/glucuronidation/

Milk Thistle (Sylbum marianum )

The medicinal use of milk thistle can be traced back to ancient Greece and Rome.  Today researchers around the world have completed more than 300 scientific studies that attest to the benefits of this herb, particularly in the treatment of liver ailments.

Common uses:

  •        Protects liver from toxins, including drugs, poisons and chemicals.
  •        Treats liver disorders such as cirrhosis and hepatitis
  •        Reduces liver damage from excessive alcohol.
  •        Aids in the treatment and prevention of gallstones
  •        Helps to clear psoriasis.

Forms : capsule, tablet, tincture.

What it is.

Know by its botanical name, Silybum marianum, as well as by its main active ingredient, sylmarin, milk thistle is a member of the sunflower family, with purple flowers and milky white leaf veins.  The herb blooms from June to August, and the shiny black seeds used for medicinal purposes are collected at the end of the summer.

What it does.

Milk thistle is one of the most extensively studied and document herbs in use today.  Scientific research continues to validate its healing powers, particularly for the treatment of liver-related disorders.  Most of its effectiveness stems from a complex of three liver-protecting compounds, collectively know as silymarin, which constitutes 4% to 6% of the ripe seeds.

Major benefits.

Among the benefits of milk thistle is its ability to fortify the liver, one of the body’s most important organs.  The liver processes nutrients, including fats and other foods.  In addition it neutralises, or detoxifies many drugs, chemical pollutants and alcohol.  Milk thistle helps to enhance and strengthen the liver by preventing the depletion of glutathione, an amino acid-like compound that is essential to the detoxifying process.  Moreover, studies have shown that it can increase glutathione concentration by up to 35%.  Milk thistle is an effective gatekeeper, limiting the number of toxins which the liver processes at any given time.  The herb is also a powerful antioxidant.  Even more potent than vitamins C and E, it helps to prevent damage from highly reactive free-radical molecules.  It promotes the regeneration of new liver cells which replace old and damaged one.  Milk thistle eases a range of serious liver ailments, including viral infections (hepatitis) and scarring of the liver (cirrhosis).  The herb is so potent that it is sometimes given in an injectable form in hospital resuscitation rooms to combat the life-threatening, liver-obliterating effects of poisonous mushrooms.  In addition, because excessive alcohol depletes glutathione, milk thistle can aid in protecting the livers of alcoholics or those recovering from alcohol abuse.

 Additional benefits.

In cancer patients, milk thistle limits the potential for drug-induced damage to the liver after chemotherapy, and it speeds recovery by hastening the removal of toxic substances that can accumulate in the body.  The herb also reduces the inflammation and may slow the skin-cell proliferation associated with psoriasis.  It may be useful for endometriosis (the most common cause of infertility in women) because it helps the liver to process the hormone oestrogen, which at high levels can make pain and other symptoms worse.  Finally, milk thistle can be beneficial in preventing or treating gallstones by improving the flow of bile, the cholesterol-laden digestive juice that travels from the liver through the gall bladder and into the intestine, where it helps to digest fats.

How to take it.

Dosage :  The recommended dose for milk thistle is up to 200mg of standardised extract (containing 70% to 80% silymarin) three times a day; lower doses are often very effective.  It is often combined with other herbs and nutrients, such as dandelion, choline, methionine and inositol.  This combination may be labelled ‘liver complex’ or ‘lipotropic factors’.  For proper dosage follow the instructions on the packet.

Guidelines for use : Milk thistle extract seems most effective when taken between meals.  However, if you want to take the herb itself, a tablespoon of ground milk thistle can be sprinkled over breakfast cereal once daily.  Milk thistle’s benefits may be noticeable within a week or two.  The herb appears to be safe, even for pregnant and breastfeeding women.  No interactions with other medications have been noted.

Possible side effects : Virtually no side effects have been attributed to the use of milk thistle which is considered one of the safest herbs on the market.  However in some people it may have a slight laxative effect for a day or two.

Buying guide.

To ensure you are getting the right dose buy products made from standardised extracts that contain 70% to 80% silymarin, milk thistle’s active ingredient. Studies show that preparations containing milk thistle bound to phosphatidylcholine, a constituent of the natural fatty compound lecithin, may be better absorbed than ordinary milk thistle.

When taking milk thistle to alleviate liver damage from excessive alcohol, avoid alcohol based tinctures as they can weaken the resolve to break the addiction.

Recent Findings.

Milk thistle may be a weapon in the fight against skin cancer.  Researchers at Case Western Reserve University in Cleveland, Ohio, found that when the active ingredient, silymarin, was applied to the skin of mice, 75% fewer skin tumours resulted after the mice were exposed to ultra violet radiation.  More studies are needed to see if it has a similar effect in humans.

Final fact.

The components of milk thistle are not soluble in water, so teas made from the seeds usually contain few of the herb’s liver-protecting ingredients.