Why You Might Want to Rethink Spending Money on Milk Thistle if you have Gilbert’s Syndrome
Milk thistle (Silybum marianum), a member of the Asteraceae family, has long been hailed as a powerful herbal remedy for liver health. Used for over 2,000 years, this plant is celebrated for its supposed benefits, which include antioxidant, anti-inflammatory, and liver-regenerating properties. But do the claims hold up under modern scientific scrutiny? Let’s explore the research to see if milk thistle deserves its reputation—or your money.
What is Milk Thistle?
Milk thistle’s active ingredient, silymarin, is a compound derived from the plant’s seeds. Silymarin is a mixture of three compounds, including silybin (the most potent component), silydianin, and silychristin. These compounds are thought to provide therapeutic effects, particularly for liver-related issues such as:
- Alcoholic liver disease
- Nonalcoholic fatty liver disease (NAFLD)
- Viral hepatitis
- Toxin-induced liver injury
The Science Behind the Claims
You may have read about the great benefits of taking Milk Thistle for protecting your liver.
Numerous preclinical studies suggest that silymarin has antioxidant and other benefits. For instance, it has shown promise in animal studies for reducing liver damage caused by substances like acetaminophen, alcohol, and certain toxins. However, when it comes to human clinical trials, the evidence is far less convincing.
A 2018 review concluded that while preclinical data are encouraging, the results from human trials remain inconsistent and inconclusive. In particular, well-designed randomized clinical trials are needed to verify whether milk thistle truly benefits liver diseases.
The Hidden Risks: Enzyme Inhibition
Beyond its questionable efficacy, milk thistle may pose risks due to its interaction with liver enzymes. This affects people with Gilbert’s Syndrome in particular. It’s time to rethink Milk Thistle and Gilbert’s Syndrome!
Research has found that silymarin, particularly silybin, inhibits UDP-glucuronosyltransferase (UGT) enzymes such as UGT1A1. People with Gilbert’s Syndrome have less of this enzyme than other people.
UGT1A1 plays a crucial role in metabolizing drugs and toxins. Inhibiting this enzyme can lead to higher levels of certain medications in the bloodstream, potentially causing adverse effects. For example:
- Chemotherapy Drug Interaction: A study on irinotecan, a chemotherapy drug metabolized by UGT1A1, found that milk thistle inhibited the drug’s metabolism. This led to increased drug concentrations, raising concerns about toxicity.
- Raloxifene Interaction: Milk thistle compounds were shown to inhibit the metabolism of raloxifene (a drug for breast cancer prevention), potentially amplifying its effects by 4-5 times—a significant risk.
These findings underscore the importance of caution when using milk thistle alongside medications with a narrow therapeutic window (where small differences in dose or blood concentration may lead to serious therapeutic failures and/or adverse drug reactions). It’s particularly important if you have Gilbert’s Syndrome, as you are already impacted, and this could cause further issues with processing of drugs.
Is Milk Thistle Safe?
Despite these concerns, milk thistle is generally considered safe at therapeutic doses. Studies show that it is well-tolerated even at high doses (up to 700 mg three times daily for 24 weeks), with mild side effects such as nausea or diarrhea reported in some cases. However, the herb’s potential to interact with medications remains a significant issue, especially for people taking drugs metabolized by UGT1A1, CYP3A4, or CYP2C9. And especially if you have Gilbert’s Syndrome.
A Closer Look at the Benefits
While milk thistle is widely marketed as a liver “saviour,” the scientific consensus suggests that’s not the case. The gap between promising laboratory studies and lacklustre clinical results leaves little reason to believe it helps for most liver diseases. Moreover, its enzyme-inhibiting properties can lead to harmful drug interactions.
The Bottom Line
Milk thistle is not the miracle herb it’s often claimed to be. While it may offer some antioxidant and liver-protective effects, the current evidence does not justify its widespread use, especially given its potential to interfere with vital enzymes. If you’re considering milk thistle for liver health or any other condition, consult a healthcare provider to ensure it’s safe and suitable for your needs.
In the end, your liver—and your wallet—may thank you for skipping this overhyped supplement.
Further reading / sources:
https://pubmed.ncbi.nlm.nih.gov/30080294
https://pubmed.ncbi.nlm.nih.gov/31069872
https://pubmed.ncbi.nlm.nih.gov/20564545
https://pubmed.ncbi.nlm.nih.gov/26070840
https://pubmed.ncbi.nlm.nih.gov/15155549
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164973
