Hi Carlee,

The FDA has determined that they could see no harm in the taking of Milk Thistle, though they won't give it an outright "Thumbs up." That being said, many with liver inflammation - whether hep B, C or NASH - take milk thistle with varying levels of satisfaction. Most responses have been pretty positive, and you'll hear alot of that here, I'll bet!

I'm not a medical professional, so I can't tell you how much you "should" take, but I will say this: If you decide to take any herbal medicines, start out slow. Follow the directions on the bottle for about a week to ten days, and while doing that, research on the dosage of people with hep C. Mention to your doctor that you are taking this, and ask him when would be the best time to increase dosage. He may tell you that day to take more, but it's always better to be safe than sorry.

Why am I so anal about pacing yourself? Simple. So many people will just start popping alternative meds - alone or in conjunction with prescribed meds - and then when there is a "side effect" they don't know what caused it. If you start slow, never taking too many at one time, then if there is a side effect, you can take a step back and say, "this didn't start until I began taking_____"

You see?:smile:

In what form is your milk thistle? There are capsules and liquids that I have used, but each should have directions which include the proper dosage.
If you are on tx, don't take milk thistle.
If you are not on tx, you can always ask your dr on the correct dosage if you don't want to go by the amount on the container.

good advice jbk, but i'd like to know the answer to carlee's question too. from what i've read it is generally thought to be safe to take 600 to 800 daily. i'm also on milk thistle. i dont know if its helped my liver but i do know its helped my diabetes. at the moment, i take 600, but i feel that i'm not getting the max effect from it. i have been thinking about taking 900 (my milk thistle comes in tabs of 300 each), but didnt know whether i should or not cos my sugar levels may go too low. they are really well controlled at the mo and thats why, so far, i havent increased my dosage. any info would be good info.
thanks:)

Why not take milk thistle if you are on treatment? I am....is this a problem? Now I'm nervous.....

i know i didnt say dont take it while on tx, but i do know that here in the uk the docs say dont take it while you're on tx. this is, as far as i understand, because they wanna know exactly what the tx is doing and if you're taking alt meds too it is more difficult to decide what is doing what to your numbers, alt meds or the tx. i dont know if there is any other reason for not taking it on tx cos i havent gone through tx yet, but i'm sure there are lotsa others on here that can advise. good luck with your tx anyway. hope it works well for you:)

no yeah, just blue said don't take while on treatment, sorry if I messed that up. I am on tx and take it, and I don't want to do further damage to myself, right.

I would have to agree that there may be issues with taking milk thistle while on tx, but that can only be determined by your doctor, which is why I say at least let him know that you're taking it, before you go on tx or during.

As for how much, I've known people who take as much as 900mg a day (3x a day), but again, it's gradual thing. If you are taking 600 now, please consider asking your doctor about increasing it by 200 a week until you get to 900mg, or do enough research to be sure that the increase is what your liver needs right now.

Need I say it again? Yup. Me no doctor, no medical professinal person. Just someone who is repeating what's seen on web. :smile:

lol linda..... it seems it was me that messed up. no worries:) i knew you didnt think i said that cos its plain as anything that just blue did. lotsa brain fog today and v tired. sorry. sure you wanna be safe, but dont worry too much. ask your doc what he/she thinks. i'd be interested to know what he says so drop back and let us know. in the meantime embrace your tx (even tho you prolly hate every minute of it) cos its your friend. it wants to help you. good luck:)

jbk thanks for the advice. let me get this right tho. i must be stupid or something cos i'm not sure how to interpret what you said. "I've known people who take as much as 900mg a day (3x a day),....." are you saying you know ppl who take 3 x 900 a day or just 3 x tabs of 300 each please? 2700 sounds a heck of a lot to me!!! i'm sure you mean 3 x tabs a day (total 900 per day) yes? its late here, i'm tired and a touch of brain fog this end. not your fault, my stupidity. sorry and thanks:)
as for asking my doc. they dont go much on alt meds here in the uk and dont profess to know anything about them. my gastro told me to "research and try anything i wanted cos anythings worth a try.". so i did and here i am on milk thistle, but i am concerned about increasing the dose in case my sugar level go too low.

jbk..... one more thing if you dont mind:) what other issues do you know of regarding taking milk thistle while on tx please?

I did ask my dr before I started it, ya know, he gave me the whole, there's no research showing evidence it helps blah blah blah, the stuff he's gotta say, this I know to well; but he did say it was okay if I wanted to, that he didn't feel it would hurt me to take it. I notice it makes me "go" more, which I really don't need, sore fanny/not funny :) I'm a goof ball today! :):):)

My doctor does not have a problem with taking milk thistle on tx. They do want us to ask about adding any OTC or alternative med that is not on the list we gave them.

Wish doctors would get it together. Tylenol or Advil? Milk Thistle or no milk thistle. and on and on and on.....

Here's what I have to go on for milk thistle. Hope it helps.

Dosage and Administration.:

1.Unless otherwise prescribed:

12.5 g per day of powdered seed for making infusions and other galenical formulations to be taken by mouth. Formulations (e.g., dry extract noted below) equivalent to 200?00 mg per day of silymarin, calculated as silibinin.
Standard Milk Thistle dosage:Most clinical trials have used daily dosages of 420 to 480 mg silymarin, divided into two or three doses daily. Until the specific effects of each of the flavonolignans is known and products are available that contain standardized ratios of these components, the optimal dosage will remain unknown. Table 1 outlines the efficacy, safety, tolerability, dosage, and cost of milk thistle.
Milk thistle seed extract, 150- to 175-mg capsule, standardized to 80 percent silymarin, three times daily.Ultrathistle (seed extract bound to phosphatidylcholine), 360-mg capsule, three times daily

2.For liver diseases:

Dry extract 40:1 (w/w), 70% silymarin: Swallow one capsule containing 100 mg of silymarin, twice daily in the morning and evening. Swallow with sufficient amounts of fluid; or, take one capsule containing approximately 140 mg of silymarin, two to three times daily.

3.For digestive disorders:

Decoction: Place approximately 3.0 g seed in 150 ml cold water, bring to a boil and simmer for 20 to 30 minutes, three to four times daily.
Infusion: Steep approximately 3.5 g seed in 150 ml boiled water for 10 to 15 minutes, three to four times daily one half-hour before meals.
Note: Silymarin is poorly soluble in water; teas have been analyzed with only about 10% of the original levels of silymarin from the fruits. Thus, for hepatic benefits, the concentrated extract is recommended.
Tincture: 15 drops, four to five times daily; 1 ml, three times daily.
No severe side effects have been reported from taking milk thistle. Doses greater than 2500 mg (2.5 grams) per day have been reported to have a slight laxative effect, however.
Occasionally, individuals taking milk thistle have reported: Abdominal bloating,Diarrhea,Gas,Loss of appetite,Nausea,Stomach upset

4.Typical suggestions:

Daily protection dosage: for daily protection dosage,200mgs silymarin daily can be good for prevention and keep health.
Liver improve dosage: for person with damaged liver or liver index higher and need improve, or persons with habit of alcohol drinking, 420mgs Silymarin daily enough for improve and treatment.
Liver Patient dosage: for patient with hepatocirrhosis,hepatitis,liver tumor or liver index double times of normal data,normally suggest taken 600mgs daily for treatment,2~3times daily, same time cooperate with docter care and liver test for further treatment.
Dosage period: Silymarin for liver protection resulted in 2 to 3 months,so patients or takeners should be a little patient.
Interactions: Milk thistle may interfere with the effects of estrogen replacement therapy and oral contraceptives due to its possible estrogenic effects. The effectiveness of drugs that are broken down by the same enzymes that break down milk thistle may also be affected. If you take prescription medications, ask your doctor or pharmacist about possible interactions before you begin to take milk thistle.
Properties: Antioxidant, anti-inflammatory, anti-carcinogenic, hepaprotective, immunostimulating, possibly estrogenic
Hepato-protective: Protects liver cells from incoming toxins, thereby also allowing it to more effectively process and release toxins that are already built up in the system.
Hepato-tonic: Strengthens the liver to function more effectively.
Anti-depressant: By helping to move stagnant liver energy.
Demulcent: Soothes and moistens. For both kidney and bladder irritations, as well as mucous membranes and inflammations of the skin and integumentary system.
Laxative: Mildly lubricates the bowels.
Indicated for: Alcoholic hepatitis, alcoholic fatty liver, cirrhosis, liver poisoning and viral hepatitis. alcoholic fatty liver, liver poisoning. It can benefits adrenal disorders and inflammatory bowel syndrome. Psoriasis. Lowering cholesterol. Protecting the liver when taking strong drugs or medicine. Candida. Food allergies.
Apply Scope: for people suffering from liver disease,liver weak;patiens of hepatocirrhosis,hepatitis,liver tumor; patients with cholecystitis and icterus; persons with alcohol drinking habit and irregular rest shedules; persons working in circumstance contaminated.
Interactions: There are no reported negative interactions between milk thistle and other medications and herbs, although certain drugs with the same therapeutic properties as milk thistle may enhance the effect of the herb. Again, individuals should consult their healthcare provider if they are taking other medications concurrently with milk thistle.

Precautions:

Individuals who suspect they have a liver disorder should always seek care from a healthcare professional.
Milk thistle should always be obtained from a reputable source that observes stringent quality control procedures and industry-accepted good manufacturing practices. Consumers should look for the designations "U.S.P." (U.S. Pharmacopeia) or "NF" (National Formulary) on milk thistle labeling. Herbal preparations prepared under USP or NF guidelines meet nationally recognized strength, quality, purity, packaging, and labeling standards as recommended by the U. S. Food and Drug Administration (FDA).
Botanical supplements are regulated by the FDA; however, they currently do not have to undergo any approval process before reaching the consumer market, and are classified as nutritional supplements rather than drugs. Legislation known as the Dietary Supplement Health and Education Act (DSHEA) was passed in 1994 in an effort to standardize the manufacture, labeling, composition, and safety of botanicals and supplements, and in January 2000, the FDA's Center for Food Safety and Applied Nutrition (CFSAN) announced a 10-year plan for establishing and implementing these regulations by the year 2010.

Side Effects and Cautions:

In clinical trials, milk thistle generally has few side effects. Occasionally, people report a laxative effect, upset stomach, diarrhea, and bloating.Milk thistle can produce allergic reactions, which tend to be more common among people who are allergic to plants in the same family (for example, ragweed, chrysanthemum, marigold, and daisy). It is important to inform your health care providers about any herb or dietary supplement you are using, including milk thistle. This helps to ensure safe and coordinated care.

There are no known contra-indications to Milk Thistle supplements. There is, however, a caution for HIV patients, because many medications taken by individuals diagnosed with HIV/AIDS (PHAs) - such as protease inhibitors and non-nukes are processed by the liver enzyme CYP3A4 which is decreased by Silymarin. If Milk Thistle is taken by someone using protease inhibitors or non-nukes, it has the potential to raise levels of these drugs. This should not be a concern as long as levels of these drugs are monitored closely and dosage is adjusted to reach the desired levels.
Milk thistle may cause mild nausea and diarrhea, or loose stools. The herb may also cause an allergic reaction in some individuals, particularly those with known allergies to plants in the Asteraceae family (thistles, daisies, artichokes). No other widely reported side effects are known when milk thistle is taken in proper therapeutic dosages. However, people with chronic medical conditions should consult with their healthcare professionals before taking the herb.
Women with hormone-dependent conditions such as endometriosis, uterine fibroids, and cancers of the breast, ovaries, or uterus should not take or use milk thistle plant extract due to its possible estrogenic effects. Men who have prostate cancer should not take milk thistle without the approval of a doctor.Do not use in patients with allergies to members of the aster family.
Adverse effect: Generally well tolerated; infrequent reports of gastrointestinal disturbances; rare reports of pruritus, eczema, rash, and anaphylaxis*
Pregnancy: Milk thistle is considered safe to use during pregnancy and in women who breastfeed. However, there are currently no long-term studies on use of the herb during pregnancy or lactation. A woman should speak with her healthcare practitioner before taking any herbs and/or medications during pregnancy.

Safety and Acute toxicity:

Silybin

Chemical name: 4H-1-Benzopyran-4-one,2,3-dihydro-2-(2,3-dihydro-3-(4-hydroxy-3-methoxyphenyl)-2-(hydroxymethyl)-1,4-benzodioxin-6-yl)-3,5,7-trihydroxy-,(2R-(2-alpha,3beta,6(2R*,3R*)))-
CAS No.: 22888-70-6. Molecular Formula:C25-H22-O10. Molecular Weight:482.47
Synonmys: 7C3MT,Flavobin,Flavobin Spofa,Silibinin,Silliver,Silybin,Silybine,Silymarine I,Silymarin I.

Acute toxicity(LD50):Silybin
LD50-Lethal dose,50 percent kill. Intravenous.Rodent-mouse. 1056mg/kg.
Details of toxic effects not reported other than lethal dose value.

LDLo-lowest published lethal dose. Unreported.Rodent-rabbit.300mg/kg.
Details of toxic effects not reported other than lethal dose value.
Reference: YHTPAD Yaoxue Tongbao.Bulletin of Pharmacology.(China International Book Trading Corp.,POB 2820,Beijing.Peop.Rep.China)V.13-23,1978-88.For publisher information,see ZYZAEU.Volume(issue)/page/year: 18,404,1983.

There are a few sites that have some great info on this topic.
This one has some very interesting background, including many trials and its effects on diabetes as well as hep and cirr.
http://www.cancer.gov/cancertopics/pdq/cam/milkthistle/HealthProfessional/page7

Here's an interesting article on liver detox and milk thistle:
http://www.medicinenet.com/script/main/art.asp?articlekey=51086

One thing to be watching is the ingredients and percentages. How much of what is in that so called milk thistle product you are thinking of buying? As the 2nd article says, not all the products are the same. Be sure you check how much or even if any silymarin is in the item.

before treatment my doctor gave me a list of vitamins to take. they were C, E, SELENIUM, MAGNESIUM, B COMPLEX and MILK THISTLE. took half one day and the other half the next. i can honestly say that they helped alot. the days i didnt take them i really felt not as good.

as far as ADVIL or TYLENOL, he said no TYLENOL, it's bad for the liver. ADVIL is better. when i did take the ADVIL it really helped alot for the meds. ADVIL PM was great for sleeping too.