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Hi @jandgritz001, I'd like to bring @rosemarya @foustr68 @gema98 and @jackieg into this discussion for their thoughts.

I did a bit of poking around for evidence on the use of Milk Thistle (Silybum marianum) with Primary Biliary Cholangitis (PBC). In short, the experts seem to say "Milk thistle is OK although there is little data in patients with PBC." https://liverfoundation.org/2017-pbc-chat/

The conclusion of this 2020 review of studies, says it's promising but more research is needed.
– The Potentiality of Herbal Remedies in Primary Sclerosing Cholangitis: From In Vitro to Clinical Studies https://www.frontiersin.org/articles/10.3389/fphar.2020.00813/full
"… due to the complexity of PSC and the lack of established cures, the roles of Silybum marianum, Curcuma longa, Salvia miltiorrhiza, and quercetin should be better evaluated in properly designed clinical studies. The possible use of these natural compounds alone or in combination with traditional drugs could represent a very promising field for future researches and therapies."

Have you talked to your specialist about your long time use of Milk Thistle, Jan?

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Replies to "Hi @jandgritz001, I'd like to bring @rosemarya @foustr68 @gema98 and @jackieg into this discussion for their..."

I should’ve tagged @athenalee on this discussion too.

Thank you for the info. I see my Gastro in early December. I do let all my doctors know what supplements I take, they are all included in my health records.

As Colleen cites, there are mixed reviews on the benefits of milk thistle, although I’ve never come across any references that say it’s harmful. Here’s a summary – https://www.webmd.com/digestive-disorders/milk-thistle-benefits-and-side-effects

Here’s a Mayo overview- https://www.mayoclinic.org/drugs-supplements-milk-thistle/art-20362885

I took it when I had liver disease as I figured it wasn’t harmful and there seemed to be some positive benefits. You’ll note in the Mayo info that milk thistle like virtually all herbal supplements have drug interactions. This is important to keep in mind if you do need a transplant. Most herbal supplements interact with calcineurin inhibitors, including Tacrolimus, which are essential medications for transplant recipients.

My liver doctor said the most important thing was to eat as healthy as possible, eat good fiber sources, get plenty of protein, limit sodium and fatty foods, exercise, and drink plenty of water and coffee! She wasn’t concerned about the arsenal of herbal supplements I was taking, as long has I took my ursodial.

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