Is it safe to take Milk Thistle with Primary Biliary Cholangitis?

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?

Since PBC is a new diagnosis for me and I do not know anything about milk thistle I cannot comment on its use. I am taking Ursodiol and so far the Dr is happy with the lab results. Thanks to everyone for your comments and information.

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

@jandgritz001, I had PSC, which is chronic progressive disease that affects the bile ducts and can lead to cirrhosis. One of the first questions that my PCP and GI asked me was whether I was taking any vitamins, herbs, or supplements. Here is information about Milk thistle. https://www.mayoclinic.org/drugs-supplements-milk-thistle/

I read that the research shows mixed results about using it to treat some liver diseases. With any liver disease, you want to be careful of what you put into your body. Some prescription medications, over the counter medications, alcohol, and natural supplements and vitamins can actually cause harm. Always check with your doctor, especially when living with a liver condition.
Your GI or liver specialist is the one who can tell you if this is safe to continue, or if you should stop taking it. We are all different and our bodies react differently.
Does your GI or liver specialist know that you have been taking it for a long time? What is your reason for taking Milk Thistle and what benefits are you experiencing?

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.

Thanks so much for info.

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.