Raloxifene is a selective estrogen receptor modulator (SERM) that is used to reduce the risk of invasive breast cancer in postmenopausal women with osteoporosis.

Researchers at Washington State University and the University of North Carolina at Greensboro evaluated the inhibitory effects of individual milk thistle constituents on the intestinal glucuronidation (detoxification) of raloxifene.

First, the details.

• The inhibitory effects of individual milk thistle constituents on the intestinal metabolism of raloxifene were studied in the lab.
• UDP-glucuronosyltransferase 1-1 (also known as UGT-1A) is an enzyme in human intestines, which along with UGT1A8, and UGT1A10 are critical to metabolizing and removing raloxifene from the body.

And, the results.

• Milk thistle components silybin A and silybin B were potent inhibitors of raloxifene metabolism.

The bottom line?

The authors concluded: “Silibinin and silymarin [the major active constituents] were predicted to increase raloxifene systemic exposure by about 5-fold, indicating a high risk of interaction. Safety of raloxifene is discussed here.

It’s understandable that these women seek CAM, including herbals, to supplement raloxifene treatment.

It needs to be studied in humans, but for now, the risk of taking milk thistle would seem to outweigh any potential benefits. Check with your healthcare professional.

6/20/15 JR

Silymarin (Silybium marianum), an extract of milk thistle, is often used to treat chronic liver disease.

Researchers with the Silymarin in the NASH and C Hepatitis (SyNCH) Study Group studied its effect when combined with interferon. (more…)

Standard therapies are of limited value for obsessive compulsive disorder (OCD).

Researchers at Swinburne University of Technology, in Australia, reviewed the value of CAM, self-help techniques, and lifestyle interventions. (more…)

The botanical extract silymarin (milk thistle,) has anti-oxidant, anti-inflammatory, and immunomodulatory properties and is used by patients with chronic liver disease.

Researchers throughout the U.S. collaborated to evaluate the response to high doses of silymarin taken by mouth on disease activity in patients with chronic hepatitis C. The results were presented during the American Association for the Study of Liver Diseases November Annual Meeting. (more…)

Cytochrome P450 2D6 (CYP2D6) is a liver enzyme responsible for the metabolism of approximately 30% of all drugs.

Researchers at the University of Arkansas for Medical Sciences in Little Rock studied the effect of CYP2D6 on the metabolism of several herbal supplements and the risk of drug interactions. (more…)

Milk thistle is often used to treat chemotherapy-associated liver toxicity.

Researchers from the US studied it in childhood acute lymphoblastic leukemia (ALL). (more…)

The American Botanical Council (ABC) has published a 40-page review of an emerging new product and market category called “energy shots.” The report focuses on shots sold mainly in the United States and the United Kingdom. (more…)

Dr. Sharon Jacob from the University of Miami/Jackson Memorial Medical Center in Florida and colleagues reviewed the scientific support for herbals used by patients with psoriasis.

Here are the highlights.
(more…)

Milk thistle is sometimes taken as a natural treatment for liver problems.

Unfortunately, most milk thistle supplements contain less than the labeled amount of silymarin. (more…)

Ms. Meenakshi Khatta is a nurse practitioner and associate professor at the University of Maryland in Baltimore. Nurse Khatta has reviewed the use of CAM to treat pain due to musculoskeletal conditions.

Here are her findings on herbal supplements used to treat fibromyalgia, osteoarthritis, and rheumatoid arthritis. (more…)

Here’s a follow-up to an earlier post on the use of CAM in the US in 2007 as surveyed by the National Center for Complementary and Alternative Medicine (NCCAM). (more…)

Researchers from Johns Hopkins University in Baltimore have reviewed natural health products (NHPs) and antiretroviral drugs (ARVs). Here are the results

(more…)

Milk thistle is used as an alternative therapy for liver disease.

Researchers in Seattle, Washington examined the effect of silybin on iron status in patients with hepatitis C. (more…)

Researchers in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial looked at the use and response to silymarin (milk thistle extract) among the patients in the study. (more…)

The review article is posted on the American Family Physician website. In addition to diagnosis and pharmacological treatment, it covers diet and exercise.

CAM options are not included. (more…)

A friend asked me to look into CAM treatments for fatty liver disease. I did, but found little to support milk thistle — the most often discussed CAM treatment.

(more…)

It’s easy to fall into the trap of using names incorrectly, assuming that differences are unimportant.

Milk thistle extracts are being studied to treat cancer and lessen the side effects of chemotherapy. Here’s what we should know, terminology-wise. (more…)

At the end of 2006 I listed milk thistle as a supplement worth additional research. This was because of a study in people with diabetes where milk thistle was associated with a decline in A1c circuclating in blood.

Now, ConsumerLab.com has tested 12 milk thistle products. (more…)

MayoClinic.com gives milk thistle (Silybum marianum seed extract [silymarin]) a “C” grade for its role in the treatment of diabetes. In other words, there is “unclear scientific evidence for this use.”

But this might change as a result of this study on the effect of milk thistle on A1c in people with type 2 diabetes.

(more…)

Milk thistle and butterbur

Here’s why.
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