narraboth
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I am preparing my first oral PH cycle and reading forums and articles. For me, the first priority of a safe cycle is not limiting the lost of gains post cycle, nor the libido/mood's problem, nor even gyno; the first priority is liver health. gyno might be annoying but you will know the sign in its beginning and solve it; even you get it you can still solve it, or not solve it, it won't kill you, just annoying. But liver damage is a different story. Once you have syndrome such as jaundice, your liver already soaked in toxic unreleased bile for a while and quite some amount of liver cells died. You can recover from that for sure, but the damaged part was inflammed, thus has much higher risk to generate crrhosis, even liver cancer in the future. More terrible possiblity is acute liver failures; the day before you might have no problem at all and within one day you will get coma and be in ICU. The biggest trouble is, before that point you won't know, when you know it's a bit late.
I found most of guys here use Milk Thistle as a liver supporter so I made some search on line. There are quite some studies but I am not very sure about the quality. Then I found an AHRQ (Agency of Healthcare Research and Quality) evidence report about Milk Thistle:
(please google NCBI website)
21: Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects: Evidence Report/Technology Assessment Number 21
all research papers about milk thistle were checked carefully by independent scientists. In general, the results are:
' * Sixteen prospective placebo-controlled trials were identified.
* Interpreting the evidence was difficult because of inadequate reporting and study design regarding severity of liver disease, subject characteristics, and potential confounders. Outcome measures, dose, duration, and followup widely varied among studies.
* Four of six studies of chronic alcoholic liver disease reported significant improvement in at least one parameter of liver function or histology with milk thistle.
* In three of six studies that reported multiple outcome measures, at least one outcome measure improved significantly with milk thistle compared with placebo, but there were no differences between milk thistle and placebo for one or more of the other outcome measures in each study.
* Three studies evaluated the effects of milk thistle on viral hepatitis. The acute hepatitis study showed no improvement in liver function. Improvement in aspartate aminotransferase and bilirubin was significant in the study of acute hepatitis. Two studies of chronic viral hepatitis showed improvement in aminotransferases with milk thistle in one and a trend toward histologic improvement in the other.
* There were two studies of patients with alcoholic or nonalcoholic cirrhosis. In one study, milk thistle showed a positive effect, but no data were given. In the other, milk thistle showed a trend toward improved survival and significantly improved survival for subgroups with alcoholic cirrhosis or Child's Group A severity.
* Two trials specifically studied alcoholic cirrhosis. One showed no improvement in liver function, hepatomegaly, jaundice, ascites, or survival but did show nonsignificant trends favoring milk thistle in the incidence of encephalopathy, gastrointestinal bleeding, and death in subjects with hepatitis C. The other reported significant improvements in aminotransferases with milk thistle.
* Three trials evaluated thistle as therapy or prophylaxis in the setting of hepatotoxic drugs; results were mixed.
* Meta-analyses generally showed small effect sizes, some statistically significant and some not, favoring milk thistle.
* Available evidence does not define milk thistle's effectiveness across preparations or doses.
* Little evidence is available regarding causality, but evidence suggests milk thistle is associated with few, generally minor, adverse effects.'
Their brief conclusion is:
'Milk thistle's efficacy is not established. Published evidence is clouded by poor design and reporting. Possible benefit has been shown most frequently, but inconsistently, for aminotransferases, but laboratory tests are the most common outcome measure studied. Survival and other clinical outcomes have been studied less, with mixed results. Future research should include definition of multifactorial mechanisms of action, well-designed clinical trials, and clarification of adverse effects.'
OK, at least it got some possible benefits, which is not too bad if you compare to many other supplements we are taking anyway.
But then this sentence crasped my attention:
'No studies were found that evaluated milk thistle for cholestatic liver disease.....'
wait....
indeed, seems that most of positive studies that made about milk thistle and liver toxic effects were based on alchohol, Amanita phalloides or acetaminophen.
However, the mechanism of those things and oral steroid/PH on Hepatotoxicity is very different. There is a clear explanation in Wikipedia: Hepatotoxicity. In brief, toxin such as acetaminophen do hepatocellular damage more directly (in acetaminophen's case, it destroys glutathione thus kills liver cells), while anabolic steroids cause bile accumulates in liver rather than screet out, liver cells are then soaked in harmful bile and die, which is called cholestatic liver damage.
So, the thing is, anabolic steroids users need something to keep us from cholestatic liver damage. But can milk thistle do this? the evidence is poor.
I found most of guys here use Milk Thistle as a liver supporter so I made some search on line. There are quite some studies but I am not very sure about the quality. Then I found an AHRQ (Agency of Healthcare Research and Quality) evidence report about Milk Thistle:
(please google NCBI website)
21: Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects: Evidence Report/Technology Assessment Number 21
all research papers about milk thistle were checked carefully by independent scientists. In general, the results are:
' * Sixteen prospective placebo-controlled trials were identified.
* Interpreting the evidence was difficult because of inadequate reporting and study design regarding severity of liver disease, subject characteristics, and potential confounders. Outcome measures, dose, duration, and followup widely varied among studies.
* Four of six studies of chronic alcoholic liver disease reported significant improvement in at least one parameter of liver function or histology with milk thistle.
* In three of six studies that reported multiple outcome measures, at least one outcome measure improved significantly with milk thistle compared with placebo, but there were no differences between milk thistle and placebo for one or more of the other outcome measures in each study.
* Three studies evaluated the effects of milk thistle on viral hepatitis. The acute hepatitis study showed no improvement in liver function. Improvement in aspartate aminotransferase and bilirubin was significant in the study of acute hepatitis. Two studies of chronic viral hepatitis showed improvement in aminotransferases with milk thistle in one and a trend toward histologic improvement in the other.
* There were two studies of patients with alcoholic or nonalcoholic cirrhosis. In one study, milk thistle showed a positive effect, but no data were given. In the other, milk thistle showed a trend toward improved survival and significantly improved survival for subgroups with alcoholic cirrhosis or Child's Group A severity.
* Two trials specifically studied alcoholic cirrhosis. One showed no improvement in liver function, hepatomegaly, jaundice, ascites, or survival but did show nonsignificant trends favoring milk thistle in the incidence of encephalopathy, gastrointestinal bleeding, and death in subjects with hepatitis C. The other reported significant improvements in aminotransferases with milk thistle.
* Three trials evaluated thistle as therapy or prophylaxis in the setting of hepatotoxic drugs; results were mixed.
* Meta-analyses generally showed small effect sizes, some statistically significant and some not, favoring milk thistle.
* Available evidence does not define milk thistle's effectiveness across preparations or doses.
* Little evidence is available regarding causality, but evidence suggests milk thistle is associated with few, generally minor, adverse effects.'
Their brief conclusion is:
'Milk thistle's efficacy is not established. Published evidence is clouded by poor design and reporting. Possible benefit has been shown most frequently, but inconsistently, for aminotransferases, but laboratory tests are the most common outcome measure studied. Survival and other clinical outcomes have been studied less, with mixed results. Future research should include definition of multifactorial mechanisms of action, well-designed clinical trials, and clarification of adverse effects.'
OK, at least it got some possible benefits, which is not too bad if you compare to many other supplements we are taking anyway.
But then this sentence crasped my attention:
'No studies were found that evaluated milk thistle for cholestatic liver disease.....'
wait....
indeed, seems that most of positive studies that made about milk thistle and liver toxic effects were based on alchohol, Amanita phalloides or acetaminophen.
However, the mechanism of those things and oral steroid/PH on Hepatotoxicity is very different. There is a clear explanation in Wikipedia: Hepatotoxicity. In brief, toxin such as acetaminophen do hepatocellular damage more directly (in acetaminophen's case, it destroys glutathione thus kills liver cells), while anabolic steroids cause bile accumulates in liver rather than screet out, liver cells are then soaked in harmful bile and die, which is called cholestatic liver damage.
So, the thing is, anabolic steroids users need something to keep us from cholestatic liver damage. But can milk thistle do this? the evidence is poor.
