Does Milk Thistle really work for steroid users?
- 03-13-2010, 07:51 PM
Does Milk Thistle really work for steroid users?
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.....'
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.
- 03-13-2010, 07:58 PM
an AD in this anabolicminds website is actually worthy reading. In the AD of somewhat milk thistle juice, there is a very nice description about how prehormones cause liver problem. However, the conclusion of that AD is not what I recommand. they claimed that milk thistle juice can effectively protect liver from bile accumulation, which I didn't see a solid research base.
- 03-13-2010, 08:16 PM
So what is your conclusion on possible alternatives? Or do you not have one?
This is definitely an interesting study even with the small sample size, liver damage is such a hard beast to ascertain but "AHRQ" seems to have done a decent job. I personally continue to supplement with milk thistle, more because I feel much better when I do than when i don't. But hey, maybe thats a placebo effect. Either way I don't plan on stopping anytime soon.
Interesting find narraboth, Repped.
03-13-2010, 08:54 PM
I myself will use milk thistle too, if i decide to do the cycle in the end. It's not expensive anyway (at least in the UK) and won't do bad. It's just that I won't rely on milk thistle only if I am going to use methyl compound.
for alternatives, some people here suggest Tauroursodeoxycholic acid (TUDCA), which is Liver Longer actually. I can't comment much because I havn't read much about it. In theory it should do the work of increasing bile screet. It's funny that I think milk thistle juice did a ad article more suitable for Liver Longer did... The complete AD of Liver Longer is also not bad to read though. It's expensive, but if I am going to do Havoc cycle I think I will have to use it.... or whatelse can I have?
03-13-2010, 10:16 PM
yeah liver longer is a great product, personally i take a week of milk thistle supplementation before my cycle and then start liver longer or pro liver upon the start of the cycle. If your running a methylated compound i would definitely recommend one of those two for during the cycle, they make a huge difference.
03-14-2010, 05:02 AM
n-acetyl cysteine is used to treat acetaminophen over dose, rebuild the glutathione system in liver. still, it's a different mechanism from anabolic steroid generated liver damage. and the bio avaliability is low in oral taking. (see wikipedia: n-acetyl cysteine)
I checked TUDCA on pubmed. It seems that it can somehow support liver function in cholestasis in many reports, although it failed to prevent choletasis from Total parental nutrition in new born babies....
For how to use, yeah, maybe it's good to start liver longer on cycle. Currently there is no evidence that TUDCA can prevent anabolic steroid generated choletasis anyway. Also not everyone can really afford using liver longer from pre cycle to the end of post cycle.
03-14-2010, 05:11 AM
run milk thistle before cycle and after/or on PCT. Run liv 52, life suport, cycle support or other liver products that contain NAC during cycle and PCT really if u have enough.
03-14-2010, 07:23 PM
again, i don't think NAC directly handle anabolic steriods caused liver problem since it's different mechanism.
it may decrease liver pressure somehow though.
03-14-2010, 07:47 PM
03-21-2010, 10:26 PM
Personally, I'll be looking into TUDCA and liv.52 for future cycles, thank OP.
also, don't forget aspirin and NAC
Paging Dr. Banner. . .
03-22-2010, 09:52 AM
03-23-2010, 10:32 PM
SAMe is also a good option, although expensive.
03-23-2010, 10:38 PM
03-24-2010, 08:13 AM
03-24-2010, 10:13 AM
I mean, NAC is not the compound to 'prevent' liver accumulate bile (which is the reason why Superdrol cause liver damage)?
The NAC studies I saw are mainly about preventing liver damage from acetaminophen?
acetaminophen use up all glutathione ---> liver cells died
NAC restore glutathione --> protect liver cells
anabolic compounds won't directly decrease the glutathione; they decrease the bile flowing out thus make liver cells 'soaked' in bile and die.
For the damage-already-there, NAC has no big help even for acetaminophen toxified liver. If you want to rescue a acetaminophen overdose guy, you got to give NAC within 12-16 hours; longer than that the guy might still die.
03-24-2010, 10:16 AM
03-24-2010, 10:18 AM
Cycle support has both RYR and idebenone in addition to silymarin, NAC, hawthorne, grape seed extract, etc.
M.Ed. Ex Phys
03-24-2010, 12:55 PM
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