Two years ago, my friend Lisa died of cirrhosis at age 35. I know what you're thinking: She must have been a hopeless alcoholic to succumb to liver disease so young. But Lisa's cirrhosis was caused not by alcoholism but by hepatitis C.
Chances are, you've heard of hepatitis A and B but not C. The test to detect hepatitis C has been available only since 1990, and scientists still aren't sure how the viral liver infection spreads. It appears to be transmitted through contact with infected blood and body fluids -- through transfusions, sharing of intravenous drug needles, and unprotected sex. An estimated 4 million Americans now have hepatitis C, and 8,000 die annually from liver disease associated with the virus.
Unfortunately, people with liver disease have few options. Until recently, there was no treatment for hepatitis. Now there's interferon, but it is costly and causes many unpleasant side effects. For cirrhosis, all doctors can do is treat the complications.
Cirrhosis kills more than 25,000 Americans a year (almost as many as die from homicide). And you don't have to be passing out in gutters to get alcoholic cirrhosis. Over several years, as few as two to three drinks a day (particularly for women) can damage the liver. The liver also can be damaged by large doses of over-the-counter and prescription drugs, occupational exposure to toxic chemicals, and eating poisonous mushrooms.
But the real tragedy of liver disease is that a possible natural remedy does exist -- milk thistle -- and mainstream American medicine has virtually ignored it.
Milk thistle helps the liver in three ways: It binds tightly to the receptors on liver cell membranes that allow toxins in, thus locking them out; it's a powerful antioxidant; and it spurs repair of damaged liver cells. It's also remarkably safe. The vast majority of users report no side effects.
Pharmacologists began to investigate milk thistle based on anecdotal evidence from traditional herbalists. In 1968, German researchers isolated three liver- protective compounds, collectively known as silymarin, from the herb's seeds. They then produced a standardized silymarin extract that has proved effective in numerous tests of its ability to treat liver disease:
Scandinavian researchers recruited 97 heavy drinkers with liver damage, but not cirrhosis, and gave 47 of them silymarin for four weeks. The silymarin group showed significant decreases in abnormally high levels of several liver enzymes and showed a greater likelihood of returning to normal liver function. In addition, several German and Swiss studies found that hepatitis sufferers who received silymarin recovered more quickly than those who did not receive it.
In an Austrian study of 170 people with cirrhosis, those taking 200 milligrams of silymarin three times a day fared better than those taking a placebo. Within four years, 37 percent of the placebo group died of liver disease, compared to only 21 percent of the silymarin group.
Death cap mushrooms (Amanita phalloides) contain one of nature's most potent poisons. Silymarin, however, can block the poison's entry into liver cells. In a Swiss study involving 205 victims of death cap poisoning, 189 received standard medical care and 16 received silymarin. In the standard care group, 46 (24 percent) died. In the silymarin group, none died.
In one animal study, silymarin helped prevent liver damage from large doses of acetaminophen, the active ingredient in Tylenol. In other studies, silymarin protected the liver from damage caused by antibiotics, antidepressants, and antipsychotics.
However, in the U.S. silymarin remains virtually unknown outside of herbal medicine circles. Why? To win Food and Drug Administration approval, drugs must be proven safe and effective. That sounds reasonable enough. But proving safety and efficacy to the FDA's satisfaction costs millions of dollars per drug. There's only one way to recoup that kind of investment -- develop unique molecules that can be patented, own them exclusively for the patent's term, and sell them for major bucks (the main reason why so many drugs are so expensive). Silymarin cannot be patented. From the drug industry's perspective, why spend millions to win approval for a plant extract you can't make a profit on?
So silymarin falls through a major crack at the junction of capitalism and federal drug regulations, discouraging the use of a safe, clearly valuable, easily affordable medicine that could help tens of thousands of people with liver disease. The FDA should do what Germany has done -- create a panel of experts to review the scientific evidence and approve useful natural medicines, and then let drug companies market them. But I'm not holding my breath.
In the meantime, if enough people with liver problems use milk thistle, and enough doctors see them survive, eventually silymarin will become mainstream. And we don't have to wait for FDA approval. Silymarin is sold over the counter at most health food stores.
Lisa was vivacious, but her cirrhosis diagnosis embarrassed her into silence. None of her friends learned what killed her until after her death. Her decision not only denied her the support of those who loved her, it also kept me from telling her about milk thistle -- which just might have saved her life.
Best-selling author Michael Castleman is working on a home medical guide.