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AHRQ releases new evidence report on use of milk thistle to treat liver disease

The Agency for Healthcare Research and Quality recently released the summary of an evidence report on Silybum marianum, also called milk thistle, an herbal remedy often used to treat liver conditions. Milk thistle is a member of the aster or daisy family and was used by ancient physicians and herbalists to treat a range of liver and gallbladder diseases and to insulate the liver from a variety of poisons.

Ten key research questions guided development of the evidence report. The questions focus on whether milk thistle supplements, compared with other therapies, alter the physiologic markers of liver function, reduce illness or mortality, or improve the quality of life of adults with alcohol-related, toxin-induced, or drug-induced liver disease.

The EPC researchers were unable to clearly establish the clinical efficacy of milk thistle due to insufficient evidence. They reviewed 11 electronic databases searching for evidence about milk thistle and ultimately narrowed the field to 16 placebo-controlled studies. However, research methods varied widely among the studies, and the researchers found it difficult to assess the evidence because of incomplete information. Overall, their analysis did suggest that there may be positive effects associated with milk thistle, but poor study methods and poor reporting of research findings hampered their ability to draw definitive conclusions from the evidence. The review did show that taking milk thistle at typical doses is unlikely to cause harm.

The evidence report was prepared for AHRQ by the San Antonio Evidence-based Practice Center (EPC) at the University of Texas Health Science Center and the Veterans Evidence-based Research, Dissemination, and Implementation Center (contract 290-97-0012). AHRQ sponsored development of the report at the request of the National Center for Complementary and Alternative Medicine, a component of the National Institutes of Health. AHRQ-supported evidence reports provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies.

Select Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects to access the summary online.

Print copies of the summary (AHRQ Publication No. 01-E0240) are also available from the AHRQ Publications Clearinghouse. Copies of the full report (AHRQ Publication No. 01-E025) will be available in spring 2001.

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