Study on Vitamin E and Milk Thistle for Liver Scarring

Alternative Medications May Help Prevent or Delay Onset of Liver Scar Tissue in Patients with Chronic Hepatitis
UCSF researcher presents data on vitamin E, milk thistle and herbal products
by Jorge Herrera, MD

Jacquelyn J. Maher, MD, from the University of California in San Francisco presented exciting data regarding the efficacy of herbal products and nutritional supplements in preventing or delaying the formation of scar tissue (fibrosis and cirrhosis) in the liver of patients with chronic hepatitis. Dr Maher spoke at the postgraduate course in Dallas held in conjunction with the the annual meeting of the American Association for the Study of Liver Disease (AASLD).

Now that the basic process of how the liver lays down scar tissue is known, research can be done to determine if different compounds can stop the liver from developing scar tissue. Vitamin E supplements were found to be effective in diminishing the amount of liver scar tissue that developed in rats exposed to a poison that causes cirrhosis. Silymarin, which is the active component of milk thistle was studied in 1989 in patients with liver cirrhosis secondary to alcohol and found to be beneficial. The Japanese compound sho-saiko-to also known as TJ-9, which is a mixture of different herbal products, has been found to reduce scar tissue in rats with cirrhosis by 25%. In addition, it appears to have anti-tumor effects, decreasing the risk of cancer. As the knowledge about liver injury increases, we will likely find more traditional and alternative medical products that may prevent or improve cirrhosis in patients with chronic liver disease.

Complementary and Alternative Medicine for Chronic Liver Disease

Leonard B. Seeff, MD, from the National Institute of Health (NIH) in Bethesda, Maryland, gave a report on the recent NIH Symposium focusing on the issue of botanical preparations and herbal preparations available to treat chronic liver diseases. He spoke at the postgraduate course in Dallas held in conjunction with the annual meeting of the American Association for the Study of Liver Disease (AASLD).

Dr. Seeff presented data showing that most patients with chronic liver disease use some type of alternative medicine products and that "conventional" Western science needs to examine these products to find out which ones are effective and helpful and which ones may be harmful. He pointed out some herbal products that appeared to be beneficial and deserve further study.

Some of the potentially beneficial herbal products listed by Dr Seeff included milk thistle and sho-saiko-to (TJ-9) as mentioned above. In addition, he noted that Glycyrrhizin (licorice root extract), a product used in Japan for the treatment of hepatitis, appears to have anti-inflammatory properties and improves ALT levels when given intravenously. Some studies have been reported using glycyrrhizin in pill form for the treatment of viral hepatitis. One study gave interferon only or interferon plus glycyrrhizin to patients that had failed to respond to interferon. ALT levels normalized in 33% of those receiving interferon only, but in 64% of those receiving the glycyrrhizin in addition to the interferon. HCV-RNA became undetectable in 38.5% of those receving the herbal product, but in only 13% of those treated with interferon only.

Another interesting product is Compound 861. This is a liquid medicine that contains 10 herbs based on traditional Chinese medicine. This compound appears to be anti-fibrotic (prevents or improves the scar tissue in the liver). A study in China gave this compound to patients with hepatitis B and found improvement in most patients.

The NIH has allocated funds to be used for research related to herbal products. Hopefully we will soon be able to tease out those products that are effective from those who may not help at all or even be harmful.

11/7/99