Topic: Milk Thistle while on Rifampin or Rifabutin
bcb1200
Frequent Contributor (1K+ posts)
Member # 25745
posted
So...I've seen people mention that you shouldn't be on both at the same time. Why not?
I've done it...but admit that every time I start Rifampin I have to stop due to high liver counts. Is that because of the Milk Thistle? Isn't it supposed to HELP the liver?
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
IgM Igenex +/CDC + + 23/25, 30, 31, 34, 41, 83/93
Currently on:
Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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posted
Milk thistle inhibits CYP3A4 and Rifampin upregulates CYP3A4. That's why they interact.
Rifampin would be increasing your enzymes by increasing the rate of metabolism of substances cleared by Cytochrome P450 enzymes (3A4 and 2C9). Check the hepatic metabolism of other drugs you take, as if they use CYP3A4 or 2C9, they could actually contribute to (or cause) your high enzyme count.
You can check for drug and supplement interactions here (not all supplements have been evaluated of course).
Perhaps something like Alpha Lipoic Acid would be effective, but I am not sure.
Posts: 967 | From A deserted island without internet access | Registered: Sep 2009
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posted
I have been on Rifampin for a couple of months and started taking Milk thistle a coule of weeks ago. Should I not be taking these together??
Posts: 376 | From New York | Registered: Jan 2011
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quote:I have been on Rifampin for a couple of months and started taking Milk thistle a coule of weeks ago. Should I not be taking these together??
Hard to say. Though I haven't looked it up, so I'm not sure how big the interaction is.
I am not sure how potent of an inhibitor milk thistle is, but it can potentially increase or decrease the half-life of other drugs that interact with the P450 system.
I personally take Milk Thistle even though I take Klonopin. Those two could *theoretically* interact, but I never noticed any difference when stopping/starting.
As far as Rifampin, I believe its half-life will be longer when taken with Milk Thistle (my brain isn't working too well right now and excuse me if I got that backwards).
A lot of herbs that help the liver are CYP3A4 inhibitors. Schisandra fruit is great for liver support and is a very potent CYP3A4 inhibitor (more than grapefruit).
Things like ALA and NAC are fine. I lean towards ALA for the liver (With vitamin C, Vitamin E, and Selenium) for preventing and repairing liver damage because in my experience it seems that NAC can actually hinder my DNA methylation (preventing detox) for some reason. Unfortunately there isn't medical text to back this statement up, but I have read some others with detox problems were noticing the same thing. And for boosting glutathione, B12, Folate, and P5P (a methylation protocol) seem to be much more effective than NAC in my experience.
Posts: 967 | From A deserted island without internet access | Registered: Sep 2009
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kidsgotlyme
Frequent Contributor (1K+ posts)
Member # 23691
posted
My daughter takes milk thistle and rifampin. I just make sure that she takes them away from each other.
She has been doing this for six months now and hasn't had any reactions. All of her blood work has been fine.
-------------------- symptoms since 1993 that I can remember. 9/2018 diagnosed with Borellia, Babesia Duncani, and Bartonella Hensalae thru DNA Connections. Posts: 1470 | From Tennessee | Registered: Dec 2009
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posted
My son takes milk thistle and Rifampin. The LLMD said to take milk thistle with lunch away form abx. He has done this for 4 months and all monthly blood work has been fine so far.
Posts: 54 | From Texas | Registered: Oct 2010
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