"Milk thistle, an herb used to support liver function, contains a group of bioflavonoids called silymarin. Silymarin may inhibit intestinal P-gp and liver CYP3A4.
Surprisingly, concomitant administration of milk thistle significantly decreased the absorption of metronidazole (a drug used to treat the spore form of Borrelia).[6]
This interaction could not have been predicted from knowledge of the herb's effects on drug metabolizing enzymes.
Moreover, vitamin C (500 mg/day) and vitamin E (400 units/day) decreased the effectiveness of metronidazole in treating H. pylori infection of the stomach.[7]
The mechanism of this interaction is unknown but suggests that anti-oxidants should not be used with metronidazole therapy."
Is this true, and if so, what do you use to protect your liver while taking flagyl?
Thanks, Kristie
Posted by micul (Member # 6314) on :
Yep, looks like it's true. I think that Mlk Th and anti-oxidants are a big reason why babs Tx fails so much. Artemisinin works by oxidizing, and people are greatly reducing the effects of it, and possibly Mepron, by taking these supps within 4 hrs of the meds. Here's what the Townsend letters had to say about it:
"A common misconception concerning milk thistle (Silybum marianum) is that, since it is a liver herb, it is likely to increase the metabolism and clearance of many drugs due to enhanced hepatic detoxification. This is certainly fueled by in vitro studies showing this effect (1) and an in vivo study in rats where high doses increased phase I hepatic metabolism. Oral administration of silymarin (100 mg/kg/day) to rats resulted in a significant increase in the activity of the mixed-function oxidation system (cytochrome P450; aminopyrine demethylation, p-nitroanisole demethylation). However, an experimentally-induced reduction in activities of the mixed-function oxidation system and glucose-6-phosphatase could not be prevented by pretreatment with silymarin.
In human volunteers, treatment with silymarin (210 mg/day for 28 days) had no influence on the metabolism of aminopyrine or phenylbutazone. (2) Concentrated milk thistle (silymarin) extract at commonly administered doses did not interfere with indinavir therapy in patients with HIV. (3) In other words, despite the findings of in vitro and in vivo studies, there was no evidence from clinical studies that milk thistle extract increases phase I/II liver metabolism. The reason behind this discrepancy is probably that normal clinical doses are not high enough to achieve the effects shown at the artificially high doses used in experimental models.
But a study has recently been published which, on the face of it, appears to challenge this position. (4) A clinical study was undertaken in 12 healthy volunteers. At first, subjects received metronidazole (Flagyl; a substrate for cytochrome CYP3A4 and CYP2C9) alone at a dose of 400 mg every 8 h for 3 days. On day 4, blood and urine were collected at different time points and metronidazole levels were measured. After a washout period of one week silymarin was given at a daily dose of 140 mg for 9 days. From day 7 both silymarin (140 mg/day) and metronidazole (3 X 400 mg/day) were given till the 9th day. On day 10, blood and urine were collected as above and the levels of metronidazole and its metabolite were measured. Administration of silymarin increased the clearance of metronidazole and its major metabolite, hydroxy-metronidazole (HM) by 29.51% and 31.90% respectively, with a concomitant decrease in half-life and maximum concentration. Urinary excretions of acid-metronidazole, HM and metronidazole were all decreased."
[ 09. February 2006, 08:42 AM: Message edited by: micul ]
Posted by Boomerang (Member # 7979) on :
Arrgh.............
Is this damned if you do, damned if you don't thing?
Posted by hopeful123 (Member # 3244) on :
DocLand & others--
thank you so much for posting and discussing this. i am a milk thistle flagyl taking lymie. wow.
i'm sticking with taking the flagyl until i talk to my llmd.
thanks again.
hopeful123 Posted by DeniseS (Member # 7276) on :
Thank you so much for posting this.
I guess one of my LLMDs is right in being so cautious about mixing drugs and supplements. Back goes the milk thistle, Vit C and Vit E to the unused supplements drawer.
Posted by micul (Member # 6314) on :
I don't know if the right approach is to totally abstain from using supplements, but surely they must be used prudently so that they give us the protection and nutrition that we need without interfering with the abx too much.
Like Boomerang says, "we're damned if we do, and damned if we don't." How much good is it going to do us if somewhere down the road we end up needing a liver transplant because of all the abx?
Posted by dontlikeliver (Member # 4749) on :
Am I correct in thinking that Milk Thistle may also interfere with ketek then? Doesn't Ketek have something also to do with CY3P4? I can't pretend to know how these things work or what they mean, which is whY I ask, because I have seen that number mentioned with Ketek and interactions with other drugs.
What about milk thistle and Mepron? Does anyone know for sure. I have heard they are not good to take together.
Posted by valymemom (Member # 7076) on :
We also take dandelion for liver support.....wonder if this could be used by those taking flagyl ( my one son).
I also got a mixture from NutriCology that contains 200 mg of dandelion, and the same of milk thistle and phyllanthus amarus extract. On the bottle it says phyllanthus (an herb) has been used for centuries to support liver function.
Posted by JimBoB (Member # 8454) on :
From all I have read, both here and elsewhere, and from my own personal experience, I persoanlly would KEEP the Milk Thistle and get rid of the flagyl.
There are many, many different abx that can be used in treatment.
I don't think I am alone when I think I would MUCH rather have a GOOD liver than a bad one.
THAT is the main reason why I detest abx, though I have had my share of them through the years. They destroy the good with the bad.
THINK, Act, Prosper.
Jim. Posted by caat (Member # 2321) on :
up
Posted by caat (Member # 2321) on :
If I was being treated I'd personally want to KEEP that very very expensive mepron and do the milk thistle after the protocol was over.
Posted by valymemom (Member # 7076) on :
I just was reading about bee venom and was directed to a Dr. K. site. Here's what he says......yes, it confuses things. I wonder though if anyone is taking wobenzyme.
Multiple antibiotic regimes have been tried with varying successes. The cystic stage responds only to one antibiotic: metronidazole (Flagyl). This drug should be given intravenously. The oral version is less effective and hard on the liver. It should always be given together with the herb “milk thistle�? because of its liver-protective effect. A less toxic alternative is tinidazole, a Flagyl-derivative that is available in compounding pharmacies.
I use proteolytic enzymes for the purpose of breaking up the cyst wall and making the dormant form of B. burgdorferi inside the cyst vulnerable to both the host's immune system and the medications given for treatment.
Dosage: Wobenzyme, 8-10 tablets three times/day between meals and first thing a.m.
My preferred treatment is a combination of enzymes, herbs, specific transfer factors and the injection of honeybee venom.
Posted by micul (Member # 6314) on :
"Dr. Stratton Cautions on Protecting the Liver In recent correspondence, Dr. Stratton has been discussing reports in the medical literature that certain antibiotic agents can cause liver damage or failure.
Noting that these agents are typically the most potent anti-chlamydials, he has drawn some important hypotheses from this that anyone on an antibiotic protocol should know about.
His cautionary note is that use of some of the new, powerful agents against Cpn must be carefully monitored, and that a more gradual treatment for many is advisable.
His observations also affirm the importance of supplementsii in their liver-protective role.
Dr. Stratton notes: "A recent report of Ketek causing liver failure has crystallized some thoughts that I have had for some time. Cpn can infect the liver and the kidney, but in particular the liver is a target due to the Kupfer cells. Any drug that acts against Cpn (including statins) will therefore in some patients cause hepatic damage or even hepatic failure.
The better the activity against Cpn of the agent (or combination of agents), the more likely the liver damage. Even penicillamine can cause liver damage, as does Augmentin.
"Surprisingly, the only anti-chlamydial agent that did not cause hepatitis in some patients was NACi. In fact, NAC is recognized as being protective. See attached references.
My conclusion is that NAC should be the first agent in an anti-chlamydial regimen and should be a constant part of the therapy for this protective effect, not to mention it's effect against elementary bodies.
This, of course, is another reason to go slowly, but liver damage has been seen with only a few days of Ketek, for example. Notice the NAC in the Clarithromycin-induced hepatic injury in the end seemed protective in that transplantation was not needed.
I think this caveat needs to be in the therapy Website. Although we have not seen hepatitis in any of our patients at Vanderbilt, soon or later this could happen."
Dr. David Wheldoni concurs that this is a very important observation by Dr. Stratton, noting that it takes someone of Dr. Stratton's depth of understanding about Cpn's affect on body systems to recognize these reports as possibly Cpn related (ie not necessarily toxicity originating from the drug itself).
Dr. Wheldon notes that, in addition to NAC, supplements such as Alpha-Lipoic Acid, acetyl-L-carnitine, selenium and zinc, are also important liver protectors. These all have been recommended supplements for people taking a combination antibiotic protocol for Cpn."
Posted by DocLand (Member # 7794) on :
Micul, Could you please tell me what Cpn is? Thank you! Kristie
Posted by micul (Member # 6314) on :
So, what's the general consensus on this one? Just take the milk thistle 4 hours away from any ABX?
I know the milk thistle is important with long term ABX.
Husband is on Flagyl now. Should he continue with Milk Thistle or not?
I think he should.....since he's been on ABX for close to 5 months now.
Thoughts? Thanks.
Posted by JimBoB (Member # 8454) on :
Five months on abx, steady, is way too long.
What is the matter with these ducks anyhow?
We have two lungs, two eyes, two ears, legs, arms,testicles, ovaries, hands, feet, etc., but only ONE liver, ONE heart, ONE stomach, ONE colon.
GET THE PICTURE?
I LOST MY COLON. I surely don't want to lose my liver or heart too.
Geeeeez, people. THINK. Even if your ducks can't.
Get on a treatment protocol that will SAVE your body, not destroy it. WHAT about those who have already died from Ketek? WHO is going to be next?
HOW lame do our Lyme brains have to become before we DO something about our treatment regimen?
I was headed down that road to a degree also, but not anymore.
NO more abx for me. There ARE better ways!
Jim Posted by JimBoB (Member # 8454) on :
caat:
It is okay to KEEP the "expensive" Mepron; just don't take it!
Milk Thistle isn't going to do you ANY good, AFTER your liver is destroyed. You take it NOW to help, if at all possible, to keep it from BEING destroyed.
THINK!
JIM. Posted by Marnie (Member # 773) on :
It does appear that the acids...as well as the minerals... "compete" with one another.
Another example...the toxins in cigarette (not the nicotine - addictive - locking onto acetylcholine receptor, but the other stuff) appear to compete with Vitamin C.
Our liver, our major "detox" organ,is capable of amazing regeneration.
It contains 2000 mitochondria PER CELL. These are the powerhouses of our cells where Mg-ATP is stored.
It also contains some other nutrients...notably B6 and a day's worth of glycogen (in case of starvation - our brain and WBCs need glycogen).
Milk thistle is given in Germany to counteract the toxins (acidic) from eating the "wrong" mushroom. It is thought to act to release Mg to do this.
Another acid may do the same. ALA...as in the OTC supplement developed by Prof. Bruce Ames called Juvenon.
ALA is a very powerful anti-oxidant. This is really, really important in lyme disease because way too many damaging free radicals are happening. We need to raise the pH...
Hydrogen is THE most powerful "antioxidant".
Vitamin E is known to help by RELEASING hydrogen thus raising the pH....become more alkaline.
Personally, I think the soy lecithin in Juvenon is not bad, but needed...for the choline replacement as well as the phosphorus and Mg...for starters.
Personally, I'd rather take natural supplements as opposed to man-made drugs.
We mess things up when we try to duplicate them. Example: Foxamax. It is a bisphosphate...analog to pyrophosphate. However, Foxamax causes an INCREASE in TNF alpha, an INCREASE in CRP, a DECREASE in Mg, a risk for uveitis...the list goes on.
P.S. Interesting website talks about Flagyl and Mg for tetanus:
[ 01. March 2006, 08:17 AM: Message edited by: Marnie ]
Posted by dontlikeliver (Member # 4749) on :
So far, there is ONE report of a death from Ketek, and it was reported that the 'victim' also used alcohol while on Ketek, which is not advisable.
Posted by Marnie (Member # 773) on :
Ethanol overload...from the alcohol converting as well as thanks to Bb.
Posted by DocLand (Member # 7794) on :
Boomerang,
With my husband, he has decided to continue with the milk thistle while he does his one week a month of cyst-busting flagyl. He gets quite a herx-like reaction from the flagyl even with taking both at the same time.
Micul's article shows that milk thistle will decrease both the half life and the blood concentration of flagyl, so my husband is not getting as much from each flagyl pill as he could, but is still having a positive outcome, i.e. a herx.
And he feels that protecting his liver is important in the big picture, since he also takes ketek, doxy, and diflucan.
His decision was made with the knowledge/approval of his LLMD.
I orginally started this post to gather information so that my husband and I could be better informed about some of the medications (and their interactions) that he is taking. With what we have learned, I feel comfortable with that decision.
Kristie
Posted by Boomerang (Member # 7979) on :
Thanks Kristie. It just amazes me how many different answers you can get from a simple question.
We're like you...we think taking the milk thistle is important WHILE taking the ABX. It doesn't seem right to take it after any damage has been done. Husband had blood work done in January, and all was fine with liver, etc.
Your husband does a week of "busting"...and off for three weeks? How does that work? What doseage?
I think my husband needs to do something like that. He pushes the flagyl too much to suit me. But he wants to get well so badly, he just keeps pushing the ABX.
I hate fuss at him, cause I know how frustrated he is.
Thanks!
Posted by JimBoB (Member # 8454) on :
Boomerang:
Did you ever hear the old saying: "Less is More"?
You can only do SO MUCH with abx's. After that you are just throwing good money after bad. It is a waste.
So then what?
GO full time with herbs. He will FEEL better and GET better, faster. Abx's are NOT the cure all for Lyme, to be sure. They have their place, but definitely NOT the cure all.
I totally agree with you that the Milk Thistle is SUPER important. Another thing you may strongly consider for his liver and the REST of his Lymph SYSTEM is Red Root. Read about it in Buhner's book.
To MY knowledge, I have had NO trouble with my liver in my treatment so far. Another cleanser I am taking is Smilax. Very important for cleaning the blood.
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