Cases in CAM: Milk Thistle for the Liver -- Any Evidence?

Désirée Lie, MD, MSEd

Disclosures

March 02, 2010

Case Study

Mr. Y is a 40-year-old divorced car dealer who admits to binge alcohol consumption over the weekend with his buddies, consisting of 5 to 12 bottles of beer each on Friday and Saturday nights. He reports that he is sometimes inebriated and awakes the following morning with a hangover and amnesia for some of the previous night’s events. His father died of alcoholic cirrhosis at age 54 years. He is on no medications other than acetaminophen for occasional headaches. At his annual physical he expresses a desire to control his alcohol intake because of a new relationship he has forged which he believes has long-term potential. His new girlfriend has urged him to seek medical advice to control his alcohol intake. He denies alcohol dependence manifested as withdrawal symptoms when he misses the 'weekend booze.' His girlfriend brought up milk thistle as a treatment and suggested that he ask the doctor if it can reduce his appetite for beer and/or counteract acute effects of liver damage from alcohol consumption. She was also wondering whether milk thistle could improve her own complexion and reduce wrinkles.

On examination, Mr. Y is healthy and normotensive with no physical signs of chronic liver disease. A metabolic panel including liver function tests (LFTs) is normal. His last alcohol binge was 5 days ago.

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