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Silymarin prevents hepatotoxicity caused by anti-tuberculosis drugs

A number of herbal preparations, including silymarin (milk thistle or milk thistle extract), are capable of preventing or reducing the hepatotoxicity of a number of anti-tuberculosis drugs without affecting their therapeutic effect.

A group of Turkish researchers studied the hepatoprotective properties of silymarin in an animal model (rats) using two different combinations of anti-TB drugs (isoniazid, rifampicin and pyrazinamide). Treatment with these drugs results in approximately a 2-fold increase in ALT and a 75% increase in AST and alkaline phosphatase. In addition, combinations of anti-tuberculosis drugs cause a significant decrease in serum albumin and total protein levels and, in addition, a double increase in total bilirubin.

As the results of this study have shown, with the simultaneous intragastric administration of silymarin and a combination of anti-tuberculosis drugs, there is a significant decrease in the activity of enzymes in blood serum, the level of albumin and total serum protein increases, and the level of total bilirubin also decreases compared to that of rats receiving only anti-tuberculosis drugs. drugs. Co-administration of silymarin with anti-tuberculosis drugs also leads to a decrease in the incidence and severity of fatty hepatosis and focal liver necrosis compared to the use of the above SAPs only.

Thus, silymarin has important protective properties aimed at preventing the development of drug-induced hepatotoxicity for the treatment of tuberculosis. However, to start using silymarin or its components in humans, high-quality randomized, placebo-controlled trials are necessary.