Gastroenterologists frequently recommend milk thistle. Carole does not recommend it, but she does not discourage patients from taking it. It is not a panacea, but it does have its place, similar to saw palmetto for prostates. Here is a blurb from one medical journal:
SUMMARY — Historically, milk thistle was used as a digestive tonic; a general tonic for the spleen, stomach and liver; for the gallbladder; to promote bile flow; and as a stimulant for milk flow in nursing mothers. Milk thistle appears to supply important compounds for hepatic detoxification reactions (including drug metabolism) and to block the hepatotoxic effects of some compounds. It has also been used in a variety of liver disorders.
PHARMACOLOGY — The activity of milk thistle is reported to be derived from silymarin, which is composed of three primary flavonoids (silybin, silydianin, and silychristin). Silymarin reportedly alters the composition of hepatocytes, limiting entry of hepatotoxins, and stimulates protein synthesis as well as hepatic regeneration. Silymarin increases hepatic glutathione by over 35%. Glutathione is an important antioxidant in detoxification reactions, acting as an important sulfhydryl donor. Milk thistle is also reported to inhibit inflammatory effects of leukotrienes which could contribute to hepatic damage. Milk thistle is reported to be hepatoprotective against psychotropics (eg, phenothiazines, butyrophenones), ethanol, acetaminophen, and other drugs that modify hepatic function (Morazzoni, 1995).
Silybum marianum (milk thistle), given alone or in combination with traditional therapy has limited scientifically proven value, although it is commonly used and probably safe . Because it has active properties, it continues to be studied. (See "Emerging therapies for hepatic fibrosis").
And for balance, a negative or neutral blurb:
Silymarin — Silymarin (silybum marianum) is a natural component of milk thistle, which has exhibited promising anti-fibrotic activity in experimental liver injury and is widely used as a non-prescription agent in patients with chronic liver disease, particularly those with HCV. Based upon its structure, silymarin belongs to a group of flavonoid compounds, the other members of which include quercetin, baicalin, and baicalein (see below). These flavonoids have drawn increasing attention because of their antifibrogenic properties . Silymarin functions as an antioxidant and may decrease hepatic injury via cytoprotection and inhibition of Kupffer cell function. Despite its theoretical benefit, a systematic review that included 14 studies found no clear evidence showing a reduction in mortality, improvement in liver histology, or biochemical markers of liver function in patients with chronic liver disease . Similar conclusions were reached in an evidence report on the efficacy of milk thistle in liver disease performed through the Agency for Healthcare Research and Quality (http://www.ahrq.gov
I guess everyone has to decide for themselves if the value is real or not. I have seen patients liver enzymes improve with milk thistle, but it is anecdotal.