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Complementary & Alternative Medicines (CAM)

There is a great deal of information available on diet on the internet with many people offering dietary advice.

If you have liver disease, it is important to seek advice from your doctor and ask to be referred to a dietitian before taking any complementary medicines or dietary supplements.

Your doctor or a registered dietitian will have full access to your medical history and be able to offer advice that is specific to you and will not interact with any of your other medications.

Registered dietitians are also regulated, whereas other professionals such as those working in health food stores or for example as Chinese herbalists or nutritional therapists are not. There are many complementary and alternative medicines that are available that claim to ease the symptoms of liver disease or to reduce your risk of developing liver disease. Most of these medicines are processed by the liver, and can be very dangerous to people with liver problems. Some can damage the liver and make you more severely ill.

Most complementary and alternative medicines or treatments are based on principles and an evidence base that are not recognised by the majority of independent scientists. At present, healthcare professionals are not clear on the role and place of some therapies in managing liver disease. More research needs to be done on the use of such therapies.

Many products are not classified as a medicine and therefore are not licensed, which means you cannot be sure how much of the active ingredient you are getting or how pure it is. Traditional herbal medicines do not have to undergo the stringent regulatory processes that medical drugs have to; therefore manufacturers do not have to prove effectiveness in well-designed large trials.

It is wise to be cautious about the claims made for herbal remedies, particularly those advertised on the internet, as they can offer false hope.

Please do not take these remedies before discussing them with your doctor.

What about food supplements and vitamins?

When you have cirrhosis you may find that you have trouble absorbing all of the vitamins and minerals in your diet.

However, a wide variety of dietary supplements may cause damage to the liver. For example, supplements containing vitamin A, green tea extract, kava (often taken for anxiety or insomnia), conjugated linoleic acid supplements (sometimes used for slimming), noni juice have all been reported as causing liver damage. It is therefore important to discuss with your doctor or registered dietitian before taking any dietary supplements.

Does milk-thistle help the symptoms of liver disease?

Milk-thistle (also known as Silybum marianum) is an over-the-counter supplement, which some people believe can be beneficial to people with liver disease. Some laboratory studies have shown the herbs active components (silymarin) have a positive effect on liver cells38. However, milk-thistle is not licensed as a medicine and so studies into its effectiveness in the body have been limited, with conflicting results. If milk thistle is not properly produced it can also contain other toxins that are harmful to people with liver disease.

There is not currently enough evidence to prove or disprove any beneficial effects on the liver. Milk-thistle may lower blood sugar levels and people with diabetes or hypoglycaemia (low blood sugar) should use with caution. If you are thinking of using milk-thistle, please discuss this with your doctor.