The claimEvidence B · meta-analysis
My transaminases came down, so my liver has healed
The evidence
Transaminases are enzymes that leak from ruptured hepatocytes — a leakage reading, not a function reading; in end-stage disease with nothing left to leak it reads normal, and it fluctuates on its own, so any before-after pair of draws may show a fall.
The mechanism, in brief
Nearly every liver-pill pitch lands on the same sentence: my transaminases came down. That marker deserves its own scene, because it measures something other than what most people assume.
Sources (3)
- National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Milk Thistle. In LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Human trials in chronic liver disease have been 'promising but inconclusive'; milk thistle itself has not been implicated in serum enzyme elevations or clinically apparent liver injury (likelihood score E); intravenous purified silybinin is approved in Europe for Amanita phalloides poisoning.
- Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., et al. (2012). Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial. JAMA, 308(3), 274-282. SyNCH trial, N=154, silymarin 420 or 700 mg three times daily × 24 weeks vs placebo: no significant difference in decline of serum ALT and no difference in HCV RNA — higher-than-customary doses did not help.
- Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., et al. (2018). The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328-357.