00:02:45 Glenn:        Welcome back to Natural Health for People and Pets. I'm co-host of the show, Glenn Cooke, and after a long hiatus, I'm gonna introduce the host of the show, Narelle Cook.  

00:02:54 Narelle:       Hello everyone. Oh my goodness, I don't know where time goes.  

00:02:57 Glenn:        I do, on CanineCeuticals.

00:03:00 Narelle:        Yeah, it does.  

00:03:01 Glenn:        I'm a widower, a work widower to CanineCeuticals these days.

00:03:05 Narelle:        Unfortunately, that is the reality of running a small business and growing a business.  

00:03:10 Glenn:        That's becoming successful. 

00:03:12 Narelle:        But all good, here we are for another episode.  

00:03:14 Glenn:        And you've been doing your ‘Thursday Thoughts’ and all that on your Instagram and your social media.  

00:03:19 Narelle:       If you're not following me on social media, it's canine.ceuticals on Insta and Facebook. But the New Year's resolution was to try and have a greater presence on social media, so I am trying to put my anxiety aside and every week do a ‘Thursday's Thoughts’ because I come across so much interest in scientific information that I think is so relevant for the average pet parent is to share that information.  

00:03:40 Glenn:        That's good. I think people really appreciate it 'cause they get to have a little bit of an insight on what's happening there.  

00:03:46 Narelle:       The funny thing is the topic that I picked for this podcast, I did so because I had anticipated releasing it in December. What we're gonna talk about today is Milk Thistle, which is a herb, and the botanical name of which is Silybum Marianum. Traditionally Milk Thistle is used to treat a range of liver disorders, gallbladder disorders, things like hepatitis, fatty liver disease, cirrhosis, lots of stuff around the liver. So I thought, ah, perfect for the lead up to Christmas, in December everyone's having a bit more to drink. Yes, I would educate them about the benefits of Milk Thistle for liver health, but I missed that one.  

00:04:18 Glenn:        It's still January, people are still on holiday and Australia Day's coming up.  

00:04:24 Narelle:       Yeah, so if you've had a big December with drinking and eating and you're still celebrating with friends and families over the holidays, then this will be a really relevant podcast for you.  

00:04:33 Glenn:        Absolutely.  

00:04:34 Narelle:       Milk Thistle is one of the common names of Silybum Marianum, and it's probably one of the most common names used, but there are lots of other ones. So it's often referred to as Mary's Thistle, St Mary's Thistle. Oh my goodness, this is not good for my lisp.  

00:04:47 Glenn:        So many thistles.

00:04:49 Narelle:       Holy Thistle, Our Lady's Thistle. A lot of those common names come from a legend about the white veins on the leaves of the plant. And the legend is that those white veins were caused by a drop of breast milk from Mary, the mother of Jesus when she was nursing him. So that's why you get the St. Mary's Thistle and the Holy Thistle.  

00:05:08 Glenn:        Ah.  

00:05:09 Narelle:        So yeah, a bit of an interesting fun fact.  

00:05:12 Glenn:        Isn't it funny, old folklore, where people don't really care to look it up or bother about it. But now that you've explained it, that's something that I didn't know. Once again, I'm educated on this show.  

00:05:22 Narelle:        Yes. So whenever I research a podcast, I always have in my mind, I've gotta keep them short and sweet. But I think I've failed again today, so I'll try and just get to it. Jumping straight into how Milk Thistle works in the body, to have all these amazing liver protective properties and general health promoting benefits, which we'll go into in a little bit. Firstly, it acts as an antioxidant, that means it can inhibit free radicals that come about from the metabolism of toxic substances. Things like alcohol, paracetamol, or for those in the US acetaminophen. Anything that comes into the body gets processed by the liver, but these toxic substances are particularly damaging in terms of free radical damage. Milk Thistle can stop that, it can actually protect the cell membranes from that free radical induced damage.  

00:06:08 Narelle:        And it can increase the activity of enzymes, which play a really important role in the defense system of our cells. Things like glutathione, which many people may know, is a master antioxidant in the body. In addition to antioxidant properties, it has anti-inflammatory properties, and that's due to its ability to regulate compounds called cytokines, which are responsible for triggering inflammation in the body. It's been shown to down regulate and inhibit the expression of Cox2. And that is also a major mediator of inflammation in the body in that regard. Many people may be familiar with the drug Celebrex which is a type of non-steroidal anti-inflammatory drug that acts as a COX2 inhibitor and that's how it's working to reduce pain and inflammation. But how interesting that Milk Thistle is also working on the same Cox2 inhibition that these common prescription medications are doing.  

00:06:58 Narelle:        You're not gonna get the same potency, but it's still beneficial in that regard. Milk Thistle also shows promise as an antifibrotic agent. In this regard, it can indirectly prevent the deposition of collagen fibres in the liver and that's what leads to the progression of liver injury. So if you think about cirrhosis of the liver, that scarring of the liver, that's through the deposition of all these collagen cross fibres. It's early days in the research, but there's evidence to show that Milk Thistle can prevent that scarring from happening to the same degree, which can slow down the development of cirrhosis of the liver. There's evidence to show the Milk Thistle stimulates the process by which cells make proteins, and this is where its role comes into play for repairing and replacing cell tissue, particularly damaged liver tissue. So that's really awesome.  

00:07:49 Narelle:       But probably my favorite benefit in terms of the action of Milk Thistle in the body is its anti-toxin effects. Milk Thistle has the ability to regulate the permeability of the cell membrane, but even more importantly, it can inhibit toxins in viruses from binding to the cells, in the case of viruses entering the cell and multiplying, or in the case of toxins entering the cell and killing it. So whenever I read research around that antitoxin effect, I always get this visual, it's not scientifically accurate of course, but I imagine a little soldier going around the outside of the cell, and then whenever a virus or a toxin approaches, he takes up arms and protects the cell.

00:08:31 Glenn:        Those little analogies or even those visuals help people who don't have a scientific background and don't understand the science behind it. So sometimes simplifying, it is helpful to your audience.  

00:08:42 Narelle:       Yeah, and whenever I think about free radicals and free radical damage, I always think of little Pacmen going around the body, nom, nom, noming and damaging cells and tissues. So keep that one in mind.  

00:08:53 Glenn:        Pacmen and soldiers, got it.  

00:08:55 Narelle:        A really good example of Milk Thistle's antitoxin effect is in relation to poisonous mushrooms. Many people may know of the death cap mushroom and that it produces a toxin that is deadly if you ingest it and you're not treated quickly. But they did a review of hundreds of documented cases of death cap mushroom poisoning, and they found that the overall mortality or the death in patients treated with Milk Thistle was less than 10% in comparison to more than 20% if patients were only treated with penicillin. For example, additional case studies have shown that if Milk Thistle is given within 48 hours of poisoning, only mild to moderate liver injury is observed. But if it goes for more than 48 hours untreated with Milk Thistle, severe liver damage, coagulation disorders, coma and death are likely to occur. But the really sad thing is they've actually tested this on dogs, now that wouldn't get past any ethics communities these days, but back in 1978 and 1984, they gave a number of beagles, a decent amount of death cap mushroom, and then they had a treatment group that got Milk Thistle.  

00:10:00 Narelle:       They had a control group that didn't, and the Milk Thistle was actually given intravenously in these studies. But the first study showed that all of the liver enzymes of dogs that received Milk Thistle remain nearly normal throughout the test period. The dogs in the control group that didn't get Milk Thistle, had significantly elevated liver enzymes. And then in the second study, four of the 12 dogs in the control group died. And then the histopathology showed severe liver necrosis. So that's like the death of the liver tissue. Whereas none of the dogs died in the Milk Thistle group and their liver histopathology was nearly normal. So that's pretty phenomenal, just for a herb to have such a protective effect against such a powerful toxic agent.  

00:10:44 Glenn:        There you go. In essence, you've got a herb versus a fungi. You've got a tiny little mushroom that can take your life, and you've got another one that can enhance and save your life and it's incredible. I know I've embarked on this before, but it still makes me laugh when people say herbal medicine is woo. Well, there's so much evidence to support that it's not and just in my limited understanding, those two examples really showcase how people have got it so wrong sometimes.  

00:11:23 Narelle:       Yeah, absolutely. And the other thing with herbal medicine, yes, the research is definitely increasing, but there's not a lot of people willing to fund a lot of the research. So people need to keep in mind, no evidence doesn't equate to negative evidence. When it comes to herbs, we do base it a lot on traditional use, but it's great to see that the evidence is increasing. So if you've got a dog that likes to run around eating random things off the ground, including potentially mushrooms, I know I worry about that in the yards around our house. I know we don't have death cap mushrooms, or any probably poisonous mushrooms, but I still see mushrooms and just get paranoid and pick them all out. 

00:11:57 Glenn:        Well, they're not mushrooms that we see, sometimes they're toadstools. After good rains and a little bit of humidity here and there, I often go out in the fields and I spot fungi of some capacity that have popped up and I often do the same thing, I pluck them out just in case. You know, we've got a bored and trained dog that runs along and hoovers them up like a greeted Labrador or something like that.  

00:12:28 Narelle:        Yeah, so if you do have a dog that does hoover things off the ground, or you live in an area where there are mushrooms that may not be good for you or your dog, keep a bottle of Milk Thistle in the cupboard.  

00:12:40 Glenn:       What about dogs that scoff chocolate? Would it help against that toxicity from chocolate?  

00:12:45 Narelle:        Good question. I'm not sure, I've got a feeling it would be a different mechanism of action, of the theobromine, in what it's doing to the dog, versus a toxin trying to attach to a cell. But yeah, now I'm gonna have to look into that. They're the main ways by which Milk Thistle will work in the body, and as I mentioned at the beginning, the main uses and what most of the studies revolve around are it's benefits in various liver diseases, like toxic liver damage, chronic liver disease, alcoholic liver disease, non-alcoholic fatty liver disease, viral hepatitis infection, and liver cancer. But there are lots of other areas of health that Milk Thistle can help us with. It's just that the research isn't as robust. But that's not to say there isn't any science behind these other conditions that I'm not gonna touch on now, but just putting that out there. It’s good for reducing cholesterol levels in anyone with hypercholesterolemia, and the way it does this is by reducing cholesterol synthesis in the liver as well as increasing the rate of cholesterol conversion to other compounds. And people don't realise that, let's say all of our sex hormones, estrogen, progesterone, testosterone, our steroid hormones, you know, things like cortisol, they all come from cholesterol, it's the beginning compound and they all are derivatives of cholesterol. So having too little cholesterol is also not a good thing.  

00:14:10 Glenn:       So once again, it's the Goldilocks syndrome, just right. 

00:14:13 Narelle:        But by reducing cholesterol, obviously that can help in the prevention of various cardiovascular diseases. It can help prevent gallstones by reducing cholesterol levels in the bile and by increasing the fluidity of the bile. Bile gets released by the gallbladder. We want it to be nice and loose and fluid and not sludgy and causing blockages and forming stones, so it can help with that. And because it does stimulate the production of bile, this also helps with digestion, particularly fats and breaking down fats, but also absorbing the fat soluble vitamins, which are A, D, E, and K. We cannot absorb fat soluble vitamins if we don't have enough bile in the body. Bile is essential for removing toxins from the body via the faeces. So again, if you don't have enough bile, toxins won't be pulled outta the body in a timely fashion.  

00:14:58 Narelle:       So you can get a buildup of toxins in the body. If you know someone, or if you experience symptoms of fat intolerance like nausea, headaches, if you're chronically constipated, these can all be related back to poor liver function and poor bile production. In addition to Milk Thistle, there are other herbs that can stimulate bile as well, but we won't go into those today. Milk Thistle has been shown to be great for protecting the liver from exposure to the drugs used in chemotherapy. The preliminary research shows that combining Milk Thistle with the chemotherapy drug Cisplatin can reduce the toxic effects of that drug and enhance the anti-tumor activity. That's pretty awesome. And there's evidence it can protect against drug and stress-induced gastric ulcers. Something that I'm sure no one thinks about, but because it's a really potent antioxidant and people forget that sperm and eggs, if you're trying to get pregnant, the sperm and the eggs are really vulnerable to oxidative damage. So Milk Thistle can actually help promote fertility by reducing the oxidative stress that can negatively impact sperm and egg development and health. Just wanna put a little note in here if you are planning to get pregnant, anything new, introduce it well before you start trying. Ideally speak to a professional for preconception support.  

00:16:13 Glenn:       So this really is a people and pets episode.  

00:16:16 Narelle:        It is, isn't it? I'm jumping back and forth. I will get into the dog stuff a bit more deeply shortly. I just really wanted to cover the broad range of health conditions that Milk Thistle can touch on.  

00:16:26 Glenn:        It's actually good if we have a symbiotic relationship between the two, because you can have it in the cupboard and use it for yourself, and you can have it in the cupboard and use of your dog.  

00:16:34 Narelle:        Absolutely.  

00:16:34 Glenn:        Unless it's indicated for dogs only. 

00:16:37 Narelle:        Yeah, but really fascinating. There's research to show that it also has a neuroprotective role in conditions such as Alzheimer's, Parkinson's disease, epilepsy, MS. I haven't gone down the rabbit hole of how it's helping in those conditions, but there was a recent review paper highlighting that it does help in those conditions. It's been shown to have a role in psychiatric disorders as well, things like anxiety and depression. And part of the way it's working there is to restore certain levels of neurotransmitters in the brain, but more interestingly is by reducing inflammation in the brain. So we know now that inflammation and psychiatric disorders are closely tied together. And remember that movie Brain On Fire? Did you ever watch that?

00:17:20 Glenn:        No, I didn't.  

00:17:22 Narelle:        It's a few years ago now.

00:17:23 Glenn:        Was that the one where they had to use the clock to get it back? Yes, I have seen it, and it was only one doctor that figured out what it was. He showed her a clock face or something like that.  

00:17:34 Narelle:        They thought she was psychotic,  this one doctor figured out she just had a certain disease that caused severe inflammation of the brain.  

00:17:42 Glenn:        Spoiler alert.

00:17:45 Narelle:        Oh, it's an old movie. Hopefully everyone's seen it by now.  

00:17:47 Glenn:        Well, if you haven't, it's a good movie anyway.  

00:17:49 Narelle:        Yes. Some of the compounds in Milk Thistle have been shown to work in a similar way to diabetic medications, and in that sense can help improve insulin sensitivity and decrease blood sugar. An interesting thing about Milk Thistle, again, that many people may not realise is that it can chelate or bind to iron and decrease iron excess. So not good if you're anemic, but awesome if you suffer from hemochromatosis, that's an iron overload condition. It's a genetic condition because excess iron causes a lot of oxidative stress in the body, and particularly in the liver. So what the liver does when there's too much iron in the body, so think of too much iron in the body, oxidising and literally causing internal rust, so to speak. To protect the organs and the tissues of the body, the liver actually pulls any excess iron into itself and stores it there, which is great for the rest of the body, but eventually will lead to cirrhosis of the liver and all the consequences of that.  

00:18:48 Narelle:        So, it can help with iron excess, but if you're anemic, you'd wanna be careful. Milk Thistle’s been shown to stabilise Mast cells. And I've definitely spoken about Mast cells in past episodes with the PEA, so that can help with allergic conditions by having an antihistamine effect in the body. And just the last sort of additional health benefit that I'll touch on today, 'cause there are lots more, is that it's being shown to protect against kidney damage due to drugs and toxins. Particularly things like Cyclosporine and the chemotherapy drug Cisplatin. But they're suggesting now that Milk Thistle for kidney health might be just as important as it's role in liver health. I just found that really interesting.  

00:19:26 Glenn:        It is very interesting.  

00:19:27 Narelle:        We are very liver centric when it comes to Milk Thistle. But as the research evolves, so does our understanding of its benefits. So I guess why would you give Milk Thistle to your dog? Because as I said, a lot of those conditions I've just mentioned are more relevant to humans than dogs, but we have to remember, whether we're talking about humans or dogs, our livers are performing just hundreds and hundreds of vital functions 24/7, it doesn't stop. It helps the digestion of food, it helps break down food, it helps in the creation of nutrients, it regulates blood sugar, it regulates amino acid levels, blood clotting, stores vitamins and minerals. But one of the main roles I wanna focus on today in relation to dogs is that because it's filtering the blood in the body and removing toxins, well, not just toxins and metabolic byproducts, you've got bacteria and other harmful substances. We need to always remember the greater exposure that our dogs get to environmental toxins compared to us.  

00:20:25 Glenn:       Considering they're omnivores and they forage and pick up things off the ground and they eat things that they probably shouldn't eat.

00:20:33 Narelle:        The fact that they are close to the ground, and I actually wrote a blog post about this very topic, but to quickly summarise the key points, the environmental working group, which is in the States from memory, they actually tested the blood and urine of pet dogs and cats and they found that they were contaminated with dozens of industrial chemicals, with 43 chemicals at levels higher than those typically found in people. Every time I think of that, it blows my mind because if you think of a five kilo cat, or a 15 kilo dog having a greater chemical body burden than a 70 or 80 kilo human being, it's just scary. And you know, the most prevalent chemicals that they found in our pets are from the Teflon family. Think of non-stick pans, plastic softeners, stain proofing chemicals, fire retardants.  

00:21:22 Narelle:        New furniture, it's got stain sealant and fire retardants and a lot of the plastic toys and bowls that our dogs are using are gonna have toxic chemicals in them. If you've painted your house, toxic fumes and chemicals, and it just goes on and on. And because they're close to the ground and things stick to their fur and then they lick their fur, they're ingesting all of these chemicals. But from the study, and I'll just highlight the dog results, 35 chemicals were identified in dogs. 11 were known carcinogens, we know the rates of cancer are just skyrocketing in our dogs these days. 31 were toxic to the reproductive system, and 24 were neurotoxins. Thinking about the reproductive system, I get a lot of allergy dogs and they seem to be getting younger and younger with more severe symptoms. And I always think, what happened to that puppy when it was still in the mum? What was the mother exposed to that changed the epigenetics of that puppy to make them so susceptible at such a young age to environmental toxins and compromised immune function. I'm not saying that's causing it, but it makes you stop and think. And with 24 being neurotoxins, I know there's a million factors that can influence dog behavior, but potentially this is one piece of the puzzle. The fact that our dogs are exposed to so many chemicals that are impacting their neurology and their brain health and their brain function  

00:22:40 Glenn:        Well, you'd have to expect some form of mutation to occur from it.  

00:22:44 Narelle:        I think going forward, the evidence is just gonna reveal so much interesting information around the connection.  

00:22:50 Glenn:       It's a common thing that I've spoken about in some of my other experiences, being that I'm in my fifties now and I recall going to school and knowing that one person who had an allergy was an outlier to everybody else. There was one asthmatic at school and there was one person that had some form of allergy that was a complete outlier to every other student in the school. Like it was an anomaly. Those people are kind of focused on, what's wrong with you? Why do you have this thing? Fast forward 50 years later, it's a common denominator. There are children everywhere across the world that if they even sniff a peanut, they're literally going into anaphylaxis. Those concerns are the mutations that must have occurred through chemicals, and exposures, and food groups, and processing and all those sort of things. So it's no wonder that we see mutations in behavior, and mutations in physicality because there are things that are in our environment that are mutating our genes. 

00:23:49 Narelle:        It's just crazy, isn't it how it's shifted so significantly.  

 00:23:53 Glenn:       I've seen the evolution of it. There are people that maybe are 20 years old now or maybe a little older that look at it and go, that doesn't sound right. But they haven't lived those extra 20, 30 years that I have. They haven't seen what I've seen. And it's not to say that it wasn't more abundant in different areas, it's just that I didn't see it growing up. And I changed schools a lot when I was younger, we were shifting around quite a fair bit. So, you know, I was probably in school for three, four years at a time before I was shifting to a new location. And every time I shifted the same process, kids who had allergies or asthmas, it just wasn't prevalent. It wasn't so known in comparison to what it is these days. I guess that's the point I'm trying to make.  

00:24:34 Narelle:       Yeah, banning certain food groups from lunchboxes just wasn't a thing back in the day. 

00:24:42 Glenn:        We only really ate mostly fresh foods. I mean we still had Cheezels and Twisties and all those sort of things, but most of the time it was sandwiches.  

00:24:53 Narelle:       But we could have peanut butter on our sandwich  

00:24:54 Glenn:        Good point, you could have peanut butter. Peanut butter wasn't restricted from school. In fact, there were peanut butter sandwiches sold in the cafeteria.  

00:25:02 Narelle:        Yeah, we'd better move on then.  

00:25:05 Glenn:       We better  

00:25:06 Narelle:        The allergy rant. So in addition to toxins from the environment, other factors can contribute to poor liver health in our dogs. Genetics, some dogs are just predisposed, certain breeds are predisposed. Infections can trigger liver issues in our dogs. Regular prescription medications, we're giving our dogs a lot of chemicals on a monthly or three monthly basis. So all of that in my mind is the reason that we need to support our dogs' liver health function. And that's where Milk Thistle can come in and play a significant role. So if we jump into the dog specific studies, well firstly there's a veterinary textbook,  it's called the Veterinary Herbal Medicine textbook and it's like a bible of herbal medicine for animals. It states a number of indications for the use of Milk Thistle in animals. They say hepatitis, toxic injury to the liver, especially aflatoxicosis. Now that's really interesting that they mention that specifically, because a lot of… 

00:26:03 Glenn:       What is that?  

00:26:04 Narelle:        It's a mycotoxin, it comes from fungi. When you see grain that's contaminated with mould, that's creating mycotoxins and aflatoxins are a type of mycotoxins and aflatoxicosis is poisoning due to aflatoxins.  

00:26:21 Glenn:       I think that's what happened in Salem when the rye got mouldy. It created almost an LSD effect and that's where they were seeing demons and accusing people of witches and so forth. Interesting story. Look into it. 

00:26:34 Narelle:        I hope I explained that correctly, but what's interesting is a lot of kibbles have been tested for this mycotoxin contamination and in some studies a hundred percent of kibble test positive for some level of mycotoxin contamination. And aflatoxins are actually hugely carcinogenic, they're so detrimental to health it's not funny. That's one of the benefits that the textbook mentions. Fatty liver, this is really interesting as an adjunct for giardia treatment, but not to treat the Giardia, but to decrease the adverse effects of the drug that's used to treat the Giardia and also for the protection of the pancreas during pancreatitis. I know a lot of dog owners have dogs with chronic pancreatitis, so Milk Thistle would be a lovely safe edition in those instances. But just touching on that Giardia study, it was done in 2005, and I won't go through the methodology, but what was interesting is that side effects were not observed.  

00:27:33 Narelle:        With Milk Thistle, the main constituent that's extracted is called Silymarin. Silymarin is made up of multiple sub compounds and then those sub compounds are made up of additional sub compounds, so the chemistry of Milk Thistles is quite complicated. But in this study they used a Silymarin extract and the drug was, I hope I pronounce this correctly, Metronidazole. The dogs that didn’t get the Milk Thistle with the drug, experienced vomiting and reduced body weight. But if they were given the Milk Thistle with the drug, they didn't experience any of those side effects. The dogs that didn't get the Milk Thistle also had increased liver enzymes. That was just really interesting about its veterinary use to protect against the veterinary drug. Other studies have been done more recently in 2021 looking at the effects of Milk Thistle on healthy dogs and then dogs with liver disease.  

00:28:23 Narelle:        And they found that supplementing with Milk Thistle didn't interfere with nutrient digestion. It didn't have any detrimental effect on liver function or any blood parameters. But in dogs with liver disease it decreased their liver enzymes and improved liver function overall. It’s good to know that basically there are no adverse effects to its use. I won't go into the studies.The dog studies are all saying Milk Thistle can decrease liver enzymes in the case of elevated liver enzymes. But something that  I often get asked is about dosing. But it's so tricky because it really does depend on the individual dog or the person and why you're wanting it. Whether you wanna use it preventatively or there's an actual disease diagnosis that you're trying to target. But in the human health space, the typical dose of silymarin ranges from let's say 400 to 600 milligrams per day.  

00:29:17 Narelle:        But studies have gone much lower than that and much higher than that. If you are giving or taking Milk Thistle, ideally it's best taken in divided doses. Let's say someone, a human, was taking 600 milligrams per day, you might do that twice a day or three times a day. The research does state that higher doses are needed for more serious liver disease and for more chronic conditions that it must be taken over an extended period for maximum efficacy. That's really interesting because I see a lot of comments online and I get a lot of emails to CanineCeuticals from pet owners who are using Milk Thistle with their dogs and they've read online that it shouldn't be given every day long term. But I cannot find a strong reference to actually support that line of thinking.  

00:30:01 Glenn:        That's interesting. I was about to ask you, is there any negative downside to Milk Thistle?  

00:30:06 Narelle:        The studies are saying the sicker your liver is, the longer you need to use it every day. Human research actually goes up to 41 months of daily use. That's the longest study that I've seen referenced, so what's that three and a half years?

00:30:21 Glenn:       Yeah, something like that. 

00:30:22 Narelle:        So technically I can't say it's safer for a person to use it for longer than 41 months.  

00:30:27 Glenn:        No, it's nearly four years.  

00:30:30 Narelle:        I went through the mechanism of action of Milk Thistle at the beginning of the show, you know, antioxidant, anti-inflammatory, antitoxin. I can't see how any of the way that it's working in the body would be detrimental to use every day, long term, in terms of liver function. And even a lot of the key herbal references, and if there are any naturopaths from Australia listening, you'll know about the Mills and Bone Phytotherapy reference book, it's like a bible to herbalists in Australia. They even state no restriction on long-term use. It's a bit of a gray area, but I don't see an issue. I mean most people aren't gonna give it every day without a break to their dog for 10 years.  

00:31:09 Glenn:        So the authority figures who are putting out paper and publication are saying it's safe to use. And it's just individuals who feel that it's not,  

00:31:18 Narelle:        Yep, some of that's coming from animal herbalists from back in the day when maybe we didn't have the same knowledge that we have now about how it is actually working in the body. And you know how those things just carry on over time. Even if they were believed to be accurate then, and even if we know they're not now, those things just persist, particularly with the internet being what it is. And even the veterinary textbook said Milk Thistle should be used for at least eight weeks, every day for eight weeks to see improvements in blood markers. So if you've gone to the vet, your dog's got elevated liver enzymes and you're like, we're gonna jump on some Milk Thistle, you need to give it for at least eight weeks before you go and get retested to see any changes in those blood markers.  

00:31:58 Narelle:        So in terms of safety, while we're talking about dosing and safety. In 2016, the European Medicines Agency actually published an assessment report just on Milk Thistle. Within that report they stated that there have been no cases of overdose with Milk Thistle. They said that data from clinical trials showed low toxicity and that the data was obtained from more than 4,000 patients. That treatment duration ranging from one month up to 41 months, the frequency of adverse events was reported as low. And even according to the pharmacological studies included in the report, they say that Milk Thistle is recognized as a safe herb since taking it at therapeutic doses is not toxic. Lots of benefits, lots of positives around the safety and the dosing. But like everything, it's not without its potential side effects, but they are stated as rare. It's the exception rather than the rule. If someone were to react to Milk Thistle, things that they might experience are mild gastrointestinal symptoms such as dry mouth, nausea, gastric irritation, potentially diarrhea, headache, and there've been some skin symptoms reported as well, like hives. But I imagine that's someone who's probably got an allergy to the plant.  

00:33:15 Glenn:       Which is possible.  

00:33:16 Narelle:        Yeah. Milk Thistle is part of the plant family called the Asteraceae family. That includes other plants such as ragweed like Daisies, Marigolds, Chrysanthemums. So if someone's got an allergy to any of those types of plants, chances are they'll also react to Milk Thistle 'cause it's part of the same family. Keep that in mind.  

00:33:36 Glenn:       So if they do have the reactions, what would you recommend?  

00:33:40 Narelle:        Stop taking it and see your doctor or your vet. Because it's a bit harder to know if your dog's got a Marigold reaction or not, you know, to that family. There's no safety data in kids, so don't give it to children and probably not even puppies I'd say, although I'll have to look into that now that I've said it. I didn't actually look at the puppy research. Anything around children and pregnancy. There's like just a default caution. Because even with Milk Thistle and pregnant and lactating women, it has been given to those women because they've been experiencing some severe form of liver disease, but they just happened to be pregnant so they gave the Milk Thistle, there were no adverse consequences at all. But still, even though there might have been half a dozen studies on pregnant women that showed it to be safe, you still need to put caution around pregnancy and lactation. 

00:34:30 Glenn:        You wouldn't want to be the catalyst for somebody having an issue with their pregnancy.  

00:34:34 Narelle:        Well why would you risk it? If you don't need to be on it. Anything, just wait. Just relates to anything when you're pregnant. Just be smart. There was a 2019 paper on the safety and toxicity of Milk Thistle in animals, it stated that it has no major toxicity. And they've done rat studies and dog studies, unfortunately, with various doses of Milk Thistle getting to very, very high doses. Then when they did the postmortem studies there was no evidence of toxicity. As I said, there are cautions if you're diabetic, or if you've got a diabetic dog, it could potentially lower blood glucose levels further, which can be problematic. We've already commented on the potential for an allergic reaction if you're already very sensitive to some plants in the same family that Milk Thistle comes from. If you've got existing gallstones, be really careful.  

00:35:23 Narelle:        Because if you're gonna start triggering the flow of bile and you've got gallstones that are blocking the bile duct, that could trigger some issues. In terms of drug interactions, really, really good. Safety reviews have concluded that the drug interaction risk for Milk Thistle is minimal and generally not clinically relevant. There is a theoretical caution around its potential impact on liver enzymes, but they had to give what they call supra therapeutic concentration, doses way above what you would ever give in reality to trigger that theoretical influence on the liver enzymes. But again, if you are on any prescription medications, particularly any medications with narrow therapeutic windows, talk to your vet, talk to your doctor before using anything. In terms of how I use Milk Thistle, because I do get a lot of emails from people wanting to use it, or you know, being told they should use it, but then they're not sure how to use it.  

00:36:18 Narelle:        Our dogs get Milk Thistle regularly. They don't get it every day, but that's more because I give them a lot of supplements every day individualised to the dog. But at least a few times a week. And the other thing is, I know our dogs are healthy. Pretty much every 12 months we'll get bloods done on all our dogs just to see where things are sitting. So if I did see  a red flag or the beginning of some elevation in liver enzymes, absolutely, they would be on it. That dog would be on it every day. And the good thing too, particularly about the CanineCeuticals Milk Thistle is it tastes good, so compliance is great for fussy dogs and fussy cats.  

00:36:54 Glenn:        Cats can have it?  

00:36:55 Narelle:        Cats can have the Milk Thistle.  

00:36:57 Glenn:        How do you get a cat to take Milk Thistle?  

00:36:59 Narelle:        Cats are so challenging.  

00:37:00 Glenn:        Yeah I know, that's what I was saying.  

00:37:02 Narelle:       I'm just recently entering into the realm of giving cats supplements because a lot of the CanineCeuticals range is safe and suitable for cats and beneficial. The challenge is …  

00:37:13 Glenn:       Getting it into the cat,  

00:37:14 Narelle:        A lot of liquid herbal tonics on the market are alcohol based, but the Milk Thistle isn't so that’s really great 'cause cats metabolise alcohol differently to dogs. It's a lot more toxic to cats than dogs. But just so people know, if you do buy a herbal tonic that is extracted with alcohol, at the doses given it is very safe for dogs. But you do have to be careful for cats. And even the veterinary medicine herbal medicine textbook states that the top preference for a herbal remedy is the ethanol extracted version for a variety of reasons, which I won't go into today. But even they're saying it's safe and beneficial. Because the CanineCeuticals Pure Milk Thistle tastes good. you don't need to use a lot of it. It's really easy to add to food and they don't even know it's there and it gives you super flexibility with dosing.  

00:38:04 Glenn:        And it's human grade.  

00:38:05 Narelle:       It's the same liquid formula that if I had a human client in my clinic, they would get the same product, with a human label. But think about it, if you live near a busy road and you get in all that exhaust particulate matter, if you regularly walk your dogs in council managed areas, chances are they're spraying herbicides to manage those areas. If you live somewhere on an estate that used to be, back in the day, farming land, oh my goodness. The chemicals that used to be used in agriculture way back persist for decades and decades and decades.  

00:38:39 Glenn:        And tell people why and how, you know that.  

00:38:42 Narelle:        So my first Bachelor's Degree was in Agricultural Science and then I went into regulatory affairs with an agrochemical company. So if you are living on ex farmland, the severity will vary based on whatever was grown there in terms of the nastiness of the chemicals.  

00:39:01 Glenn:       What's some of the highest? I know we're off topic, but what's some of the highest,  

00:39:04 Narelle:        Oh, I dunno, off the top of my head. It's been too long for me to retain that information. Maybe another podcast if it comes up. Most people don't know if you buy a house and it's on an established estate, whether the soil in your backyard is contaminated.  

00:39:22 Narelle:        I can't remember where I heard it, but it's actually a thing where if you plan to grow your own vegetables in the backyard, you 100% need to be sending that soil off for testing for contaminants. Like heavy metals and all of that sort of stuff, because that's gonna get taken up into the food that you're growing, and you don't know what used to be put in the soil where you now live because you know, cities expand. Farmland used to be a lot closer and then the city just takes over as it expands. So that's a really good reason to have your dog on Milk Thistle. If you've got new furniture, like any furniture, recent furniture, but particularly brand new furniture, brand new carpets, are so bad for our dogs.  

00:40:02 Narelle:        I'm paranoid about us if we ever have to paint a room. But if someone's painting a whole house at once and there's no ability to escape, rather than doing one room and closing it off to being in there, with the windows open, that's not good. And as I mentioned earlier with that study done by the environmental working group, there's just so many things. Even the drinking water, most people don't think about the drinking water their dogs get. Our taps run brown for a period of time when they're first turned on, so imagine if someone wasn't paying attention and that's probably rust coming through the water and if your dog's drinking that … 

00:40:35 Glenn:       That's why we have triple filtered water in our house.  

00:40:38 Narelle:        But even the backyard taps, I always run the water for ages, but all the indoor bowls have filtered water in them.  

00:40:46 Glenn:        Yep, tri filtered.  

00:40:47 Narelle:        If you're regularly flea and tick treating your dog, I would recommend that on the day you give this treatment dose with Milk Thistle twice daily and do that for, I usually say three or four days or up to a week for that dog. Just to support their liver in processing that chemical burden that we are putting on them. If you're feeding kibble every day, you don't have to give Milk Thistle every day, but you might think about somehow incorporating it into their regime. The good thing about a liquid version is, let's say you want to use Milk Thistle for prevention and general health, you might give the lower end of the dosing range once a day. But if you've got concerns, or you know your dog's been exposed to something or you know your dog's got a particular disease, you might give the higher end of the dosing regimen twice a day. So you've got that flexibility to chop and change. Some people do it once a month in Spring as a detox for the dog. Some people do a week, a month, so you can see there's no hard and fast rules. It depends on you, it depends on your dog, it depends on your environment.  

00:44:00 Narelle:        I guess we can wrap it up there, but I just wanna stress, absolutely everything that we consume, everything that goes into the body gets processed by the liver. To me, the liver is the heart of the body in terms of health. So we need to look after our livers. We need to look after our dogs’ livers. Milk Thistle is part of that liver care regime. So if you do have any questions about how you might use Milk Thistle for your dog, please email us at info@canineceuticals.com.au. We've got some good resources on the website, that's canineceuticals.com.au under the resources tab where you can learn more about lots of different things. That's it for today's episode on Milk Thistle, I hope you learnt something new and you're as excited about the Milk Thistle herb as I am. 

00:44:46 Glenn: Sounds fantastic, I think I need to be on it. 

00:44:48 Narelle: I'm on it. 

00:44:49 Glenn: I know you are.

00:44:50 Narelle: I should give it to you too. So thank you for listening everyone, and I will catch you next time.

00:44:55 Glenn: Bye everyone.

00:44:46 Narelle: Bye.

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