The Natural Connection

On a summer day in 1995, a 51-year-old grandmother in Alabama sent her husband to collect mushrooms for a family Sunday brunch. On his return to the kitchen, she breaded and fried the morsels, then proudly served her brunch specialty to her children and grandchildren. 

The chef and her husband had recently moved from Illinois to the South, and they were happy to find that the mushrooms that they loved to collect up North were plentiful in Alabama as well. 

Within twelve hours, the cook and three of the brunch guests were sickened with abdominal pain, diarrhea, and vomiting. The three adults eventually recovered, but the youngest patient, her 3-year-old granddaughter, did not survive—a victim of fulminate liver failure. Unknowingly, the Alabama grandmother had mistakenly served her precious loved ones a heaping platter of deep fried deathcap mushrooms, Amanita phalloides, perhaps the most deadly of the 2000 species of mushrooms found on our planet. 

Self-taught mushroom collectors such as the grandfather, who had safely eaten a look-alike mushroom in Illinois for over 30 years, commonly mistake amanita mushrooms for edible species. The toxin responsible for the poisoning, called amatoxin, has no smell or taste, and is not destroyed by cooking. The ingestion of a single mushroom can result in death by liver failure in a matter of days in 30 % of patients. 

Over the past few decades, amateur mushroom hunting has increased in popularity as restaurants and home cooks seek out “natural foods”. Amanita poisonings account for more than 90% of the fatalities from mushroom poisoning that occur in Western Europe and the United States. Ironically, if this little girl had been a brunch guest in France or Germany, the outcome may have been different. 

In ditches and dry spots around the world, the prickly milk thistle plant thrives. Physicians of ancient Greece and throughout the Middle Ages used it as a remedy for snakebites, yellow jaundice, and other liver diseases. The milk thistle plant earned its name due to the milky white markings on it leaves, and from its reported ability to stimulate milk production in lactating women. 

The active ingredient in milk thistle, silymarin, is the most powerful antidote to the amatoxin of the deathcap mushroom available to modern physicians. To be effective in mushroom poisonings, however, it should be given intravenously. Sadly, this form of herbal medication is not available in the United States. In Europe, where botanical medicine is more firmly established, milk thistle extract for mushroom poisoning is widely used with success. 

Fortunately, liver failure due to mushroom toxins is still a relatively uncommon occurrence. Much more common are liver injuries due to toxins such as alcohol and medications, and viruses like hepatitis. Here too, we find that milk thistle may be of benefit. 

Several randomized trials have shown that milk thistle extract has a protective effect on the liver against toxic chemicals such as alcohol, carbon tetrachloride (a cleaning solvent), and acetaminophen (found in many non-aspirin pain relievers). Patients with liver damage due to alcoholic cirrhosis had lower death rates, for instance, when they were treated with milk thistle extracts. 

In patients with viral hepatitis, milk thistle has been shown to normalize their liver function tests, and improve symptoms of abdominal pain, fatigue, and decreased appetite. Patients with chronic hepatitis can safely take milk thistle along with prescription anti-viral drugs for prolonged periods of time without side effects. 

In the United States, milk thistle extracts are available in capsules and tinctures. It is best to purchase a standardized extract. The dose that is required for liver protection is slightly less than what is necessary to treat an acute illness, and therefore you should always consult your physician if you decide to take milk thistle. It is however, considered a very safe herb with essentially no reported side effects except for a mild laxative effect in higher doses. 

To receive a Patient Information Sheet on milk thistle, please write to:

The Natural Connection c/o Pauline Bellecci, MD, PO BOX 777, Waycross, GA 31502 or visit www.swampdocs.com

 10/23/00

©2000-2003 Pauline M. Bellecci, MD