Silybin treatment is associated with reduction in serum ferritin in patients with chronic hepatitis C

Goals: The goal of this study was to examine the effect of a standardized silybin and soy phosphatidylcholine complex (IdB 1016) on serum markers of iron status. Background: Milk thistle and its components are widely used as an alternative therapy for liver disease because of purported antioxidant, anti-inflammatory, and iron chelating properties. Study: Thirty-seven patients with chronic hepatitis C and Batts-Ludwig fibrosis stage 11, 111, or IV were randomized to I of 3 doses of IdB 1016 for 12 weeks. Serum ferritin, serum iron, total iron binding capacity, and transferrin-iron saturation were measured at baseline, during treatment, and 4 weeks thereafter. Wilcoxon signed rank tests were used to compare baseline and posttreatment values. Results: There was a significant decrease in serum ferritin from baseline to end of treatment (mean, 244 vs. 215 mu g/L; median, 178 vs. 148 mu g/L; P = 0.0005); 78% of subjects had a decrease in serum ferritin level. There was no significant change in serum iron or transferrin-iron saturation. Multivariate logistic regression analysis in a model that included dose, age, sex, HFE genotype, history of alcohol use, and elevated baseline ferritin levels demonstrated that stage III or IV fibrosis was independently associated with decreased posttreatment serum ferritin level. Conclusions: Treatment with IdB 1016 is associated with reduced body iron stores, especially among patients with advanced fibrosis stage.