Posted by Larry Hoover on March 30, 2009, at 8:06:25
In reply to Re: Liver supplements: make you process meds quicker?, posted by qbsbrown on March 29, 2009, at 23:48:45
> http://www.gnc.com/product/index.jsp?productId=2133747
>
> Vitamin B6 (Pyridoxine HCl) 10.00 mg 500%
> artichoke extract (flower) 90.00 mg **
> beet leaf 90.00 mg **
> Dandelion Root 90.00 mg **
> milk thistle extract (seed) 90.00 mg **
> tumeric extract (rhizome) 90.00 mg **
> black radish root 30.00 mg **
> Inositol 10.00 mg **
> Astaxanthin 500.00 mcg
>
>
> Thanks Larry.
>
> BrianWhat a mixture. It had to be complicated, eh?
At the level of the liver, I cannot find any direct action on the two major enzyme isoforms responsible for metabolizing diazepam, but there was potential for a possible minor pathway with questionable effect. Interestingly enough, turmeric inhibits the same two enzymes that black radish induces. I wonder what the net effect is? Neither affects diazepam, so I'm just reacting rhetorically.
I couldn't verify it absolutely, but there is probably some modest inhibition of intestinal uptake, however. The active constituents in milk thistle and artichoke (also a thistle) are actively transported from the gut by p-glycoproteins. Other pgp substrates are known to have reduced uptake when co-administered with the thistles, and diazepam is a pgp substrate. There are different pgp variants, so I can't be certain that they overlap. It's a competitive effect; if they ride the same bus, and the bus is already full, some passengers can't get where they're going.
So, in summary, I can't find any drug metabolism effects, but if the uptake transport is inhibited, then you're getting less valium into the blood than you'd expect from the dose you're taking (20-30% reduction in blood concentration of the drugs I found which were affected in this way). Now, that wouldn't matter at all if you've always been taking the liver supp during the period of tapering intake. It's already factored in.
BTW, why are you taking the liver supp? Are your AST and ALT elevated?
Lar
poster:Larry Hoover
thread:887470
URL: http://www.dr-bob.org/babble/alter/20090204/msgs/887707.html