Frequently Asked Questions

Use the search field below to find answers to some of our most commonly asked questions posted by the Editors at If you cannot find the information you are seeking, visit our contact form.

However, please note, that we are not medical advisors. Any medical questions you have about your personal condition and treatment options should be directed to your personal health care provider.

Questions and Answers

Most people do not feel different when they have a liver issue and only learn of one when they go to the doctor. Therefore, when taking milk thistle, most people will not actually "feel" milk thistle working but it is. Milk thistle is primarily used to maintain liver health and to protect the liver from toxins. However, in addition to supporting and protecting the liver, milk thistle offers numerous other non-liver-related health benefits, which can be found here.

Silymarin is the whole medicinal extract of the milk thistle plant. It is made up of three key bioflavonoids, including silybin (also called silibinin), silydianin and silychristin. Silybin normally makes up about 50% of silymarin. Silybin has been shown in clinical studies to be the most beneficial constituent of the milk thistle extract.

While most of our products address the primary concerns for liver health: fighting free radicals and removing toxins; we do offer some products that are especially beneficial for fatty liver.

Recommend supplements for fatty liver include:

  • Clinical LiverSupport - addresses many of the primary issues affecting liver health. It helps reduce fatty accumulation in liver cells, neutralizes toxins, protects and regenerates liver cells, promotes natural, anti-inflammatory actions, fights free radicals and oxidative stress, and promotes bile flow.
  • Liver Support & Detox - a comprehensive liver support formula that keeps your body clear of toxins so that it can function at a healthy level. Liver Support & Detox contains Vitamin B6, which is essential for amino acid and glucose absorption in the liver. Folic acid, B12 and choline help support healthy liver detoxification which makes it easier for the body to rid itself of toxins. Choline also assists the liver in soaking up healthy fats.
  • Maximum Milk Thistle and UltraThistle – helps reduce the inflammation that often accompanies a fatty liver. They also support the liver's function in fat, carbohydrate and protein metabolism, and storage of vitamins and minerals.

As you know, the liver filters and cleans the blood. A fatty liver will result in a decrease in its ability to perform optimally. Offering a fatty liver this type of nutritional support may assist in an increase in liver function.

We suggest contacting the American Holistic Medical Association at 505-292-7788 or go to their website,

According to the Centers for Disease Control (, studies regarding the transmission of Hepatitis C through sexual contact (whether it is genital, oral or anal) show that body fluids such as saliva, semen or urine must contain traces of infected blood for contamination to take place. If there are breaks in the skin (or lining of the mouth vagina or anus) Hepatitis C has the potential to be transmitted through intimate contact where blood from an infected individual crosses into the bloodstream of the non-infected person.

Hepatitis C individuals in long-term monogamous relationships rarely transmit the virus to their partners. Around 2% of sexual partners of Hepatitis C infected people test positive for Hepatitis. But, it is unknown whether these people contracted the virus from their partners during intimacy, or through some other route.

For those diagnosed with Hepatitis C we believe there is no acceptable level of alcohol and it should be eliminated completely.

Maximum Milk Thistle contains 240 mg of Silybin Phytosome(Siliphos). Silybin is the most beneficial compound in milk thistle extract bound to phosphatidylcholine. This molecular bonding provides for a more absorbable product. It is 8 to 10 times more absorbable due to this bond with phosphatidylcholine.

Our Maximum Milk Thistle is absorbed more easily by the body than the regular milk thistle products that are found in stores. In addition, Maximum Milk Thistle offers 240 mg of the active ingredient while store bought products typically only offer 180 mg of the less absorbable milk thistle extract.

NT Factor, Silymarin Phytosome and Silybin Phytosome are hypoallergenic. The phospholipids are derived from soy but contain no soy protein, therefore, no allergens.

If you’re having trouble deciding which milk thistle supplement to take, we encourage you to read the below article, which will explain in detail the difference between each of our products:

Milk Thistle – Varying Levels of Liver Support

There are no known contraindications between Maximum Milk Thistle and other supplements or medications. However, we have heard from some of our customers that sometimes their physicians will suggest to discontinue taking other supplements so that they can make a determination as to whether the medications are working. As we are not medical advisors, we suggest consulting with your physician.

We have seen no evidence that shows that an herbal or nutritional supplement can eliminate the Hepatitis C virus. Companies that sell products that claim to 'cure Hepatitis C' are lying to you. However, many people choose to take advantage of the many benefits of alternative therapies, including supplements, to manage and support their health and well-being. Supplements offer people the ability to support and improve liver health and function, as well as the ability to manage the unwanted symptoms associated with a compromised liver. For more information about the benefits of alternative therapies, click here.

Maximum Milk Thistle contains the active ingredient Silybin Phytosome (Siliphos). Silybin is the most beneficial component of the milk thistle extract. Silybin is then bound to phosphatidylcholine which has been shown to dramatically increase absorption, biological activity and delivery of silybin to your liver.

Of course you can give your dog milk thistle, in fact some veterinarians have recommended it.

Consider a person weighing about 150 lbs., on average, will take approximately 3 capsules per day - a dog weighing about 50 lbs. would then take approximately one capsule per day. Keep in mind that some people will double or triple their dosage without side effect. Therefore even for a small dog of 10 to 15 lbs. a one-capsule-per-day dosage should also suffice without side effect.

We suggest opening the capsule and mixing it with their wet food.

For very small dogs consider just a half capsule.

We suggest contacting your pet's veterinarian if you have any additional questions.

It is a phospholipid derived from soy.

There is no independent clinical evidence for its use in systemic viral conditions. Silver has been shown useful for topical application, such as burns, or as a topical antibiotic, but we have found no proof that ingesting it will have any effect on a virus.

There are many things that can raise liver enzymes, not the least of which being alcohol or even many over the counter medications.

Liver enzymes are introduced to the bloodstream when liver cells deteriorate. Through natural attrition a certain number of liver cells are expected to die and decompose on a daily basis. This leads to the acceptable or normal level of enzymes. If enzymes are elevated it could be an indicator that more liver cells than normal are dying on a daily basis.

Hepatitis C is not that contagious. Blood to blood transmission is the only way to contract the virus. In addition, it is not spread from mother to child at birth very easily.

The normal liver volume is approximately 1500 ± 100 cc in adult males and 1300 ± 100 cc in adult females. Accurate ultrasound measurement of liver volume is technically difficult.

While not specifically indicated for headaches, some of our liver support supplements can help with headaches. Since the liver is responsible for blood purification and removing toxins from the body, a headache arising from these circumstances can benefit from improved liver health. By improving liver health with UltraThistle or Maximum Milk Thistle in conjunction with a detoxifier such as Liv.52, headaches may subside.

There are many possible causes for chronic headaches, some are serious and some are not. We strongly suggest that you consult with a physician to find the cause of your daily chronic headaches.

If you are referring to whether it will show up on a test as an illegal substance, no, milk thistle does not break down into an analogue that could be misinterpreted as an illegal drug.

NAC stands for N-acetyl-L-cysteine. This is an amino acid that is easily turned into the potent antioxidant, glutathione, by your body.

Glutathione is essential for normal phase two detoxification in your liver. To give you an idea of its importance - here is an example; if you were rushed to the hospital with Tylenol (acetaminophen) poisoning they would give you intravenous NAC to detoxify the acetaminophen before it destroyed a fatal amount of liver cells.

It may be important for you to know that taking NAC and nitroglycerin may cause severe headaches.

We recommend consulting with your health care provider before taking any supplements.

Since the product is chemically isolated to just silybin, any other product, specifically pesticides or other possible contaminants, would not be prevalent since it is broken down into just silybin.

Organically grown milk thistle would be valuable if you were ingesting the whole plant.

Traditionally, liver biopsy has been considered the "gold standard" for assessment of the state and degree of liver damage that can be a consequence of Hepatitis C.

A sonogram or CT scan of the liver can assess the liver's size and structural changes. They give some information, but are not nearly as specific as a liver biopsy.

There is an alternative to liver biopsy that carries less risk than a liver biopsy. Fibro-Test and Fibro-Spect are blood tests for determining the condition of the liver that have been approved by the FDA within the past few years. These have been tested for many years in Europe with great success. When used properly to measure certain blood chemicals, these test results have been shown to adequately correspond with biopsy results. We have heard from some that the tests are only accurate in determining State 1 or Stage 4 liver damage and not between, however the manufacturers of these test say that is not true.

Again, we suggest speaking with your health care provider if you have any questions regarding these tests.

Viral load is not an indicator of the severity of Hepatitis C.

There normally is fluctuation in viral load levels with Hepatitis C but there is no table or graph that demonstrates what normal fluctuation is.

We have spoken to people with viral counts totaling 30 million who feel great, and people with viral counts of 200,000 that can't get out of bed.

The only true reflections of possible liver compromise are fibrosis markers - determined either by liver biopsy or specialized blood tests.

It is our understanding that many hospitals have what is called a Charity Care Program.

To apply for this program you would complete an application, and often provide proof of income, but if you qualify, this program may cover blood tests and ultrasound up to $1000. Contact your local hospitals for more details.

Also if you are in Texas, the Texas Liver Coalition offers free hepatitis B & C testing and the PCR confirmatory test, education, literature, and resources to possibly get treated. Visit for more information.

Hepatitis B is transmitted through blood only, not through any other bodily fluid.

As we are not medical advisors, we are unable to provide any advice regarding your health choices. This is a decision that needs to be made with your primary healthcare provider.

In our experience, the choice to begin interferon therapy is best made by weighing individual circumstances (genotype, patient health) with education (about hepatitis, interferon therapy and liver protection).

Migraines and/or headaches can be the result of toxins in or thickening of the blood. Since the liver is responsible for blood purification and toxin removal, a headache arising from these circumstances can benefit from improved liver health.

Acne and/or psoriasis - One of the tasks of the liver is to cleanse the blood. If the liver is not functioning well, it will be unable to effectively cleanse the blood which can result in skin problems ranging from acne to psoriasis, eczema, and dermatitis. Therefore if liver function is impaired, it could cause skin problems, so supporting and protecting the liver can also improve the skin.

Irritable Bowel Syndrome - As the liver secretes digestive fluids via the small intestine, it has a significant role in digestive disorders. Therefore, improving liver health often improves digestive health.

Gallbladder disease (includes gallstones and bile obstruction diseases)- The gallbladder stores bile, a substance the liver produces to aid digestion. Since the gallbladder and liver share a close relationship, improving the liver's health can positively effect the gallbladder.

Biliary Atresia - This disease results in inflammation and obstruction of the ducts which carry bile from the liver into the intestine. Protecting the liver from incurring further damage can help it cope with the back-up of bile that commonly occurs with this disease.

Hemochromatosis is a condition where the body absorbs and stores too much iron. Excessive amounts of iron can lead to liver injury, so protecting the liver can minimize or eliminate damage.

Primary Biliary Cirrhosis is a chronic liver disease that causes slow, progressive destruction of bile ducts in the liver. Protecting the liver from incurring further damage can hamper the progress of this disease.

Primary Sclerosing Cholangitis is a disease in which the bile ducts inside and outside the liver become narrowed due to inflammation and scarring. Protecting the liver from incurring further damage can help prevent scarring.

Wilson's Disease is an inherited disorder of copper secretion by the liver, which can result in copper accumulation in the liver and ultimately cause liver damage. Protecting the liver can insulate it from this toxic accumulation.

Diabetes is associated with liver disease. Poorly controlled blood sugar can increase the risk of fatty liver disease. On the other hand, some types of liver disease - such as hemochromatosis - increase the risk of diabetes. Protecting the liver can reduce the risk diabetes poses to the liver.

High cholesterol - The liver makes and distributes most of the cholesterol in our body. When liver function is impaired, cholesterol levels can skyrocket. Clinical studies demonstrate that protecting and supporting the liver can lower cholesterol and triglyceride levels.

Obesity - Liver Disease is linked to obesity. Protecting the liver can enhance the body's ability to metabolize fat.

Reye's syndrome - this acute, often fatal disease (secondary to flu or other infections) can result in fat accumulation in the liver. Protecting the liver can enhance fat metabolization and maintain liver function.

Milk thistle is the #1 researched and recommended herb for liver health. Besides being a powerful antioxidant, milk thistle protects the cells of the liver by blocking the entrance of harmful toxins and helping remove these toxins from the liver, by fighting free radicals, increasing glutathione levels, and stimulating protein synthesis in hepatic cells. Furthermore, milk thistle not only protects your liver from future damage, but also has the ability to regenerate healthy liver cells to repair past damage.

The therapeutic value of milk thistle has been confirmed by intensive chemical, pharmacological and clinical research, not only for a wide range of liver-related conditions including the ones stated above, but also for non-liver-related conditions as well. However, before taking any milk thistle supplement, research should be done into the types of milk thistle and their varying absorption rates and effectiveness. For more information on the benefits of milk thistle and what to look for, click here.

Selenium is an essential mineral found in trace amounts in the body. It works as an antioxidant.

It appears that low selenium levels MAY be associated with an increased risk for liver cancer in people with Hepatitis B and/or C. Also, low selenium levels may worsen the toxic effects of alcohol on the liver.

Although its not clear, whether selenium supplementation can help prevent or treat liver damage, studies in China showed that provinces with elevated levels of liver cancer were brought to normal levels very quickly by the introduction of selenium into the inhabitant's diets.

We recommend speaking with your health care provider before taking any supplements.

The Centers for Disease Control indicate that Anti-HCV can be found in 7 out of 10 persons (70%) when symptoms begin and in about 9 out of 10 persons (90%) within 3 months after symptoms begin. However, its important to know that many people who have hepatitis C have no symptoms.

The Centers for Disease Control indicate that there are several blood tests that can be done to determine if you have been infected with HCV. Your doctor may order just one or a combination of these tests. The following are the types of tests your doctor may order and the purpose for each:

  • Anti-HCV (antibody to HCV)- Anti-HCV does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.
    • EIA (enzyme immunoassay) or CIA (enhanced chemiluminescence immunoassay)test is usually done first. If positive, it should be confirmed
    • RIBA (recombinant immunoblot assay)is a supplemental test used to confirm a positive EIA test
  • Qualitative tests to detect presence or absence of virus (HCV RNA)
  • Quantitative tests to detect amount (titer) of virus (HCV RNA)

A single positive PCR test indicates infection with HCV. A single negative test does not prove that a person is not infected; the virus may be present in the blood and just not found by PCR. In addition a person infected in the past who has recovered may have a negative test. When hepatitis C is suspected and PCR is negative, PCR should be repeated.

The Centers for Disease Control ( say Yes. A false positive test means the test looks as if it is positive, but it is really negative. This happens more often in persons who have a low risk for the disease for which they are being tested. For example, false positive anti-HCV tests happen more often in persons such as blood donors who are at low risk for hepatitis C. Therefore, it is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti-HCV tests are reported as negative on supplemental testing.

Phosphatidylcholine is a phospholipid derived from the fatty component of the soybean (like lecithin). It contains NO protein and NO phytoestrogens.

Like lecithin, phosphatidylcholine has been shown to aid the body in utilizing, processing and absorbing foods. Milk thistle is notoriously difficult for the body to absorb. The patented Phytosome™ process, whereby one molecule of silybin is bound to three molecules of phosphatidylcholine, sees to it that more milk thistle gets to where you need it and less is simply "washed" out of your digestive system. The main benefit of the Phytosome™ process is that it provides enhanced delivery of the beneficial components of the herb. This way there is much less waste and much, much greater benefit.

According to the Centers for Disease Control only 20-30% of Hepatitis C patients will experience life-threatening complications due to Hepatitis C. Far more people die WITH Hepatitis C than FROM Hepatitis C.

We recommend visiting the HCV Forum on at You can read through threads or you can participate yourself, it's up to you.

Ascites is the presence of excess fluid in the peritoneal cavity, which is the space between the abdominal organs and the skin. As a result of this fluid buildup, the abdomen swells and distends.

While liver disease – specifically cirrhosis – is the most common cause of ascites, it can also have other causes, such as cancers, congestive heart failure or kidney failure. For more information regarding causes visit

Ascites may be asymptomatic (having no symptoms) or a person may complain of increased abdominal width, becoming full quickly upon eating or breathing difficulty, depending upon the amount of fluid that has accumulated.

A physician may perform various physical tests. More information can be found at

The treatment of ascites depends on its cause. If portal hypertension is the cause of ascites, medical management using diuretics and salt restriction is often effective in portal hypertensive patients.

If diuretics and salt restriction are not effective, in some cases, doctors may perform paracentesis to draw off the fluid from the abdomen. A few liters of fluid can be removed at a time.

In other cases where the paracentesis procedure is repeatedly required to prevent the re-accumulation of fluid, the physician may resort to other means. A transjugular intrahepatic portosystemic shunt (TIPS) may be implanted to redirect the fluid and provide relief. This procedure is performed by a vascular radiologist.

Blood passes through the liver at about 3 pints (6 cups) per minute, making the liver an extremely busy organ. The liver is in charge of producing bile, manufacturing hormones, regulating carbohydrate metabolism, storing vitamins and minerals, cleaning the blood, etc. More information can be found at

Since fatigue is a symptom, not a disease, the treatment depends on what is causing the fatigue. For those that have liver impairment, being informed about the detrimental effects of alcohol, drug use, poor sleep, dietary habits and a highly stressful life can empower an individual to make positive lifestyle changes. In addition to making healthful lifestyle decisions to reduce fatigue, these changes will also support the liver and strengthen the immune system.

For helpful tips visit

Fatty liver is a reversible condition without the potential to lead to cirrhosis. It is characterized by the deposit of fat particles (triglycerides) in the cells of the liver and can be caused by a variety of factors.

Nonalcoholic fatty liver disease (NAFLD) refers to a spectrum of liver abnormalities/disease ranging from the relatively harmless fatty liver to nonalcoholic steatohepatitis (NASH) to cirrhosis. The common factor is that all of these stages have an accumulation of fat in the liver cells.

When fatty liver is accompanied by varying degrees of inflammation and scarring (fibrosis) of the liver, it is known as nonalcoholic steatohepatitis or NASH. Unlike a fatty liver, NASH is not considered relatively harmless. Instead, NASH is considered a liver disease with the potential to cause cirrhosis, which can lead to liver failure.

The liver is involved in the metabolism of fat. This process can be disrupted by a variety of factors, including certain types of diseases, poor diet, certain medications and some toxins. When this process of fat metabolism is disrupted, the fat can accumulate in the liver in excessive amounts, thus resulting in a fatty liver.

This excess fat is stored in the liver mainly in the form of triglycerides. When this fat accumulates in the liver, but there is no inflammation or scarring, this fatty liver condition is relatively harmless.

Niacin (also known as Vitamin B3 or nicotinic acid), is a water-soluble vitamin that is used therapeutically as a cholesterol and blood lipid-lowering agent.

The side effects of niacin include flushing and gastrointestinal disturbances, and at higher-sustained doses, hepatotoxicity.

Hepatic toxicity is:

  • Most common with high doses of slow-release niacin
  • Less common with extended-release niacin
  • Rare with immediate-release forms

Like the statin drugs, niacin helps treat high blood cholesterol levels. Similar to the statins, it can also damage the liver. Niacin is capable of causing mild elevations in blood levels of AST and ALT, jaundice, and, rarely, liver failure. Liver toxicity with niacin is dose-dependent; toxic doses usually exceed 2 grams per day. Thus, those with liver disease are at higher risk for niacin toxicity and are advised to only supplement with niacin under a physician’s close supervision.

All B vitamins:

  • Help the body convert carbohydrates to glucose, which is used to produce energy
  • Help the body metabolize fats and protein
  • Are necessary for a healthy nervous system, skin, hair, eyes and liver

The body's needs for niacin can usually be met through diet; it is rare for anyone in the developed world to have a Vitamin B3 deficiency.

The absorption of the B vitamins is not niacin dependent. Instead, the following factors are common culprits of Vitamin B absorption difficulties:

  • Alcohol blocks Vitamin B absorption
  • Tobacco smoke decreases Vitamin B absorption
  • Certain digestive disorders like Celiac disease reduce Vitamin B absorption
  • Intrinsic factor is needed to absorb Vitamin B12; its deficiency is seen in pernicious anemia

For any questions regarding supplements or vitamins one is taking or considering taking, it is important to speak with a physician, as well as your pharmacist for their professional opinions and recommendations.

Understanding the liver’s role in energy production clarifies how a compromised liver can result in fatigue. The liver is intimately involved in supplying the body with energy. As indicated above, the liver converts glucose into glycogen, storing it for later use. When the body needs energy, liver glycogen can release glucose to provide fuel for creating a burst of energy. If the liver is compromised, it could be causing your fatigue. For more information visit

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