There is preliminary suggestive evidence of a potentially hepatoprotective activity of silymarin extract (from Milk Thistle), but some animal and preclinical studies have raised a concern for the potential estrogenic activity of certain silymarin components, although no human clinical trial, or meta-analysis or systemic review of such, among many has found or confirmed evidence of this potential risk at a clinically relevant level. Despite this, the concern is disquieting until prospective human clinical trials definitely establish safety in active breast carcinoma, and given that the evidence base supporting SAM-e is more compelling than that on silymarin, with no evidence of harm whatsoever, it would appear most prudent at this juncture to try SAM-e. And although there are many other potentially hepatoprotective natural agents (including the otherwise stellar curcuminoids), the evidence for none of these has as yet risen to sufficient methodological level for recommendation.
The strongest evidence of hepatoprotective and liver-supportive activity of any CAM (complimentary and alternative medicine) intervention is for SAM-e (S-adenosylmethionine), which I briefly discussed in these forums in terms of its benefit in relieving the musculoskeletal adverse events of aromatase inhibitors (and possibly also for mild to moderate depression), and this would be your best - and safest - bet. The body itself manufactures SAM-e for use in chemical-to-chemical conversion processes and some highly suggestive evidence suggests that SAM-e oral supplementation may exert beneficial effect in various liver diseases or disorders (chronic viral hepatitis, cirrhosis, and drug-induced and chemical-induced hepatotoxicity (liver toxicity)). It is known to be without harm.
The dose range varies but most trials used 1200 - 1600mg daily in divided dosing of 400mg per serving. SAMe should be taken with meals to minimize a slight risk of GI upset, and to further mitigate against that, I would advise building up to a maximum of 1600mg daily in a graduated step-up program of 400mg for the firth three to four days, increasing by 400mg each third or fourth day thereafter until the threshold is reached. Only a handful of commercial products have been rigorous tested for quality control, with brands from Jarrow, Kal, and Natrol being approved, and these would be available at discount from the online health retailers Vitacost.Com and iHerb.com.
Breast Cancer Watch