Berberine and Milk Thistle for Gout is my review of two herbal extracts that help gout sufferers. Mainly I review a combined herbal medicine for gout called Berberol. Then I explain some common issues about the practical use of these supplements.

Milk Thistle for Gout Audience

I wrote Milk Thistle for Gout for GoutPal Herbalists. Because they need to understand how to choose the right type of herbal medicine to match their situation. So if you are not sure which type of gout person you are, read Questions for Gout Sufferers now.

Berberine and Milk Thistle for Gout

My review is based on a study of 52 obese patients with high cholesterol[1]. As such, it is not a study of gout patients. However, the average uric acid level at the start of the trial was 7.5mg/dL. So this clinical research is particularly relevant to gout sufferers. But before I describe this latest research, I will explain some history.

Milk Thistle for Gout

Scientifically, milk thistle is usually known as Silybum marianum or as the plant extract, silymarin. Historically, there has been very little research into milk thistle for gout. Firstly we had a lab study showing that silymarin extracts might act as a herbal alternative to allopurinol[2]. But so far, that idea has not been researched further with gout sufferers. However, it is referenced in a review that describes milk thistle as a good anti-inflammatory[3-4]. Unfortunately, there is no clear indication what the dose should be for anti-inflammatory gout pain relief. Because the authors note that low doses of milk thistle are anti-inflammatory. But high doses can promote inflammation.

Milk thistle obviously has an anti-inflammatory action. However, there are many botanicals with more thoroughly established actions for this purpose, such as turmeric (Curcuma longa). We do not prescribe milk thistle as a first-line, general anti-inflammatory but would consider its use in this manner if other agents failed and, of course, for patients with hepatic inflammation

In conclusion, milk thistle might help lower uric acid. Also, it might help fight gouty inflammation. But we don’t know what dosage is good.

Berberine for Gout

Many plants contain berberine and my next gout study notes[5]:

Berberine is a well known Chinese herbal medicine extensively used for treating a wide range of inflammatory disorders.

In this lab study, they simply buy the readily available extract. Then they use it to treat rats with induced gout. So they can tell us:

Conclusively, our current findings suggest that berberine may represent as a potential candidate for the treatment of gouty arthritis by suppressing inflammatory mediators and activating Nrf2 anti-oxidant pathway.

But this is a long way from being a practical guide to the dose of berberine required to prevent or relieve gout attacks in humans.

Berberine & Milk Thistle for Uric Acid

Now I return to the main uric acid study[1]. Excitingly, we now have some human data to prove that a combination of berberine and milk thistle can significantly lower uric acid. Also at the dose used, there were no reported side effects. Additionally, this combination herbal medicine for uric acid had significant benefits for other Metabolic Syndrome disorders including obesity, cholesterol, and diabetes.

This study used a commercially available herbal medicine sold in Italy as Berberol. Because Berberol is a mix of 500mg berberine with 105mg milk thistle. Interestingly, I have noticed that an American brand of berberine claims to include milk thistle in its ingredients. However, I’m unable to find the latest ingredients profile even on the EzyAbsorb website. But their berberine is widely available on Amazon and eBay if you want to try it.

We saw in other studies that both berberine and milk thistle should be beneficial for gout sufferers. But the quality of data was poor. Also, berberine is notoriously difficult to absorb because of the way it reacts with our digestive system. However, milk thistle makes us absorb more berberine. So we get the double whammy of more effective berberine plus benefits of milk thistle.

Unfortunately, as this was not a gout study, the researchers did not investigate effects on gout attack recovery or prevention. But it showed an impressive improvement in uric acid from 7.5 to 5.4 mg/dL in 24 weeks. Then down to 4.2 mg/dL after the first year.

Note, the results were based on two tablets each day – one after lunch and the other after dinner. General guidance for berberine dosage is historically higher. But I caution against increasing beyond 1000mg per day when taken with milk thistle. Because the increased absorption rate might lead to complications. But let’s hope that this study generates more detailed gout research. Then we can get a clearer idea of how best to adjust doses to match different stages of gout recovery.

Berberine and Milk Thistle Lowers Uric Acid
Berberine and Milk Thistle Lowers Uric Acid

Beware Uricinex, Uriciplex, UrixTep etc.

Beware Uricinex, Uriciplex, UrixTep, and other Milk Thistle Gout Remedies. Because they are impossible to check for the right dose. Although you might find an exception. But every herbal milk thistle supplement that I have seen fails to mention the actual amount of silymarin that a dose contains. If you know different, join the discussion about milk thistle products.

Also, we get frequent questions about Uriciplex side effects. But I believe the worst side effect of this type of gout cleanse or uric acid support product is years of wasted time. Because everyone who has realized they must also check their uric acid has seen that they are not effective enough.

More importantly, there is no science to confirm that other combinations work. Therefore, I suggest you use a pre-formulated berberine and milk thistle dietary supplement. Or buy your supplements separately and experiment with different ratios. Because your anti-inflammatory requirements will change during different stages of gout recovery.

Your Milk Thistle for Gout

Always remember to use this herbal medicine for uric acid as part of a comprehensive gout management plan. Because you need regular blood tests to ensure the medicine is working safely. So, arrange for monthly blood tests for uric acid, kidney function, and liver function. Then, as you make progress, you can get tested less frequently. But never less than once per year. Also, never change the dose of either of these herbal gout medicines without checking your 3 important blood test results.

Also, we can see that berberine might help your fight against gout flares. But until you have cleared most of your old uric acid crystals, you are at risk of gout attacks. So make sure you have an effective plan to fight inflammation and gout pain.

Do you need more personal help with berberine and milk thistle for gout? Then please ask in the gout forum.

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Milk Thistle for Gout References

  1. Guarino, G., F. Strollo, L. Carbone, T. Corte Della, M. Letizia, G. Marino, and S. Gentile. “Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Silybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes.” Journal of biological regulators and homeostatic agents 31, no. 2 (2017): 495-502. Note I have corrected the spelling of Bilybum from the common citation to match the actual title of Berberol Lowers Uric Acid PDF.
  2. Sheu, Shiow Yunn, Chih Hao Lai, and Hsüch Ching Chiang. “Inhibition of xanthine oxidase by purpurogallin and silymarin group.” Anticancer research 18, no. 1A (1998): 263-267.
  3. Abascal, Kathy, and Eric Yarnell. “The many faces of silybum marianum (Milk Thistle): Part 1-Treating cancer and hyperlipidemia and restoring kidney function.” Alternative & Complementary Therapies 9, no. 4 (2003): 170-175.
  4. Abascal, Kathy, and Eric Yarnell. “The many faces of Silybum marianum (milk thistle): part 2-clinical uses, safety, and types of preparations.” Alternative & Complementary Therapies 9, no. 5 (2003): 251-256.
  5. Dinesh, Palani, and MahaboobKhan Rasool. “Berberine, an isoquinoline alkaloid suppresses TXNIP mediated NLRP3 inflammasome activation in MSU crystal stimulated RAW 264.7 macrophages through the upregulation of Nrf2 transcription factor and alleviates MSU crystal induced inflammation in rats.” International immunopharmacology 44 (2017): 26-37.

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