Hello I have ED all my test are normal but even Viagra or Cialis does not work.
When I started taking milk twisle a month ago they started to work, and I even can get erections and have intercorse without Viagra.
What efect can milk thistle have on me?
I would guess it centers around cytochrome activity:https://www.ncbi.nlm.nih.gov/pubmed/11038151
"Treatment with silymarin (0.1 and 0.25 mM) significantly reduced the activity of CYP3A4 enzyme
(by 50 and 100%, respectively) as determined by the formation of 6-beta-hydroxy testosterone and the activity of uridine diphosphoglucuronosyl transferase (UGT1A6/9) (by 65 and 100%, respectively) as measured by the formation of 4-methylumbelliferone glucuronide."https://www.ncbi.nlm.nih.gov/pubmed/15637532
"Negligible competitive inhibition of CYP3A was observed in vitro. Mechanism-based inhibition of CYP3A was detected, albeit with a low potency. In human hepatocytes, exposure to 1 micromol/L or greater of tadalafil resulted in increased CYP3A protein expression; "
The reason that I believe it's 3A4 is because of the likely pomegranate Cialis interaction that has been reported. Check this out for example:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355694/
"After oral administration, sildenafil is rapidly absorbed and the bioavailability reaches around 40% only due to extensive first-pass metabolism. This is also influenced by age of the patient and liver and kidney function. Warrington et al. reported that about 79% of the intrinsic clearance of sildenafil is attributable to cytochrome P450 (CYP) 3A4
and remaining to CYP2C9."