Is liver-protective syrup safe with antitubercular drugs?

Question

Hello doctor.

I am 31 years old. Recently, I have been diagnosed with tubercular lymphadenitis, and I have been taking the anti-tubercular medicine Akurit 4 for one week. I have done Hb electrophoresis by the HPLC method test, where, along with other values, HbA1c % was shown 4.8 %.

Is it the same HbA1c that people test for diabetes, or is that HbA1c different?
Since I am on Akurit 4 and will be on antibiotics for a minimum period of 6 months, can I add Silymarin syrup for liver protection?
Many suggest no need to take, but if I take, will there be any harm?
Is there any tonic for the liver?
My prostate size in ultrasonography is 28 x 28 x 26 mm and weighs around 11 gm, and in another ultrasonography, it weighs around 13 gm. Are the prostate size and weight normal?
What is the normal weight?

Please help me out. The only issue I have is that one or sometimes twice I get up at night to urinate. I do not have diabetes.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I understand your concern.

1. It is the same as that used in diabetics, and it is normal. In the attached report (the report has been removed to maintain the privacy of the patient), HbA2 is elevated, and it is an indicator of a beta thalassemia carrier.

2. There are no convincing studies available or proven benefits in patients having ATT (anti-tubercular therapy). However, it is found beneficial for the liver in other conditions. Side effects are not serious, including diarrhea, indigestion, etc., so I do not think there is any harm in having it, but yes, it is not routinely recommended. If you insist on having it, then you can have it. But keep a gap of at least 2 hours between ATT medicine and this syrup in order to prevent any hindrance in the absorption of the medicine. Taken 140 mg twice a day. Strictly avoid alcohol consumption, if any.

3. Prostate size and weight are normal. Weight ranges from 0.25 oz to 0.53 oz.

So no need to worry about it. You should avoid drinking too much water at bedtime, as there is very little water loss through the skin; all is excreted through urine, leading to excessive urination.

All the best.

I hope it helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

There are no significant interactions between ATT (anti-tubercular therapy) and Cresar (Telmisartan).

You should keep a two-hour gap between the medicines.

Silymarin has some evidence of benefit in the case of liver disease. No need to add Ornithine or Aspartate (L-Ornithine-L-Aspartate) in addition to Silymarin. ARBs (angiotensin 2 receptor blockers) act by antagonizing the effect of angiotensin, which acts on renal efferent arteries to cause their constriction.

It basically relieves pressure within the kidneys. As one grows, there is progressive enlargement of the prostate due to hypertrophy and hyperplasia. There is no age-wise normal value. Whatever is above the normal range is abnormal; roughly, more than 25 grams (0.88 oz) is considered abnormal.

Your prostate gland is well within the normal range and is not responsible for your symptoms.

I hope it helps.

Thank you.