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Alternative Health
Milk Thistle
 


Deepi Brar
CONSUMER HEALTH INTERACTIVE

Below:
 • What is it good for?
 • How does it work?
 • How safe is it?
 • What's the best way to take it?


Milk thistle (Silybum marianum ) is a common herb with spiny white-veined leaves and pink flowers that has been used as a liver tonic for at least 2,000 years. A Greek physician in the first century named the herb based on the legend that the white mottling on each leaf was caused by a drop of the Virgin Mary's milk.

What is it good for?

Milk thistle seed extract contains a group of substances called silymarin that may help protect the liver. Human studies have found milk thistle seed extract beneficial in treating alcoholic liver disease, drug-induced liver disease, bile duct inflammation and chronic hepatitis. Among 170 patients with cirrhosis (chronic scarring of the liver, often caused by alcoholism), those who took milk thistle extract survived longer than those who took placebos (dummy pills). In another small study, it significantly improved symptoms of chronic hepatitis. However, more research is needed to verify these results. When injected, milk thistle extract has been used successfully to treat liver failure caused by amanita mushroom (Amanita phalloides) poisoning.

How does it work?

Silymarin is a mixture of chemical compounds (called flavonolignans) that may help protect and even repair the liver. Researchers hypothesize that it blocks toxins from entering liver cells. The liver is the only organ that can regenerate itself, and silymarin may accelerate this process by stimulating the production of the proteins that are the building blocks of new liver cells. Finally, some data suggests that silymarin is an antioxidant, which means it might protect cells from damage by scavenging oxygen molecules called free radicals.

How safe is it?

The vast majority of milk thistle users report no side effects, but a few have experienced a mild laxative effect. Although no interactions have been reported, laboratory research suggests that milk thistle has the potential to interact with many prescription drugs. If you take prescription medicines, check with your pharmacist or physician before using milk thistle. If you suspect you have a serious liver condition, see a doctor immediately for a diagnosis and appropriate treatment options.

What's the best way to take it?

Human studies have used milk thistle seed extract containing 70 percent silymarin. Keep in mind, though, that the government doesn't regulate herbal remedies as strictly as it does drugs, so quality and potency can vary from product to product. In rare cases supplements may be contaminated with undesirable substances. A typical dose for chronic liver conditions is one or two 200 milligram capsules a day. The herb is not effective as a tea. Also, don't confuse milk thistle with blessed thistle (Cnicus benedictus), which some people take to stimulate the appetite.



References


Jellin JM, Gregory P, Batz F, Hitchens K, et al. Pharmacist's Letter/Prescriber's Letter Natural Medicines Comprehensive Database. Stockton, CA: Therapeutic Research Faculty; http://www.naturaldatabase.com

Budzinski JW, Foster BC, Vandenhoek, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomed 2000;7(4):273-82.

Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl. Drug Metab Dispos 2000;28(11):1270-3.

Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Pharmacol Toxicol 2000;86(6):250-6.

Mayo Clinic. Milk Thistle (Silybum marianum). May 2006. http://www.mayoclinic.com/health/silymarin/NS_patient-milkthistle



Reviewed by Forrest Batz, Pharm.D., an assistant clinical professor at UCSF's school of pharmacy and a consultant in natural medicines based in Santa Rosa, California.


Our reviewers are members of Consumer Health Interactive's medical advisory board.
To learn more about our writers and editors, click here.

First published September 3, 1998
Last updated January 24, 2008
Copyright © 1998 Consumer Health Interactive and OneBody, Inc.


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