Milk thistle
is commonly found growing wild in a variety of
settings, including roadsides. The Latin
name is Silybum
marianum.
The seeds of the dried flower are used. The
active ingredient in the plant is a flavonoid called silymarin,
an antioxidant said to protect liver cells from toxins. Silymarin apparently promotes
liver cell protein synthesis and decreases the oxidation of glutathione. The
plant's flowers and seeds have been used for more than 2,000 years to treat
disorders of the liver and gallbladder.
Milk Thistle benefit
in health and disease
Studies show silymarin, silibinin, and other flavonoids found in milk
thistle may benefit in a number of conditions including
alcoholic cirrhosis and tumors. Many compounds in milk thistle, for instance silibinin, have shown potent anti-
prostate and anti-lung cancer activity.
Milk thistle herbal supplements are mostly used for
liver health.
Anti-inflammatory benefit
J Nat Prod. 2015. Silymarin Suppresses Cellular Inflammation By Inducing
Reparative Stress Signaling. Silymarin, a characterized extract of the seeds of
milk thistle (Silybum marianum), suppresses cellular inflammation.
Cancer treatment of
prevention
Milk thistle (Silybum marianum) is an herb that is increasingly used in oncology
research and treatment settings. Historically, it has been used to treat liver
and biliary disorders and has been used in detoxification and cleansing
protocols. However, milk thistle is increasingly being investigated for its use
in adult and pediatric populations for oncology indications. Possible
indications during cancer treatment include cleansing and detoxification after
chemotherapy, preventing hepatotoxicity during chemotherapy, treating
hepatotoxicity after chemotherapy, and potentiating chemotherapy and radiation
therapy as an adjunctive treatment. Milk thistle may also have applications in
ameliorating long-term hepatic and cardiovascular effects of cancer treatment.
Preliminary studies are investigating its use as a chemopreventive agent and
possibly to treat cancer directly. Much of milk thistle's current clinical use
grows out of historical uses but is informed by an increasing number of clinical
trials and animal studies.
Number of studies has established the cancer chemopreventive role of silymarin in both in vivo and in vitro models. Silymarin modulates imbalance between cell survival and apoptosis through interference with the expressions of cell cycle regulators and proteins involved in apoptosis. In addition, silymarin also showed anti-inflammatory as well as anti-metastatic activity. Further, the protective effects of silymarin and its major active constituent, silibinin, studied in various tissues, suggest a clinical application in cancer patients as an adjunct to established therapies, to prevent or reduce chemotherapy as well as radiotherapy-induced toxicity.
Bladder cancer
Silibinin causes cell cycle arrest and apoptosis in
human bladder transitional cell carcinoma cells by regulating CDKI-CDK-cyclin
cascade, and caspase 3 and PARP cleavages.
Carcinogenesis. 2004.
Silibinin modulates CDKI-CDK-cyclin cascade and activates caspase 3 causing growth inhibition and apoptotic death of human TCC cells, providing a strong rationale for future studies evaluating preventive and/or intervention strategies for silibinin in bladder cancer pre-clinical models. Carcinogenesis. 2004.
Chemotherapy
In a study of 50 children undergoing chemotherapy for acute lymphoblastic
leukemia (ALL), milk thistle appeared to reduce treatment-related liver
inflammation. Dr. Kara M. Kelly, a pediatric oncologist at Columbia University
Medical Center in New York randomly assigned 50 children with ALL to take either
milk thistle capsules or placebo (inactive) capsules for one month while
undergoing their "maintenance" round of chemotherapy. Going into the study, all
of the children had signs of liver inflammation from their previous round of
treatment. After one month, however, children taking milk thistle had lower
levels of two liver enzymes than those in the placebo group -- a sign of lesser
liver inflammation. Kara M. Kelly reports that children on milk thistle were also somewhat less likely to
need their chemotherapy dose lowered at any point. Cancer, 2009.
Depression and mood disorders
Comparison of Silybum marianum with fluoxetine in the treatment of
Obsessive-Compulsive Disorder.
Prog Neuropsychopharmacol Biol Psychiatry. 2009.
Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric condition.
Although a variety of pharmaceutical agents is available for the treatment of
OCD, psychiatrists often find that many patients cannot tolerate the side
effects of these medications; do not respond properly to the treatment; or the
medications lose their effectiveness after a period of treatment. Herbal
medicine can be a solution to some of these problems. In fact many herbs with
psychotropic effects exist which can have fewer side effects. They can provide
an alternative treatment. Silybum marianum is a
well-known medicinal plant with a long history of usage in Iran. Our objective in this study was to compare the
efficacy of the extract of milk thistle with fluoxetine in the treatment of OCD.
The study was an 8-week pilot double-blind randomized trial. Thirty five adult
outpatients who met the DSM-IV-TR criteria for OCD based on the structured
clinical interview participated in the trial. The minimum score of Yale-Brown
Scale for OCD was 21 for all patients. In this double-blind and randomized
trial, patients were randomly assigned to receive either capsule of the extract
(600mg/day) or fluoxetine (30mg/day) for 8weeks. The results showed no
significant difference between the extract and fluoxetine in the treatment of
OCD. There was also no significant difference between the two groups in terms of
observed side effects.
Milk thistle
and diabetes
The efficacy of Silybum marianum in the treatment of
type II diabetes: a randomized, double-blind, placebo-controlled, clinical
trial.
Phytother Res. 2006.
Oxidative stresses are increasingly implicated in the pathogenesis of diabetic
complications which may either cause direct pancreatic beta-cell damage or lead
to metabolic abnormalities that can induce or aggravate diabetes. The present
study was designed to investigate the effects of the herbal medicine, milk
thistle seed extract (silymarin), which is known to have antioxidant properties
on the glycemic profile in diabetic patients. A 4-month randomized double-blind
clinical trial was conducted in 51 type II diabetic patients in two well-matched
groups. The first group received a silymarin (200 mg) tablet 3 times a
day plus conventional therapy. The second group received the same
therapy but a placebo tablet instead of silymarin. The results showed a
significant decrease in HbA(1)c, FBS, total cholesterol, LDL, triglyceride SGOT
and SGPT levels in milk thistle silymarin treated patients compared with placebo
as well as with values at the beginning of the study in each group. In
conclusion, milk thistle silymarin treatment in type II diabetic patients for 4
months has a beneficial effect on improving the glycemic profile.
Milk thistle and
liver disease, alcoholic and/or hepatitis B or C
virus liver conditions
Is there scientific evidence that milk thistle protects the liver or is
helpful as a treatment for liver disease?
As of 2017, I believe more research is needed in order
to know such benefits.
There are many types of liver disease and perhaps milk thistle or
extracts will be found to be of benefit in certain types of liver conditions.
Silymarin, a flavonolignan from milk thistle plant, is used for the protection against various liver conditions in
both clinical settings and experimental models.
J Vet Intern Med. 2013. Milk thistle and its derivative
compounds: a review of opportunities for treatment of liver disease. Hackett ES,
Twedt DC, Gustafson DL. Department of Clinical Sciences, Colorado State
University, Fort Collins, CO, USA.
Milk thistle extracts have been used as a "liver tonic" for centuries. In recent
years, silibinin, the active ingredient in milk thistle extracts, has been
studied both in vitro and in vivo to evaluate the beneficial effects in hepatic
disease. Silibinin increases antioxidant concentrations and improves outcomes in
hepatic diseases resulting from oxidant injury. Silibinin treatment has been
associated with protection against hepatic toxins, and also has resulted in
decreased hepatic inflammation and fibrosis. Limited information currently is
available regarding silibinin use in veterinary medicine. Future study is
justified to evaluate dose, kinetics, and treatment effects in domestic animals.
Dr. Christian Gluud of Copenhagen University Hospital in Denmark, reviewed 13 clinical trials of milk thistle for liver disease due to alcoholism or hepatitis B or C. The gold standard for clinical trials is for them to be placebo-controlled and double-blind, meaning neither patients nor the study administrators know whether a patient is taking the real drug or placebo. Just six of the trials analyzed met this standard. The researchers found no effect of milk thistle versus placebo on mortality rates or liver disease complications. While the remedy appeared to reduce death from liver-related causes when all data was included, an analysis limited to the best-quality studies found no effect. No increased risk of adverse events was seen with milk thistle. The American Journal of Gastroenterology, November 2005.
The Clinical Utility of Milk Thistle
in Cirrhosis of the Liver.
J Herb Pharmcother. 2002.
Silybum marianum is a flowering herb utilized for its potentially
protective effects on the liver. Although the mechanism of action is not fully
understood, one explanation may be that it concentrates in the hepatocytes and
competes with toxins for hepatocyte binding and penetration. Preliminary
clinical evaluations of milk thistle for cirrhosis of the liver indicate
potential benefits in healthier patients with alcoholic cirrhosis. However,
major flaws in many of the studies make it difficult to draw solid conclusions.
Milk thistle appears to be relatively safe, even with long-term use.
Randomized controlled trial of silymarin treatment in patients with cirrhosis of
the liver.
Hepatol. 1989.
To determine the
effect of silymarin on the outcome of patients with cirrhosis, a double blind,
prospective, randomized study was performed in 170 patients with cirrhosis. 87
patients (alcoholic 46, non-alcoholic 41) received 140 mg silymarin three times daily. 83 patients
(alcoholic 45, non-alcoholic 38) received a placebo. The mean observation period was 41 months. The 4-year
survival rate was 58% in silymarin-treated patients and 39%
in the placebo group. Analysis of subgroups indicated that treatment
with silymarin in milk thistle was effective in patients with alcoholic cirrhosis. No side effects of drug treatment were
observed.
Q. I am
just wondering what form of milk thistle I should order for my husband who has
always had elevated levels in blood test. AST 138 and ALT 60. I don't know
whether to get a liver cleanse or just milk thistle supplements.
A. There are many causes for elevated AST and ALT and it is not
possible to predict the role of this herb would have on the liver when the
diagnosis is not clear.
Osteoporosis
Biomed Res Int. 2013. Antiosteoclastic
activity of milk thistle extract after ovariectomy to suppress estrogen
deficiency-induced osteoporosis. Bone integrity abnormality and imbalance
between bone formation by osteoblasts and bone resorption by osteoclasts are
known to result in metabolic bone diseases such as osteoporosis. Silymarin-rich
milk thistle extract (MTE) and its component silibinin enhanced alkaline
phosphatase activity of osteoblasts but reduced tartrate-resistant acid
phosphatase (TRAP) activity of osteoclasts. The osteoprotective effects of MTE
were comparable to those of estrogenic isoflavone. Low-dose combination of MTE
and isoflavone had a pharmacological synergy that may be useful for osteogenic
activity. This study attempted to reveal the suppressive effects of MTE on bone
loss. C57BL/6 female mice were ovariectomized (OVX) as a model for
postmenopausal osteopenia and orally administered 10 mg/kg MTE or silibinin for
8 weeks. The sham-operated mice served as estrogen controls. The treatment of
ovariectomized mice with nontoxic MTE and silibinin improved femoral bone
mineral density and serum receptor activator of nuclear factor- κB ligand/osteoprotegerin
ratio, an index of osteoclastogenic stimulus. In addition, the administration of
MTE or silibinin inhibited femoral bone loss induced by ovariectomy and
suppressed femoral TRAP activity and cathepsin K induction responsible for
osteoclastogenesis and bone resorption. Collectively, oral dosage of milk
thistle extract containing silibinin in the preclinical setting is effective in
preventing estrogen deficiency-induced bone loss.
Compounds in the plant and their ability to be absorbed
There are many compounds in the
herb, mostly flavonoids, including silymarin, silybin, isosilybin, and
silibinin.
Phytomedicine. 2012. Absorption and metabolism of milk thistle flavanolignans in
humans. This study evaluated the absorption and metabolism of milk thistle
flavonolignans silychristin, silydianin, silybin and isosilybin isomers (all
together known as silymarin) in humans. Fourteen volunteers consumed an extract
of milk thistle and urine was collected up to 48 h after consumption. Thirty-one
metabolites were identified in urine by means of HPLC-MS/MS, monoglucuronides
being the most common excreted form, followed by sulphate-glucuronides and
diglucuronides, respectively. These flavonolignans are extensively modified
after ingestion and recovered in urine as sulpho- and glucuronyl-conjugates,
indicating a strong affinity for hepatic phase II enzymes. All future studies
(in vitro and in vivo) dealing with the effects of milk thistle should start by
considering the modification of its flavonolignans after ingestion by humans.
Milk thistle dosage
The dose of silymarin used in
studies has ranged from 200 to 800 mg per day. Milk Thistle extract is sold in a variety of concentrations including 70 percent
silymarin, 80% or a 10 to 1 milk thistle extract. One option is 80 to 200 mg extract (80% sylmarin) once
or twice daily.
Milk thistle
side effects, risk, danger
No significant milk thistle side effects have yet been reported thus far with milk
thistle extract but it is possible that, as more people take this herb,
potential side effects could be uncovered. It is unlikely that milk thistle side
effects exist in drinking the tea, but perhaps using several milk thistle
extract capsules daily for prolonged periods could cause problems.
Combining with
other herbs and nutrients
I've heard that milk thistle and alpha lipoic acid can be taken together to
fight fatty liver and high liver enzimes. Is this true? What are the correct
dosages and do they hurt the kidneys?
I have not seen human studies that
have evaluated the combination of the herb and alpha lipoic acid as a treatment
for liver damage so it is not easy to say what the right dosage would be when
taken together and whether they have any effect on kidney function. I personally
prefer using lower dosages than other people recommend.
Milk Thistle research review
Drug Metab Dispos. 2013. Milk thistle's active components silybin and isosilybin:
novel inhibitors of PXR-mediated CYP3A4 induction.
Inhibition of telomerase activity and secretion of prostate specific antigen by
silibinin in prostate cancer cells.
J Urol. 2004.
The down-regulation of PSA by
silibinin and its counteraction on DHT effects indicate that this compound can
interact with the expression of genes that are regulated through the androgen
receptor. Silibinin can also inhibit the telomerase activity that mediates cell
immortality and carcinogenesis. The 2 effects underline the possible therapeutic
use of silibinin as an antiproliferative agent in intervention for prostate
cancer.
Questions
Q. Is is safe to take
vitamin-E with C and milk thistle? What about taking it with serrapeptase?
A. No one can definitely promise 100 percent safety with the use of
vitamin combinations, but milk thistle and
vitamin C and E you mention are
relatively benign and should be fine to use together if not used in excess. As
to serrapeptase, we don't know enough about this enzyme to be certain how it
interacts with medicines and herbs and vitamins.
Q. I know it is difficult to predict, but do you
foresee any problems taking small amounts of milk thistle extract with
chrysin supplements?
A. I would suggest at first trying them separately each for a week
before combining. Use low dosages when combining many herbs or supplements.
Q. Milk thistle is a well-known liver cleanser but is it
also a diuretic, and as such, could it cause frequent urination, especially for
long term use? And possible cause some dehydration?
A. I am not aware of studies that show it to cause dehydration.
Nature's Bounty, Milk
Thistle, 250 mg, 200 Capsules
buy Milk Thistle Extract 80% Silymarin
Milk Thistle Extract is standardized to 80% silymarin, the key constituent that
exerts a protective effect against substances potentially harmful to the liver.
Buy Milk thistle extract
Supplement Facts:
Amount Per Serving
Milk thistle, dried extract 250 mg
(seed) standardized to 80% Silymarin
Supplement Facts | ||
Serving Size: 1 Capsule | ||
Amount Per Serving | %Daily Value | |
Milk Thistle Seed Extract (Silybum marianum) (Standardized to contain a minimum of 80% Silymarin) | 250 mg | ** |
**Daily Value not established. |
Recommendation: Take 1 or two milk thistle capsules daily or as recommended by your health care provider.
Additional products
Nature's Answer, Milk Thistle, Alcohol-Free, 2,000 mg, 1 fl oz (30 ml) - liquid
extract