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Milk Thistle

Botanical Name(s):

Silybum marianum

Other Name(s):

apihepar, laragon, legalon, marian thistle, Mary thistle, silibinin, silicristin, silidianin, silmar, silybin, silybum, silymarin, wild artichoke

General Description:

Milk thistle is an annual or biennial plant with reddish-purple flowers that grows up to three feet tall. Sometimes considered a weed, it is native to Europe and grows in dry, rocky soils. Milk thistle seeds (now known as Silybum marianum) have been used for hundreds of years to treat liver and gallbladder disease.

Milk thistle contains a group of bioflavinoids, collectively referred to as silymarin, produced from the seeds of the thistle. The most active of the group has been identified as silybin. Silymarin protects the liver from damage by preventing toxins from attaching to the liver cells and by neutralizing free radicals. It is used in the treatment of toxic-mushroom poisoning, cirrhosis and hepatitis.

Medically Valid Uses:

Within the last 30 years, silybin, the extract of milk thistle seeds, has been used by the medical community as a hepatoprotectant (protecting the liver) to treat various liver conditions, including mushroom poisoning, viral hepatitis, cirrhosis, alcoholic liver disease and carbon tetrachloride poisoning.

Silybin is used by physicians to treat mushroom poisoning. In-vitro studies show that if silybin is administered before liver cells are exposed to mushroom toxins (phalloidin and alpha-amanitine), silybin protects the liver cells completely. Other studies on animals show that the sooner silybin is administered after mushroom poisoning, the better the protective effect. Silybin is recognized as part of the routine treatment for Aminita mushroom poisoning.

Silybin has been clearly demonstrated to protect the liver from free radicals produced by a number of liver toxins. Many recognized liver toxins damage the liver by producing free radicals, which damage the liver cell membranes or interfere with important metabolic activity.

Unsubstantiated Claims:

Please note that this section reports on claims that have NOT yet been substantiated through scientific studies.

Multiple studies have been conducted regarding the protective effects of silybin against the hepatotoxicity of alcohol. Most studies agree that in the late stages of alcoholic cirrhosis, treatment with silybin does not improve either morbidity or mortality. However, in earlier stages, such as fatty liver caused by chronic or acute alcohol consumption, silybin provides protective effects.

Some studies have found no correlation between the use of silybin in hepatitis and improvement in liver function. However, other studies suggest that silybin may hasten recovery, return liver function to normal more quickly and possibly even help individuals who develop chronic hepatitis (as seen in hepatitis B and hepatitis C).

Research is evaluating the effectiveness of milk thistle in protecting the kidneys and pancreas against the effects of chemotherapy and in protecting against breast cancer.

Dosing Format:

For standardized preparations of milk thistle, follow the packaging instructions for the correct dose.

Side Effects, Toxicity and Interactions:

There are no known side effects or significant food or drug interactions associated with milk thistle.

Additional Information:

Click here for a list of reputable Web sites with general information on nutrition.

References:

  1. Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial [see comments]. J Hepatol. 1998;28(4):615-21.

  2. Trinchet JC, Coste T, Levy VG, et al. [Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients]. Gastroenterol Clin Biol. 1989;13(2):120-4.

  3. Bunout D, Hirsch S, Petermann M, et al. [Controlled study of the effect of silymarin on alcoholic liver disease]. Rev Med Chil. 1992;120(12):1370-5.

  4. Rink C. [Therapy of alcoholic hepatitis]. Schweiz Rundsch Med Prax. 1992;81(24):798-9.

  5. von Schonfeld J, Weisbrod B, Muller MK. Silibinin, a plant extract with antioxidant and membrane stabilizing properties, protects exocrine pancreas from cyclosporin A toxicity. Cell Mol Life Sci. 1997;53(11-12):917-20.

  6. Comoglio A, Tomasi A, Malandrino S, Poli G, Albano E. Scavenging effect of silipide, a new silybin-phospholipid complex, on ethanol-derived free radicals. Biochem Pharmacol. 1995;50(8):1313-6.

  7. Varga M, Buris L, Fodor M. Ethanol elimination in man under influence of hepatoprotective silibinin. Blutalkohol. 1991;28(6):405-8.

  8. Ortenberg EA, Zhikhareva AI, Byshevskii ASh. [Impairment of lipid metabolism in the liver and its correction after exposure to ethanol and antitubercular agents]. Vopr Med Khim. 1985;31(6):24-7.

  9. Tongiani R, Malvaldi G, Chieli E, Bertelli A. [Effect of silymarin on the total dry mass of hepatocytes inacute poisoning by phalloidin and alpha-amanitine (author's transl)]. Arch Toxicol. 1976;36(1):19-29.

  10. Desplaces A, Choppin J, Vogel G, Trost W. The effects of silymarin on experimental phalloidine poisoning. Arzneimittelforschung. 1975;25(1):89-96.

  11. Floersheim GL. Antagonistic effects against single lethal doses of Amanita phalloides. Naunyn Schmiedebergs Arch Pharmacol. 1976;293(2):171-4.

  12. Choppin J, Desplaces A. The effects of silybin on experimental phalloidine poisoning. Arzneimittelforschung 1978;28(4):636-41.

  13. Hruby K, Csomos G, Fuhrmann M, Thaler H. Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. Hum Toxicol. 1983;2(2):183-95.

  14. Parish RC, Doering PL. Treatment of Amanita mushroom poisoning: a review. Vet Hum Toxicol. 1986;28(4):318-22.

  15. Mourelle M, Favari L, Amezcua JL. Protection against thallium hepatotoxicity by silymarin. J Appl Toxicol. 1988;8(5):351-4.

  16. Dehmlow C, Erhard J, de Groot H. Inhibition of Kupffer cell functions as an explanation for the hepatoprotective properties of silibinin. Hepatology. 1996;23(4):749-54.

  17. Halim AB, el-Ahmady O, Hassab-Allah S, Abdel-Galil F, Hafez Y, Darwish A. Biochemical effect of antioxidants on lipids and liver function in experimentally-induced liver damage. Ann Clin Biochem. 1997;34(6):656-63.

  18. de Groot H, Rauen U. Tissue injury by reactive oxygen species and the protective effects of flavonoids. Fundam Clin Pharmacol. 1998;12(3):249-55.

  19. Bode JC, Schmidt U, Durr HK. [Silymarin for the treatment of acute viral hepatitis? Report of a controlled trial (author's transl)]. Med Klin. 1977;72(12):513-8.

  20. Kiesewetter E, Leodolter I, Thaler H. [Results of two double-blind studies on the effect of silymarine in chronic hepatitis (author's transl)]. Leber Magen Darm. 1977;7(5):318-23.

  21. Magliulo E, Gagliardi B, Fiori GP. [Results of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at two medical centres (author's transl)]. Med Klin. 1978;73(28-29):1060-5.

  22. Buzzelli G, Moscarella S, Giusti A, Duchini A, Marena C, Lampertico M. A pilot study on the liver protective effect of silybin- phosphatidylcholine complex (IdB1016) in chronic active hepatitis. Int J Clin Pharmacol Ther Toxicol. 1993;31(9):456-60.

  23. Flora K, Hahn M, Rosen H, Benner K. Milk thistle (Silybum marianum) for the therapy of liver disease. Am J Gastroenterol. 1998;93(2):139-43.

  24. Carducci R, Armellino MF, Volpe C, et al. [Silibinin and acute poisoning with Amanita phalloides]. Minerva Anestesiol. 1996;62(5):187-93.

  25. Bokemeyer C, Fels LM, Dunn T, et al. Silibinin protects against cisplatin-induced nephrotoxicity without compromising cisplatin or ifosfamide anti-tumour activity. Br J Cancer. 1996;74(12):2036-41.

  26. Gaedeke J, Fels LM, Bokemeyer C, Mengs U, Stolte H, Lentzen H. Cisplatin nephrotoxicity and protection by silibinin. Nephrol Dial Transplant. 1996;11(1):55-62.

  27. Soto CP, Perez BL, Favari LP, Reyes JL. Prevention of alloxan-induced diabetes mellitus in the rat by silymarin. Biochem Physiol C Pharmacol Toxicol Endocrinol. 1998;125-9.

  28. Zi X, Feyes DK, Agarwal R. Anticarcinogenic effect of a flavonoid antioxidant, silymarin, in human breast cancer cells MDA-MB 468: induction of G1 arrest through an increase in Cip1/p21 concomitant with a decrease in kinase activity of cyclin-dependent kinases and associated cyclins. Clin Cancer Res. 1998;4(4):1055-64.

  29. Chander R, Kapoor NK, Dhawan BN. Hepatoprotective activity of silymarin against hepatic damage in Mastomys natalensis infected with Plasmodium berghei. Indian J Med Res. 1989;90:472-7.

Date Last Modified: 4/6/2004