Milk Thistle

Common names: Milk thistle also is known as Holy thistle, lady's thistle, marian thistle, Mary thistle, St. Mary thistle, and silybum.

Efficacy rating:

●●●...Positive clinical trials

Safety rating:

What is Milk Thistle?

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This plant is a member of the Compositae family and is indigenous to Kashmir, but is found in North America from Canada to Mexico. Silybum has reddish-purple flowers ridged with sharp spines, and has large prickly leaves. When broken, the leaves and stems exude a milky sap. The drug consists of the shiny, mottled black or grey-toned seeds (fruit). These make up the “thistle” portion, along with its silvery pappus, which readily falls off.

What is Milk Thistle used for?

Milk thistle once was grown in Europe as a vegetable. The de-spined leaves were used in salads and for spinach substitution. The stalks and root parts also were consumed, even the flower portion was eaten “artichoke-style.” The roasted seeds were used as a coffee substitute. Various preparations of milk thistle, especially the seeds, have been used medicinally for more than 2,000 years. Its use as a liver protectant may be traced back to Greek references. Pliny the Elder, a first century Roman writer, (AC 23 to 79) noted that the plant's juice was excellent for “carrying off bile.” Culpepper (England's premier herbalist) noted milk thistle for use in removing obstructions of liver and spleen, and to be good against jaundice. The Eclectics (19th-20th century) used milk thistle for varicose veins, menstrual difficulty and congestion in liver, spleen and kidneys.

In homeopathy, a tincture of the seeds has been used to treat liver disorders, jaundice, gall stones, peritonitis, hemorrhage, bronchitis and varicose veins.

Milk thistle shows great promise. There are many clinical trials that indicate its benefits in the use as a liver protectant and for various conditions of the liver. Milk thistle extract and its major components have been found to be effective in treating toxin-poisoning, cirrhosis, and hepatitis. It is widely used in Europe for Amanita mushroom poisoning treatment. Milk thistle reduces liver damage due to long-term treatment with phenothiazine or butyrophenone therapy. Research shows that it shortened treatment time in patients with acute viral hepatitis. Data regarding protection against alcoholic cirrhosis and hepatitis are equivocal. Milk thistle also plays a role in blood and immunomodulation, and lipid and biliary effects. Silymarin's mechanisms mainly are due to hepatoprotection (protects the liver), increased regenerative capacity of liver cell turnover, the alteration of cell membranes preventing toxin uptake, and scavenging free radicals, thus, limiting liver damage.

What is the dosage of Milk Thistle?

Crude milk thistle seed has been administered at 12 to 15 g/day in clinical trials for hepatitis and other liver conditions. Milk thistle also is widely available in several extracts, standardized to 70% to 80% silymarin. These include IdB1016 (Silipide, Indena, a silybin phosphatidylcholine complex), Legalon (Madaus), and Silimarol. Doses of these extracts range from 200 to 800 mg/day.

Is Milk Thistle safe?

Contraindications have not yet been identified.

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Milk thistle occasionally may interfere with indinavir therapy.

Few adverse effects have been seen other than brief GI disturbances and mild allergic reactions; possible urticaria in one patient.

There are no reports of milk thistle toxicities in humans.

References

Copyright © 2006 Wolters Kluwer Health

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