MILK THISTLE Overview Information
Milk thistle is a plant. The above ground parts and seeds are used to make medicine. The seeds are more commonly used.
Milk thistle is used most often for liver disorders, including liver damage caused by chemicals, Amanita phalloides mushroom poisoning, jaundice, chronic inflammatory liver disease, cirrhosis of the liver, and chronic hepatitis. Nevertheless, researchers have not yet concluded with certainty that milk thistle is effective for any of these uses.
Milk thistle is also used for loss of appetite, heartburn (dyspepsia), and gallbladder complaints.
Some people use milk thistle for diabetes, hangover, diseases of the spleen, prostate cancer, malaria, depression, uterine complaints, increasing breast milk flow, allergy symptoms, and starting menstrual flow.
In foods, milk thistle leaves and flowers are eaten as a vegetable for salads and a substitute for spinach. The seeds are roasted for use as a coffee substitute.
Milk thistle gets its name from the milky sap that comes out of the leaves when they are broken. The leaves also have unique white markings that, according to legend, were the Virgin Mary’s milk. Don’t confuse milk thistle with blessed thistle (Cnicus benedictus).
How does it work?
Milk thistle seed might protect liver cells from toxic chemicals and drugs. It also seems to have antioxidant and anti-inflammatory effects. Milk thistle plant extract might enhance the effects of estrogen.
MILK THISTLE Uses & Effectiveness 
Possibly Effective for:
- Seasonal allergies (allergic rhinitis). Some research shows that people who take a milk thistle extract in combination with a conventional antihistamine have reduced symptoms compared to people who just use an antihistamine.
- Heartburn (dyspepsia), when a combination of milk thistle and several other herbs is used. The combination product (Iberogast, Medical Futures, Inc) contains milk thistle plus peppermint leaf, German chamomile, caraway, licorice, clown’s mustard plant, celandine, angelica, and lemon balm. When used daily over a period of 4 weeks, this combination seems to reduce severity of acid reflux, stomach pain, cramping, nausea, and vomiting.
Insufficient Evidence for:
- Liver disease caused by excessive use of alcohol. There is conflicting evidence about the effectiveness of milk thistle for treating alcohol-related liver disease.
- Amanita mushroom poisoning. Giving silibinin, a chemical found in milk thistle, intravenously (by IV) may lessen liver damage due to Amanita phalloides mushroom (death cap) poisoning. However, it is hard to get silibinin in the U.S.
- Hepatitis B or hepatitis C. Milk thistle and some of the chemicals in it do not seem to improve survival or decrease liver function tests in people with hepatitis B or C.
- Liver disease caused by chemicals. Some research suggests milk thistle may limit liver damage after exposure to industrial poisons such as toluene and xylene.
- Spleen disorders.
- Gallbladder problems.
- Swelling of the lungs (pleurisy).
- Malaria.
- Menstrual problems.
- Other conditions.
MILK THISTLE Side Effects & Safety
Milk thistle is LIKELY SAFE for most adults. Milk thistle sometimes causes a laxative effect. Other less common side effects are nausea, diarrhea, indigestion, intestinal gas, bloating, fullness or pain, and loss of appetite.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Not enough is known about the use of milk thistle during pregnancy and breast-feeding. Stay on the safe side and avoid use.Allergy to ragweed and related plants: Milk thistle may cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae plant family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many others. If you have allergies, be sure to check with your healthcare provider before taking milk thistle.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Extracts from milk thistle PLANT might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use these extracts. In contrast, the more commonly used milk thistle SEED extracts do not seem to act like estrogen.
MILK THISTLE Interactions
Moderate Interaction Be cautious with this combination
- Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with MILK THISTLE
Some medications are changed and broken down by the liver.
Milk thistle might decrease how quickly the liver breaks down some medications. Taking milk thistle along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking milk thistle talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), diazepam (Valium), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), and others. - Medications changed by the liver (Glucuronidated Drugs) interacts with MILK THISTLE
The body breaks down some medications to get rid of them. The liver helps break down these medications. Taking milk thistle might affect how well the liver breaks down drugs. This could increase or decrease how well some of these medications work.
Some of these medications changed by the liver include acetaminophen, atorvastatin (Lipitor), diazepam (Valium), digoxin, entacapone (Comtan), estrogen, irinotecan (Camptosar), lamotrigine (Lamictal), lorazepam (Ativan), lovastatin (Mevacor), meprobamate, morphine, oxazepam (Serax), and others.
Minor Interaction Be watchful with this combination
- Estrogens interacts with MILK THISTLE
Milk thistle might decrease hormones in the body. Milk thistle might help the body break down estrogen pills to get rid of them. Taking milk thistle along with estrogens might decrease the effectiveness of estrogen pills.
Milk thistle contains a chemical called silymarin. Silymarin might be the part of milk thistle that helps the body break down estrogens.
Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others. - Medications used for lowering cholesterol (Statins) interacts with MILK THISTLE
Theoretically, milk thistle might change the levels of some medications used for lowering cholesterol (statins). This could increase or decrease how well these medications work.
Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), and rosuvastatin (Crestor).
MILK THISTLE Dosing
The following doses have been studied in scientific research:
BY MOUTH:
- For seasonal allergies (allergic rhinitis): Milk thistle extract of silymarin 140 mg three times daily.
- For upset stomach (dyspepsia): A specific combination product containing milk thistle (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 1 mL three times daily.
