Artichaut Sauvage, Blessed Milk Thistle, Cardo Lechoso, Cardui Mariae Fructus, Cardui Mariae Herba, Carduus Marianum, Carduus marianus, Chardon Argenté, Chardon de Marie, Chardon de Notre-Dame, Chardon Marbré, Chardon-Marie, Épine Blanche, Holy Thistle, Lady's Thistle, Lait de Notre-Dame, Legalon, Marian Thistle, Mariendistel, Mary Thistle, Our Lady's Thistle, Shui Fei Ji, Silibinin, Silybe de Marie, Silybin, Silybum, Silybum marianum, Silymarin, Silymarine, St. Mary Thistle, St. Marys Thistle.<br/><br/>
Overview InformationMilk thistle is a plant that is native to Europe and was brought to North America by early colonists. Milk thistle is now found throughout the eastern United States, California, South America, Africa, Australia, and Asia. The above ground parts and seeds are used to make medicine.
Milk thistle is taken by mouth most often for liver disorders, including liver damage caused by chemicals, alcohol, and chemotherapy, as well as liver damage caused by Amanita mushroom poisoning, nonalcoholic fatty liver disease, chronic inflammatory liver disease, cirrhosis of the liver, and chronic hepatitis.
Some people apply milk thistle directly to the skin for skin damage caused by radiation.
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.
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 blood sugar-lowering, antioxidant, and anti-inflammatory effects.
Uses & Effectiveness
Possibly Effective for
- Diabetes. Taking milk thistle extract or milk thistle extract plus tree turmeric extract along with antidiabetes drugs seems to decrease blood sugar levels before meals in people with diabetes. It also seems to decrease average blood sugar levels in these people. It might take more than 3 months for milk thistle products to show benefit. Specific milk thistle products used in research include Livergol by Goldaru Herbal Products and Berberol by PharmExtracta.
- Indigestion (dyspepsia). When used daily for 4 weeks, a specific combination product (Iberogast by Medical Futures, Inc.) that contains milk thistle plus eight other ingredients seems to reduce the severity of acid reflux, stomach pain, cramping, nausea, and vomiting.
Insufficient Evidence for
- Acne. Taking milk thistle might lessen acne severity. But the benefits, if any, are small.
- Liver disease in people who drink alcohol. There is conflicting evidence about the effectiveness of milk thistle for treating alcohol-related liver disease. Early research shows that taking milk thistle by mouth might improve liver function and reduce risk of death. However, other research shows no benefit.
- Alzheimer disease. Early research shows that taking a combination supplement containing milk thistle extract improves mental function in people with Alzheimer disease.
- Mushroom poisoning. Early research shows that giving silibinin, a chemical found in milk thistle, by IV and then by mouth may lessen liver damage caused by Amanita phalloides mushroom (death cap mushroom) poisoning. However, it is hard to obtain silibinin in the US.
- Enlarged prostate (benign prostatic hyperplasia or BPH). Early research shows that taking a specific combination of milk thistle extract and selenium for 6 months might improve symptoms of enlarged prostate in men.
- A blood disorder that reduces levels of protein in the blood called hemoglobin (beta-thalassemia). Early research in children with this blood disorder shows that taking a specific milk thistle extract for 6-9 months, along with conventional medicine, might decrease iron levels better than conventional medicine alone.
- An adverse skin reaction caused by cancer drug treatment (chemotherapy-induced acral erythema). Early research shows that applying a gel containing milk thistle extract to the hands and feet beginning on the first day of chemotherapy and continuing for 9 weeks decreases the severity of this skin reaction caused by cancer drug treatment.
- Liver damage caused by cancer drugs. Early research shows that taking a specific milk thistle product containing the chemical silibinin beginning at the start of chemotherapy treatment does not significantly reduce liver toxicity caused by chemotherapy.
- Kidney damage caused by cancer drugs. Early research shows that taking milk thistle extract beginning 24-48 hours before starting therapy with cisplatin, and continuing until the end of the treatment course, does not prevent or decrease the rates of kidney injury.
- Liver scarring (cirrhosis). Early research shows that milk thistle extract might reduce the risk of death and improve liver function in people with cirrhosis. However, milk thistle extract does not seem to benefit all patients with liver disease.
- Kidney disease in people with diabetes (diabetic nephropathy). Early research shows that taking milk thistle extract together with conventional treatment might help treat kidney disease in people with diabetes.
- Hay fever. Some research shows that taking milk thistle extract by mouth along with the allergy medication cetirizine (Zyrtec) reduces seasonal allergies more than taking cetirizine alone.
- Swelling (inflammation) of the liver (hepatitis). Research on the effects of milk thistle in people with hepatitis is not consistent. Some research shows that taking milk thistle extract by mouth for 4 weeks reduces hepatitis symptoms, such as dark urine and jaundice, but does not improve liver function tests. But taking a product containing the milk thistle constituent silybin plus phosphatidylcholine by mouth for 2 weeks to 3 months might improve some liver function tests.
- Swelling (inflammation) of the liver caused by the hepatitis B virus (hepatitis B). Research on the effects of milk thistle in people with hepatitis B is not consistent. Early research shows that taking milk thistle extract by mouth for up to one year, or taking a product containing the milk thistle constituent silybin plus phosphatidylcholine by mouth for 1 week, improves liver function tests. But other research shows no benefit.
- Swelling (inflammation) of the liver caused by the hepatitis C virus (hepatitis C). Research on the effects of milk thistle in people with hepatitis C is inconsistent. Early research shows that taking milk thistle extract by mouth for up to one year, or taking a product containing the milk thistle constituent silybin plus phosphatidylcholine by mouth for 1 week, improves liver function tests. But other research shows no benefit.
- High cholesterol. Taking milk thistle along with tree turmeric seems to lower cholesterol levels in people with high cholesterol, including people who are taking statins but who require their statin dose to be lowered. Taking this product also seems to help lower cholesterol when used alone or along with low-dose statins or ezetimibe in people with high cholesterol who can't tolerate high dose statin treatment. It's unclear if these benefits are due to milk thistle, tree turmeric, or the combination. There is also evidence that taking a similar product containing milk thistle, tree turmeric, and chemicals called monacolins also helps to lower cholesterol levels. Monacolins are chemicals similar to statin drugs. So, it's not clear if the cholesterol reduction is due to milk thistle or the statin-like chemicals.
- High levels of lipoproteins in the blood (hyperlipoproteinemia). Taking milk thistle doesn't seem to lower lipid levels in the blood in people with high levels due to liver disease.
- Inability to become pregnant within a year of trying to conceive (infertility). Early research shows that taking milk thistle extract along with fertility hormones might provide some benefits for women undergoing in vitro fertilization due to male infertility.
- Breast feeding. Early research shows that taking milk thistle extract for 4 weeks does not increase milk production in mothers of premature infants.
- Symptoms of menopause. Research shows that taking a specific combination product containing milk thistle and other ingredients by mouth for 3 months reduces hot flashes by 73% and night sweats by 69% in people with menopausal symptoms. Sleep quality also improves. It' s not clear if these benefits are due to milk thistle or other ingredients.
- Multiple sclerosis (MS). Early research shows that taking a combination supplement containing milk thistle extract can improve mental function and increase disease stabilization in people with multiple sclerosis.
- Build-up of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease or NAFLD). There is evidence that milk thistle extract improves markers of liver injury in people with NAFLD. But these markers aren't always linked with the NAFLD severity. Most experts recommend that people with NAFLD lose weight to reduce fat build-up in the liver and lower their cholesterol to reduce the risk of heart disease. Taking milk thistle does not seem to improve either of these outcomes. But there is some evidence that milk thistle might benefit people with a severe form of NAFLD called nonalcoholic steatohepatitis (NASH). While taking milk thistle doesn't seems to improve the overall severity of NASH, it does seem to reduce scarring of the liver.
- Swelling (inflammation) and build up of fat in the liver in people who drink little or no alcohol (nonalcoholic steatohepatitis or NASH). While taking milk thistle doesn't seems to improve the overall severity of NASH, it does seem to reduce scarring of the liver.
- A type of anxiety marked by recurrent thoughts and repetitive behaviors (obsessive-compulsive disorder or OCD). Early research shows that taking milk thistle leaf extract by mouth three times daily for 8 weeks has a limited effect on OCD symptoms. It does not appear to more beneficial than conventional medication.
- Parkinson disease. Early research shows that taking a combination supplement containing milk thistle extract improves mental function and increases disease stabilization in people with Parkinson's disease.
- Prostate cancer. Prostate-specific antigen (PSA) is a protein in the blood that can be measured to diagnose and monitor prostate cancer. Early research shows that taking a supplement containing milk thistle extract, soy isoflavones, lycopene, vitamins, minerals and antioxidants by mouth daily can delay the rise in PSA levels in men with a history of prostate cancer. The effects of milk thistle alone are not clear.
- Skin toxicity caused by radiation. Early research shows that applying a specific product containing the milk thistle extract reduces the effect of radiation on the skin in women being treated for breast cancer.
- Inflammation and ulcers (mucositis) caused by radiation. Early research shows that taking milk thistle extract starting on the first day of radiation and continuing for 6 weeks thereafter decreases the severity of ulcers in the mouth and gut caused by radiation.
- Liver damage caused by chemicals. The effect of milk thistle on liver damage caused by chemicals is inconsistent. Taking milk thistle by mouth helps the liver to function in people who have been exposed to the chemicals toluene or xylene or those taking drugs for tuberculosis. But taking milk thistle extract by mouth does not seem to prevent liver damage associated with the drug tacrine (Cognex) in people with Alzheimer's disease.
- Hair pulling (trichotillomania). Early research shows that milk thistle taken for 6 weeks does not reduce the symptoms of hair pulling.
- A type of inflammatory bowel disease (ulcerative colitis). Early research shows that taking milk thistle extract by mouth for 6 months, in addition to standard medications, decreases the symptoms of ulcerative colitis and helps maintain remission.
- Gallbladder disease.
- Kidney damage caused by contrast dyes (contrast induced nephropathy).
- Menstrual cramps (dysmenorrhea).
- Spleen disorders.
- Swelling of the lungs (pleurisy).
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Milk thistle extract is LIKELY SAFE for most people when taken by mouth. In some people, taking milk thistle extract can cause diarrhea, nausea, intestinal gas, fullness, loss of appetite, and possibly headache.
When applied to the skin: Milk thistle extract is POSSIBLY SAFE when applied directly to the skin for short periods of time.
Special Precautions & Warnings:Pregnancy and breast-feeding: There isn't enough reliable information to know if milk thistle is safe to use when pregnant or breast feeding. Stay on the safe side and avoid use.
Children: Milk thistle is POSSIBLY SAFE when taken by mouth, appropriately, for up to 9 months in children 1 year of age and older.
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.
Diabetes: Certain chemicals in milk thistle might lower blood sugar in people with diabetes. Dosing adjustments to diabetes medications might be necessary.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Milk thistle extracts might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use these extracts.
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.<br /> 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.<br /> 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.<br /> 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.
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.<br /> Milk thistle contains a chemical called silymarin. Silymarin might be the part of milk thistle that helps the body break down estrogens.<br /> 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.<br /> Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), and rosuvastatin (Crestor).
The following doses have been studied in scientific research:
- For diabetes: A specific product (Livergol, Goldaru Herbal Products Pharmaceutical Company) containing 140 mg of milk thistle extract has been taken three times daily for 45 days. 200 mg of milk thistle extract has been taken once daily or three times daily for 4 months to one year. A specific product (Berberol, PharmExtracta) containing 210 mg of milk thistle extract and 1176 mg of tree turmeric extract has been taken daily for 3-12 months.
- For indigestion (dyspepsia): 1 mL of a specific combination product (Iberogast by Medical Futures, Inc.) containing milk thistle and several other herbs has been used three times daily for 4 weeks.
- Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol 2007;23:117-22. View abstract.
- Saller R, Brignoli R, Melzer J, Meier R. An updated systematic review with meta-analysis for the clinical evidence of silymarin. Forsch Komplementarmed 2008;15:9-20. View abstract.
- Salmi HA, Sarna S. Effect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind, controlled study. Scand J Gastroenterol 1982;17:517-21. View abstract.
- Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor beta (ERbeta) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx) rats. J Steroid Biochem Mol Biol. 2003;86(2):179-88. View abstract.
- Shahbazi F, Sadighi S, Dashti-Khavidaki S, et al. Effect of Silymarin Administration on Cisplatin Nephrotoxicity: Report from A Pilot, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Phytother Res. 2015;29(7):1046-53. View abstract.
- Shie Morteza M, Hayati Z, Namazi N, Abdollahimajd F. Efficacy and safety of oral silymarin in comparison with oral doxycycline and their combination therapy in the treatment of acne vulgaris. Dermatol Ther. 2019;32(6):e13095. View abstract.
- Sonnenbichler J, Scalera F, Sonnenbichler I, Weyhenmeyer R. Stimulatory effects of silibinin and silicristin from the milk thistle Silybum marianum on kidney cells. J Pharmacol Exp Ther 1999;290:1375-83. View abstract.
- Sridar C, Goosen TC, Kent UM, et al. Silybin inactivates cytochromes P450 3A4 and 2C9 and inhibits major hepatic glucuronosyltransferases. Drug Metab Dispos 2004;32:587-94. View abstract.
- Sridharan K, Sivaramakrishnan G. Efficacy and safety of iron chelators in thalassemia and sickle cell disease: a multiple treatment comparison network meta-analysis and trial sequential analysis. Expert Rev Clin Pharmacol 2018;11(6):641-50. doi: 10.1080/17512433.2018.1473760. View abstract.
- Suksomboon N, Poolsup N, Boonkaew S, Suthisisang CC. Meta-analysis of the effect of herbal supplement on glycemic control in type 2 diabetes. J Ethnopharmacol 2011;137(3):1328-1333. View abstract.
- Szilard S, Szentgyorgyi D, Demeter I. Protective effect of Legalon in workers exposed to organic solvents. Acta Med Hung 1988;45:249-56. View abstract.
- Tanamly MD, Tadros F, Labeeb S, et al. Randomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results. Dig Liver Dis 2004;36:752-9. View abstract.
- Tosukhowong P, Boonla C, Dissayabutra T, et al. Biochemical and clinical effects of whey protein supplementation in Parkinson's disease: A pilot study. J Neurol Sci. 2016;367:162-70. View abstract.
- Tóth B, Németh D, Soós A, et al. The effects of a fixed combination of Berberis aristata and Silybum marianum on dyslipidaemia - A meta-analysis and systematic review. Planta Med. 2019. View abstract.
- Trinchet JC, Coste T, Levy VG. [Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients]. Gastroenterol Clin Biol 1989;13:120-4. View abstract.
- van Erp NP, Baker SD, Zhao M, et al. Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 2005;11:7800-6. View abstract.
- Velussi M, Cernigoi AM, De Monte A, et al. Long-term (12 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol 1997;26:871-9. View abstract.
- Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metab Dispos 2000;28:1270-3. View abstract.
- Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A. Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Diabetes Res. 2016;2016:5147468. View abstract.
- Vostalova J, Vidlar A, Ulrichova J, et al. Use of selenium-silymarin mix reduces lower urinary tract symptoms and prostate specific antigen in men. Phytomedicine 2013;21:75-81. View abstract.
- Wah Kheong C, Nik Mustapha NR, Mahadeva S. A randomized trial of silymarin for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2017;15(12):1940-1949. View abstract.
- Yang Z, Zhuang L, Lu Y, Xu Q, Chen X. Effects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials. Biomed Res Int. 2014;941085. doi: 10.1155/2014/941085. Epub 2014 Aug 27. View abstract.
- Zhong S, Fan Y, Yan Q, et al. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials. Medicine (Baltimore). 2017;96(49):e9061. View abstract.
- Zhu W, Zhang JS, Young CY. Silymarin inhibits function of the androgen receptor by reducing nuclear localization of the receptor in the human prostate cancer cell line LNCaP. Carcinogenesis 2001;22:1399-403. View abstract.
- Derosa G, D'Angelo A, Maffioli P. The role of a fixed Berberis aristata/Silybum marianum combination in the treatment of type 1 diabetes mellitus. Clin Nutr. 2016;35(5):1091-5. View abstract.
- Derosa G, D'Angelo A, Romano D, Maffioli P. Effects of a combination of Berberis aristata, Silybum marianum and monacolin on lipid profile in subjects at low cardiovascular risk; A double-blind, randomized, placebo-controlled trial. Int J Mol Sci. 2017;18(2). pii: E343. View abstract.
- Derosa G, Romano D, D'Angelo A, Maffioli P. Berberis aristata/Silybum marianum fixed combination (Berberol(®)) effects on lipid profile in dyslipidemic patients intolerant to statins at high dosages: a randomized, placebo-controlled, clinical trial. Phytomedicine. 2015;22(2):231-7. View abstract.
- Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:89-96. View abstract.
- Di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes. 2012;5:213-7. View abstract.
- DiCenzo R, Shelton M, Jordan K, et al. Coadministration of milk thistle and indinavir in healthy subjects. Pharmacotherapy 2003;23:866-70.. View abstract.
- Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. View abstract.
- Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
- Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A Triple-blinded randomized controlled clinical trial. Phytomedicine. 2018;44:39-44. View abstract.
- El-Shitany NA, Hegazy S, El-Desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010;17(2):116-25. View abstract.
- Elyasi S, Hosseini S, Niazi Moghadam MR, Aledavood SA, Karimi G. Effect of Oral Silymarin Administration on Prevention of Radiotherapy Induced Mucositis: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Phytother Res. 2016;30(11):1879-85. View abstract.
- Elyasi S, Shojaee FSR, Allahyari A, Karimi G. Topical Silymarin Administration for Prevention of Capecitabine-Induced Hand-Foot Syndrome: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Phytother Res. 2017;31(9):1323-29. View abstract.
- FDA letter to GCI Nutrients Worldwide Inc. February 16, 2005. Available at: www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/CyberLetters/ucm126468.pdf (Accessed 4/2/15).
- Feher J, Deak G, Muzes G, et al. [Liver-protective action of silymarin therapy in chronic alcoholic liver diseases]. Orv Hetil 1989;130:2723-7. View abstract.
- Fenclova M, Novakova A, Viktorova J, et al. Poor chemical and microbiological quality of the commercial milk thistle-based dietary supplements may account for their reported unsatisfactory and non-reproducible clinical outcomes. Sci Rep. 2019;9(1):11118. View abstract.
- Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105-13. View abstract.
- Flora K, Hahn M, Rosen H, Benner K. Milk thistle (Silybum marianum) for the therapy of liver disease. Am J Gastroenterol 1998;93:139-43. View abstract.
- Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999.
- Freedman ND, Curto TM, Morishima C, et al. Silymarin use and liver disease progression in the hepatitis C Antiviral Long-Term Treatment against Cirrhosis Trial. Aliment Pharmacol Ther 2011;33:127-37. View abstract.
- Grant JE and Odlaug BL. Silymarin treatment of obsessive-compulsive spectrum disorders. J Clin Psychopharmacol. 2015;35(3):340-2. View abstract.
- Grant JE, Redden SA, Chamberlain SR. Milk Thistle Treatment for Children and Adults with Trichotillomania: A Double-Blind, Placebo-Controlled, Crossover Negative Study. J Clin Psychopharmacol 2019;39(2):129-34. doi: 10.1097/JCP.0000000000001005. View abstract.
- Guarino G, Strollo F, Carbone L, et al. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. J Biol Regul Homeost Agents. 2017;31(2):495-502. View abstract.
- Gufford BT, Chen G, Vergara AG, et al. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos. 2015;43(9):1353-9. View abstract.
- Gurley B, Hubbard MA, Williams DK, et al. Assessing the clinical significance of botanical supplementation on human cytochrome P450 3A activity: comparison of a milk thistle and black cohosh product to rifampin and clarithromycin. J Clin Pharmacol 2006;46:201-13. View abstract.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. . View abstract.
- Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.
- Hruby K, Csomos G, Fuhrmann M, Thaler H. Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. Hum Toxicol 1983;2:183-95. View abstract.
- Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 2006;20;1036-9. View abstract.
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. View abstract.
- Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60. View abstract.
- Kawaguchi-Suzuki M, Frye RF, Zhu HJ, et al. The effects of milk thistle (Silybum marianum) on human cytochrome P450 activity. Drug Metab Dispos. 2014;42(10):1611-6. View abstract.
- Kim CS, Choi SJ, Park CY, et al. Effects of silybinin on the pharmacokinetics of tamoxifen and its active metabolite, 4-hydroxytamoxifen in rats. Anticancer Res 2010;30:79-85. View abstract.
- Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull 1994;17:443-5. View abstract.
- Kuo YJ, Chang HP, Chang YJ, Wu HH, Chen CH. Evaluation of nephroprotection of silymarin on contrast-induced nephropathy in liver cirrhosis patients: A population-based cohort study. Medicine (Baltimore) 2018;97(37):e12243. View abstract.
- Lash DB, Ward S. CYP2C9-mediated warfarin and milk thistle interaction. J Clin Pharm Ther. 2019. View abstract.
- Lee JI, Narayan M, Barrett JS. Analysis and comparison of active constituents in commercial standardized silymarin extracts by liquid chromatography-electrospray ionization mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2007;845(1):95-103. View abstract.
- Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med 2012;52(9):1658-65. View abstract.
- Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A. A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med. 2015;15:334. View abstract.
- Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52. View abstract.
- Madisch A, Melderis H, Mayr G, et al. [A plant extract and its modified preparation in functional dyspepsia. Results of a double-blind placebo controlled comparative study]. Z Gastroenterol 2001;39(7):511-7. View abstract.
- Maitrejean M, Comte G, Barron D, et al. The flavanolignan silybin and its hemisynthetic derivatives, a novel series of potential modulators of P-glycoprotein. Bioorg Med Chem Lett 2000;10:157-60. View abstract.
- Malekshah RE, Khaleghian A. Influence of Silybum marianum on morphine addicted rats, biochemical parameters and molecular simulation studies on µ-opioid receptor. Drug Res (Stuttg). 2019;69(11):630-638. View abstract.
- Manna SK, Mukhopadhyay A, Van NT, Aggarwal BB. Silymarin suppresses TNF-induced activation of NF-kappa B, c-Jun N-terminal kinase, and apoptosis. J Immunol 1999;163:6800-9. View abstract.
- Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87. View abstract.
- Moayedi B, Gharagozloo M, Esmaeil N, et al. A randomized double-blind, placebo-controlled study of therapeutic effects of silymarin in β-thalassemia major patients receiving desferrioxamine. Eur J Haematol 2013;90(3):202-9. View abstract.
- Navarro VJ, Belle SH, D'Amato M, et al. Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: A randomized, double-blind, placebo controlled trial. PLoS One. 2019;14(9):e0221683. View abstract.
- 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. J Hepatol 1998;28:615-21. View abstract.
- Peila C, Coscia A, Tonetto P, et al. Evaluation of the galactogogue effect of silymarin on mothers of preterm newborns (<32 weeks). Pediatr Med Chir. 2015;37(3):105. View abstract.
- Piscitelli SC, Formentini E, Burstein AH, et al. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002;22:551-6. View abstract.
- Rastegarpanah M, Malekzadeh R, Vahedi H, et al. A randomized, double blinded, placebo-controlled clinical trial of silymarin in ulcerative colitis. Chin J Integr Med. 2015;21(12):902-6. View abstract.
- Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/clinic/epcsums/milktsum.htm
- Bakhshaee M, Jabbari F, Hoseini S, et al. Effect of silymarin in the treatment of allergic rhinitis. Otolaryngology - Head and Neck Surgery 2011;145:904-9. View abstract.
- 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;86:250-6. View abstract.
- Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7. View abstract.
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. View abstract.
- Bunout D, Hirsch S, Petermann M. [Controlled study of the effect of silymarin on alcoholic liver disease.] Rev Med Chil 1992;120:1370-5. View abstract.
- Buzzelli G, Moscarella S, Giusti A, et al. A pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB1016) in chronic active hepatitis. Int J Clin Pharmacol Ther Toxicol 1993;31:456-60. View abstract.
- Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005-23. View abstract.
- Chevallier A. Encyclopedia of Herbal Medicine. 2nd ed. New York, NY: DK Publ, Inc., 2000.
- Deng JW, Shon JH, Shin HJ, et al. Effect of silymarin supplement on the pharmacokinetics of rosuvastatin. Pharm Res 2008;25:1807-14. View abstract.
- Sonnenbichler, J., Goldberg, M., Hane, L., Madubunyi, I., Vogl, S., and Zetl, I. Stimulatory effect of Silibinin on the DNA synthesis in partially hepatectomized rat livers: non-response in hepatoma and other malign cell lines. Biochem.Pharmacol 2-1-1986;35(3):538-541. View abstract.
- Soto, C. P., Perez, B. L., Favari, L. P., and Reyes, J. L. Prevention of alloxan-induced diabetes mellitus in the rat by silymarin. Comp Biochem Physiol C.Pharmacol Toxicol.Endocrinol. 1998;119(2):125-129. View abstract.
- Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
- Tiwari, P., Kumar, A., Balakrishnan, S., Kushwaha, H. S., and Mishra, K. P. Silibinin-induced apoptosis in MCF7 and T47D human breast carcinoma cells involves caspase-8 activation and mitochondrial pathway. Cancer Invest 2011;29(1):12-20. View abstract.
- Tyutyulkova, N., Tuneva, S., Gorantcheva, U., Tanev, G., Zhivkov, V., Chelibonova-Lorer, H., and Bozhkov, S. Hepatoprotective effect of silymarin (carsil) on liver of D- galactosamine treated rats. Biochemical and morphological investigations. Methods Find.Exp Clin Pharmacol 1981;3(2):71-77. View abstract.
- Vailati A, Aristia L, Sozze E, and et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia 1993;64(3):219-228.
- Valenzuela, A., Lagos, C., Schmidt, K., and Videla, L. A. Silymarin protection against hepatic lipid peroxidation induced by acute ethanol intoxication in the rat. Biochem.Pharmacol 6-15-1985;34(12):2209-2212. View abstract.
- Velussi M, Cernigoi AM, Viezzoli L, and et al. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin need in cirrhotic diabetic patients. Curr Ther Res 1993;53(5):533-545.
- Vidlar, A., Vostalova, J., Ulrichova, J., Student, V., Krajicek, M., Vrbkova, J., and Simanek, V. The safety and efficacy of a silymarin and selenium combination in men after radical prostatectomy - a six month placebo-controlled double-blind clinical trial. Biomed.Pap.Med.Fac.Univ Palacky.Olomouc.Czech.Repub. 2010;154(3):239-244. View abstract.
- Wagoner, J., Morishima, C., Graf, T. N., Oberlies, N. H., Teissier, E., Pecheur, E. I., Tavis, J. E., and Polyak, S. J. Differential in vitro effects of intravenous versus oral formulations of silibinin on the HCV life cycle and inflammation. PLoS.One. 2011;6(1):e16464. View abstract.
- Wallace, S., Vaughn, K., Stewart, B. W., Viswanathan, T., Clausen, E., Nagarajan, S., and Carrier, D. J. Milk thistle extracts inhibit the oxidation of low-density lipoprotein (LDL) and subsequent scavenger receptor-dependent monocyte adhesion. J Agric Food Chem 6-11-2008;56(11):3966-3972. View abstract.
- Wenzel, S., Stolte, H., and Soose, M. Effects of silibinin and antioxidants on high glucose-induced alterations of fibronectin turnover in human mesangial cell cultures. J Pharmacol Exp Ther 1996;279(3):1520-1526. View abstract.
- Weyhenmeyer, R., Mascher, H., and Birkmayer, J. Study on dose-linearity of the pharmacokinetics of silibinin diastereomers using a new stereospecific assay. Int.J Clin Pharmacol Ther Toxicol 1992;30(4):134-138. View abstract.
- Yakoot, M. and Salem, A. Spirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial. BMC.Gastroenterol. 2012;12:32. View abstract.
- Zhang, J. Q., Mao, X. M., and Zhou, Y. P. [Effects of silybin on red blood cell sorbitol and nerve conduction velocity in diabetic patients]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1993;13(12):725-6, 708. View abstract.
- Zhang, J., Luan, Q., Liu, Y., Lee, D. Y., and Wang, Z. A comparison of the diastereoisomers, silybin A and silybin B, on the induction of apoptosis in K562 cells. Nat.Prod.Commun. 2011;6(11):1653-1656. View abstract.
- Zi, X., Mukhtar, H., and Agarwal, R. Novel cancer chemopreventive effects of a flavonoid antioxidant silymarin: inhibition of mRNA expression of an endogenous tumor promoter TNF alpha. Biochem.Biophys.Res Commun. 10-9-1997;239(1):334-339. View abstract.
- Zima, T., Kamenikova, L., Janebova, M., Buchar, E., Crkovska, J., and Tesar, V. The effect of silibinin on experimental cyclosporine nephrotoxicity. Ren Fail. 1998;20(3):471-479. View abstract.
- Zou, C. G., Agar, N. S., and Jones, G. L. Oxidative insult to human red blood cells induced by free radical initiator AAPH and its inhibition by a commercial antioxidant mixture. Life Sci 5-25-2001;69(1):75-86. View abstract.
- Abenavoli L, Capasso R, Milic N, Capasso F. Milk thistle in liver diseases: past, present, future. Phytother Res 2010;24:1423-32. View abstract.
- Adverse Drug Reactions Advisory Committee. An adverse reaction to the herbal medication milk thistle (Silybum marianum). Med J Aust 1999;170:218-9. View abstract.
- Aller R, Izaola O, Gómez S, et al. Effect of silymarin plus vitamin E in patients with non-alcoholic fatty liver disease. A randomized clinical pilot study. Eur Rev Med Pharmacol Sci. 2015;19(16):3118-24. View abstract.
- Kittur, S., Wilasrusmee, S., Pedersen, W. A., Mattson, M. P., Straube-West, K., Wilasrusmee, C., Lubelt, B., and Kittur, D. S. Neurotrophic and neuroprotective effects of milk thistle (Silybum marianum) on neurons in culture. J Mol.Neurosci. 2002;18(3):265-269. View abstract.
- Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL). Cancer 1-15-2010;116(2):506-513. View abstract.
- Lahiri-Chatterjee, M., Katiyar, S. K., Mohan, R. R., and Agarwal, R. A flavonoid antioxidant, silymarin, affords exceptionally high protection against tumor promotion in the SENCAR mouse skin tumorigenesis model. Cancer Res 2-1-1999;59(3):622-632. View abstract.
- Lang, I., Deak, G., Nekam, K., Muzes, G., Gonzalez-Cabello, R., Gergely, P., and Feher, J. Hepatoprotective and immunomodulatory effects of antioxidant therapy. Acta Med Hung. 1988;45(3-4):287-295. View abstract.
- Li, J., Lin, W. F., Pan, Y. Y., and Zhu, X. Y. [Protective effect of silibinin on liver injury induced by antituberculosis drugs]. Zhonghua Gan Zang.Bing.Za Zhi. 2010;18(5):385-386. View abstract.
- Lirussi F, Nassuato G, Orlando R, and et al. Treatment of active cirrhosis with ursodeoxycholic acid and a free radical scavenger: A two year prospective study. Med Sci Ress 1995;23:31-33.
- Locher, R., Suter, P. M., Weyhenmeyer, R., and Vetter, W. Inhibitory action of silibinin on low density lipoprotein oxidation. Arzneimittelforschung. 1998;48(3):236-239. View abstract.
- Lucena, M. I., Andrade, R. J., de la Cruz, J. P., Rodriguez-Mendizabal, M., Blanco, E., and Sanchez, de la Cuesta. Effects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis. Results of a randomized, double-blind, placebo- controlled clinical study. Int J Clin Pharmacol Ther 2002;40(1):2-8. View abstract.
- Magdalan, J., Piotrowska, A., Gomulkiewicz, A., Sozanski, T., Szelag, A., and Dziegiel, P. Influence of commonly used clinical antidotes on antioxidant systems in human hepatocyte culture intoxicated with alpha-amanitin. Hum.Exp.Toxicol. 2011;30(1):38-43. View abstract.
- Magliulo, E., Gagliardi, B., and Fiori, G. P. [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. 7-14-1978;73(28-29):1060-1065. View abstract.
- Marcelli R, Bizzoni P, Conte D, and et al. Randomized controlled study of the efficacy and tolerability of a short course of IdB 1016 in the treatment of chronic persistent hepatitis. Eur Bull Drug Res 1992;1(3):131-135.
- Marena C and Lampertico M. Preliminary clinical development of silipide: a new complex of silybin in toxic liver disorders. Planta Med 1991;57(2):A124-A125.
- Mereish, K. A., Bunner, D. L., Ragland, D. R., and Creasia, D. A. Protection against microcystin-LR-induced hepatotoxicity by Silymarin: biochemistry, histopathology, and lethality. Pharm.Res 1991;8(2):273-277. View abstract.
- Mira ML, Azevedo MS, and Manso C. The neutralization of hydroxyl radical by silibin, sorbinil and bendazac. Free Radical Res Commun 1987;4(125):129.
- Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
- Moosavifar, N., Mohammadpour, A. H., Jallali, M., Karimiz, G., and Saberi, H. Evaluation of effect of silymarin on granulosa cell apoptosis and follicular development in patients undergoing in vitro fertilization. East Mediterr.Health J. 2010;16(6):642-645. View abstract.
- Nassuato, G., Iemmolo, R. M., Strazzabosco, M., Lirussi, F., Deana, R., Francesconi, M. A., Muraca, M., Passera, D., Fragasso, A., Orlando, R., and . Effect of Silibinin on biliary lipid composition. Experimental and clinical study. J Hepatol. 1991;12(3):290-295. View abstract.
- Pade, D. and Stavchansky, S. Selection of bioavailability markers for herbal extracts based on in silico descriptors and their correlation to in vitro permeability. Mol.Pharm. 2008;5(4):665-671. View abstract.
- Palasciano G, Portincasa P, Palmieri V, and et al. The effect of silymarin on plasma levels of malon-dialdehyde in patients receiving long-term treatment with psychotropic drugs. Current Therapeutic Research 1994;55(5):537-545.
- Par, A., Roth, E., Miseta, A., Hegedus, G., Par, G., Hunyady, B., and Vincze, A. [Effects of supplementation with the antioxidant flavonoid, silymarin, in chronic hepatitis C patients treated with peg-interferon + ribavirin. A placebo-controlled double blind study]. Orv.Hetil. 1-11-2009;150(2):73-79. View abstract.
- Payer, B. A., Reiberger, T., Rutter, K., Beinhardt, S., Staettermayer, A. F., Peck-Radosavljevic, M., and Ferenci, P. Successful HCV eradication and inhibition of HIV replication by intravenous silibinin in an HIV-HCV coinfected patient. J.Clin.Virol. 2010;49(2):131-133. View abstract.
- Rambaldi, A., Jacobs, B. P., and Gluud, C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane.Database.Syst.Rev 2007;(4):CD003620. View abstract.
- Ramellini, G. and Meldolesi, J. Liver protection by silymarin: in vitro effect on dissociated rat hepatocytes. Arzneimittelforschung. 1976;26(1):69-73. View abstract.
- Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. View abstract.
- Reutter, F. W. and Haase, W. [Clinical experience with silymarin in the treatment of chronic liver disease(author's transl)]. Schweiz Rundsch.Med Prax. 9-9-1975;64(36):1145-1151. View abstract.
- Savio, D., Harrasser, P. C., and Basso, G. Softgel capsule technology as an enhancer device for the absorption of natural principles in humans. A bioavailability cross-over randomised study on silybin. Arzneimittelforschung. 1998;48(11):1104-1106. View abstract.
- Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. View abstract.
- Schrieber, S. J., Hawke, R. L., Wen, Z., Smith, P. C., Reddy, K. R., Wahed, A. S., Belle, S. H., Afdhal, N. H., Navarro, V. J., Meyers, C. M., Doo, E., and Fried, M. W. Differences in the disposition of silymarin between patients with nonalcoholic fatty liver disease and chronic hepatitis C. Drug Metab Dispos. 2011;39(12):2182-2190. View abstract.
- Schrieber, S. J., Wen, Z., Vourvahis, M., Smith, P. C., Fried, M. W., Kashuba, A. D., and Hawke, R. L. The pharmacokinetics of silymarin is altered in patients with hepatitis C virus and nonalcoholic Fatty liver disease and correlates with plasma caspase-3/7 activity. Drug Metab Dispos 2008;36(9):1909-1916. View abstract.
- Schriewer, H. and Rauen, H. M. [The effect of silybin dihemisuccinate on cholesterol biosynthesis in rat liver homogenates (author's transl)]. Arzneimittelforschung. 1977;27(9):1691-1694. View abstract.
- Schroder, F. H., Roobol, M. J., Boeve, E. R., de Mutsert, R., Zuijdgeest-van Leeuwen, S. D., Kersten, I., Wildhagen, M. F., and van Helvoort, A. Randomized, double-blind, placebo-controlled crossover study in men with prostate cancer and rising PSA: effectiveness of a dietary supplement. Eur Urol 2005;48(6):922-930. View abstract.
- Schuppan D, Strosser W, Burkard G, and et al. Influence of Legalon(TM) 140 on the metabolism of collagen in patients with chronic liver disease--Review by measurement of PIIINP-values. Zeitschrift fur Allgemeinmedizin 1998;74:577-584.
- Skottova, N. and Krecman, V. Silymarin as a potential hypocholesterolaemic drug. Physiol Res 1998;47(1):1-7. View abstract.
- Somogyi, A., Ecsedi, G. G., Blazovics, A., Miskolczi, K., Gergely, P., and Feher, J. Short term treatment of type II hyperlipoproteinaemia with silymarin. Acta Med Hung. 1989;46(4):289-295. View abstract.
- Sonnenbichler J and Zetl I. Stimulating influence of a flavonolignane derivative on proliferation, RNA synthesis and protein synthesis in liver cells. In: Okoliczanyi L, Csomos G, Crepaldi G, and et al. Assessment and Management of Hepatobiliary Disease. Berlin: Springer-Verlag;1987.
- Sonnenbichler, J. and Zetl, I. Biochemical effects of the flavonolignane silibinin on RNA, protein and DNA synthesis in rat livers. Prog.Clin Biol Res 1986;213:319-331. View abstract.
- Flory, P. J., Krug, G., Lorenz, D., and Mennicke, W. H. [Studies on elimination of silymarin in cholecystectomized patients. I. Biliary and renal elimination after a single oral dose]. Planta Med 1980;38(3):227-237. View abstract.
- Frerick F, Kuhn U, and Strenge-Hesse A. Silymarin--ein Phytopharmakon zur Behandlung toxischen Leberschaden: Anwendungsbeobachtung bei 2169 Patienten. Kassenarzt 1990;33:36-41.
- Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., Doo, E., Meyers, C. M., and Reddy, K. R. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial. JAMA 7-18-2012;308(3):274-282. View abstract.
- Gaedeke, J., Fels, L. M., Bokemeyer, C., Mengs, U., Stolte, H., and Lentzen, H. Cisplatin nephrotoxicity and protection by silibinin. Nephrol.Dial.Transplant. 1996;11(1):55-62. View abstract.
- Gatti, G. and Perucca, E. Plasma concentrations of free and conjugated silybin after oral intake of a silybin-phosphatidylcholine complex (silipide) in healthy volunteers. Int.J Clin Pharmacol.Ther. 1994;32(11):614-617. View abstract.
- Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmacol. 2009;23(3):359-365. View abstract.
- Giorgi, V. S., Peracoli, M. T., Peracoli, J. C., Witkin, S. S., and Bannwart-Castro, C. F. Silibinin modulates the NF-kappab pathway and pro-inflammatory cytokine production by mononuclear cells from preeclamptic women. J.Reprod.Immunol. 2012;95(1-2):67-72. View abstract.
- Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
- Hasani-Ranjbar, S., Larijani, B., and Abdollahi, M. A systematic review of the potential herbal sources of future drugs effective in oxidant-related diseases. Inflamm.Allergy Drug Targets. 2009;8(1):2-10. View abstract.
- Hasani-Ranjbar, S., Nayebi, N., Moradi, L., Mehri, A., Larijani, B., and Abdollahi, M. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr.Pharm.Des 2010;16(26):2935-2947. View abstract.
- Hawke, R. L., Schrieber, S. J., Soule, T. A., Wen, Z., Smith, P. C., Reddy, K. R., Wahed, A. S., Belle, S. H., Afdhal, N. H., Navarro, V. J., Berman, J., Liu, Q. Y., Doo, E., and Fried, M. W. Silymarin ascending multiple oral dosing phase I study in noncirrhotic patients with chronic hepatitis C. J.Clin.Pharmacol. 2010;50(4):434-449. View abstract.
- Hikino, H., Kiso, Y., Wagner, H., and Fiebig, M. Antihepatotoxic actions of flavonolignans from Silybum marianum fruits. Planta Med 1984;50(3):248-250. View abstract.
- Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. View abstract.
- Iakimchuk, G. N. and Gendrikson, L. N. [Study of clinical efficiency of essential phospholipids and silymarin combination in nonalcoholic and alcoholic steatohepatitis]. Eksp.Klin.Gastroenterol. 2011;(7):64-69. View abstract.
- Jacobs, B. P., Dennehy, C., Ramirez, G., Sapp, J., and Lawrence, V. A. Milk thistle for the treatment of liver disease: a systematic review and meta-analysis. Am J Med 10-15-2002;113(6):506-515. View abstract.
- Katiyar, S. K., Korman, N. J., Mukhtar, H., and Agarwal, R. Protective effects of silymarin against photocarcinogenesis in a mouse skin model. J Natl.Cancer Inst. 4-16-1997;89(8):556-566. View abstract.
- Kiesewetter, E., Leodolter, I., and 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):318-323. View abstract.
- Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. View abstract.
- Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. View abstract.
- Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
- Asghar, Z. and Masood, Z. Evaluation of antioxidant properties of silymarin and its potential to inhibit peroxyl radicals in vitro. Pak.J Pharm Sci 2008;21(3):249-254. View abstract.
- Barzaghi, N., Crema, F., Gatti, G., Pifferi, G., and Perucca, E. Pharmacokinetic studies on IdB 1016, a silybin- phosphatidylcholine complex, in healthy human subjects. Eur J Drug Metab Pharmacokinet. 1990;15(4):333-338. View abstract.
- Basaga, H., Poli, G., Tekkaya, C., and Aras, I. Free radical scavenging and antioxidative properties of 'silibin' complexes on microsomal lipid peroxidation. Cell Biochem Funct. 1997;15(1):27-33. View abstract.
- Batakov, E. A. [Effect of Silybum marianum oil and legalon on lipid peroxidation and liver antioxidant systems in rats intoxicated with carbon tetrachloride]. Eksp.Klin Farmakol. 2001;64(4):53-55. View abstract.
- Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21. View abstract.
- Becker-Schiebe, M., Mengs, U., Schaefer, M., Bulitta, M., and Hoffmann, W. Topical use of a silymarin-based preparation to prevent radiodermatitis : results of a prospective study in breast cancer patients. Strahlenther.Onkol. 2011;187(8):485-491. View abstract.
- Benda, L., Dittrich, H., Ferenzi, P., Frank, H., and Wewalka, F. [The influence of therapy with silymarin on the survival rate of patients with liver cirrhosis (author's transl)]. Wien.Klin.Wochenschr. 10-10-1980;92(19):678-683. View abstract.
- Bhatia, N. and Agarwal, R. Detrimental effect of cancer preventive phytochemicals silymarin, genistein and epigallocatechin 3-gallate on epigenetic events in human prostate carcinoma DU145 cells. Prostate 2-1-2001;46(2):98-107. View abstract.
- Boari, C., Montanari, F. M., Galletti, G. P., Rizzoli, D., Baldi, E., Caudarella, R., and Gennari, P. [Toxic occupational liver diseases. Therapeutic effects of silymarin]. Minerva Med 10-20-1981;72(40):2679-2688. View abstract.
- Bode, J. C., Schmidt, U., and Durr, H. K. [Silymarin for the treatment of acute viral hepatitis? Report of a controlled trial (author's transl)]. Med Klin. 3-25-1977;72(12):513-518. View abstract.
- Bokemeyer, C., Fels, L. M., Dunn, T., Voigt, W., Gaedeke, J., Schmoll, H. J., Stolte, H., and Lentzen, H. Silibinin protects against cisplatin-induced nephrotoxicity without compromising cisplatin or ifosfamide anti-tumour activity. Br J Cancer 1996;74(12):2036-2041. View abstract.
- Brinda, B. J., Zhu, H. J., and Markowitz, J. S. A sensitive LC-MS/MS assay for the simultaneous analysis of the major active components of silymarin in human plasma. J.Chromatogr.B Analyt.Technol.Biomed.Life Sci. 8-1-2012;902:1-9. View abstract.
- Carducci, R., Armellino, M. F., Volpe, C., Basile, G., Caso, N., Apicella, A., and Basile, V. [Silibinin and acute poisoning with Amanita phalloides]. Minerva Anestesiol. 1996;62(5):187-193. View abstract.
- Carini, R., Comoglio, A., Albano, E., and Poli, G. Lipid peroxidation and irreversible damage in the rat hepatocyte model. Protection by the silybin-phospholipid complex IdB 1016. Biochem Pharmacol 5-28-1992;43(10):2111-2115. View abstract.
- Cavalieri S. A controlled clinical trial of Legalon in 40 patients. Gazz Med Ital 1974;133:628-635.
- Comoglio, A., Tomasi, A., Malandrino, S., Poli, G., and Albano, E. Scavenging effect of silipide, a new silybin-phospholipid complex, on ethanol-derived free radicals. Biochem.Pharmacol 10-12-1995;50(8):1313-1316. View abstract.
- de Font-Reaulx, Rojas E. and Dorazco-Barragan, G. [Clinical stabilisation in neurodegenerative diseases: clinical study in phase II]. Rev.Neurol. 5-1-2010;50(9):520-528. View abstract.
- De Martiis, M., Fontana, M., Assogna, G., D'Ottavi, R., and D'Ottavi, O. [Milk thistle (Silybum marianum) derivatives in the therapy of chronic hepatopathies]. Clin Ter. 8-15-1980;94(3):283-315. View abstract.
- Dehmlow, C., Murawski, N., and de Groot, H. Scavenging of reactive oxygen species and inhibition of arachidonic acid metabolism by silibinin in human cells. Life Sci 1996;58(18):1591-1600. View abstract.
- Desplaces, A., Choppin, J., Vogel, G., and Trost, W. The effects of silymarin on experimental phalloidine poisoning. Arzneimittelforschung. 1975;25(1):89-96. View abstract.
- Detaille, D., Sanchez, C., Sanz, N., Lopez-Novoa, J. M., Leverve, X., and El Mir, M. Y. Interrelation between the inhibition of glycolytic flux by silibinin and the lowering of mitochondrial ROS production in perifused rat hepatocytes. Life Sci 5-23-2008;82(21-22):1070-1076. View abstract.
- El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis. Phytomedicine. 2009;16(5):391-400. View abstract.
- Eurich, D., Bahra, M., Berg, T., Boas-Knoop, S., Biermer, M., Neuhaus, R., Neuhaus, P., and Neumann, U. Treatment of hepatitis C-virus-reinfection after liver transplant with silibinin in nonresponders to pegylated interferon-based therapy. Exp.Clin.Transplant. 2011;9(1):1-6. View abstract.
- Fallah Huseini, H., Larijani, B., Fakhrzadeh, H., Rajabi Pour, B., Akhondzadeh, S., Toliat, T., and Heshmat, R. The clinical trial of Silybum Marianum seed extract (Silymarin) on type II diabetic patients with hyperlipidemia. Iran J.Diabetes Lipid Disord. 2004;3(2):201-206.
- Fallahzadeh, M. K., Dormanesh, B., Sagheb, M. M., Roozbeh, J., Vessal, G., Pakfetrat, M., Daneshbod, Y., Kamali-Sarvestani, E., and Lankarani, K. B. Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic patients with overt nephropathy: a randomized, double-blind, placebo-controlled trial. Am.J.Kidney Dis. 2012;60(6):896-903. View abstract.
- Feher, J., Lang, I., Nekam, K., Muzes, G., and Deak, G. Effect of free radical scavengers on superoxide dismutase (SOD) enzyme in patients with alcoholic cirrhosis. Acta Med Hung. 1988;45(3-4):265-276. View abstract.
- Fintelmann V. Zur Therapie der Fettleber mit Silymarin. Therapiewoche 1970;20:1055-2064.
- Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients with localized prostate cancer. Prostate 6-1-2010;70(8):848-855. View abstract.
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