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.
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. It also seems to help the liver in people who take isotretinoin for acne or 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.
- A skin disorder that causes white patches to develop on the skin (vitiligo). Early research shows that taking the milk thistle constituent silymarin along with phototherapy for 3 months is no better than phototherapy alone for improving vitiligo severity.
- 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.
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.
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).
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.
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- 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.
- 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.
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- 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.
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- 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.
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- 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.
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