What Is Milk Thistle Used for Today?
What Is the Scientific Evidence for Milk Thistle?
Acute Viral Hepatitis
Chronic Viral Hepatitis
Protection from Medications That Damage the Liver
Interactions You Should Know About
- Medications that could damage the liver, such as acetaminophen, phenytoin (Dilantin), alcohol, and phenothiazines: Milk thistle might be protective for some of these drugs.
- Oral contraceptives : Milk thistle might reduce their effectiveness.
1 Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:215.
2 Muriel P, Garciapina T, Perez-Alvarez V, et al. Silymarin protects against paracetamol-induced lipid peroxidation and liver damage. J Appl Toxicol. 1992;12:439-442.
3 Paulova J, Dvorak M, Kolouch F, et al. Verification of the hepatoprotective and therapeutic effect of silymarin in experimental liver injury with tetrachloromethane in dogs [in Czech]. Vet Med (Praha). 1990;35:629-635.
4 Skakun NP, Moseichuk IP. Clinical pharmacology of legalon [in Russian]. Vrach Delo. 1988;5:5-10.
5 Tuchweber B, Sieck R, Trost W. Prevention of silybin of phalloidin-induced acute hepatotoxicity. Toxicol Appl Pharmacol. 1979;51:265-275.
6 Boari C, Montanari FM, Galletti GP, et al. Toxic occupational liver diseases. Therapeutic effects of silymarin [in Italian]. Minerva Med. 1981;72:2679-2688.
7 Szilard S, Szentogyorgyi D, Demeter I. Protective effect of Legalon in workers exposed to organic solvents. Acta Med Hung. 1988;45:249-256.
8 La Grange L, Wang M, Watkins R, et al. Protective effects of the flavonoid mixture, silymarin, on fetal rat brain and liver. J Ethnopharmacol. 1999;65:53-61.
9 Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine, 3rd ed. Berlin, Germany: Springer-Verlag; 1998:216.
10 Hikino H, Kiso Y. Natural products for liver disease. Econ Med Plant Res. 1988;2:39-72.
11 Muzes G, Deak G, Lang I, et al. Effects of silymarin (Legalon) therapy on the antioxidant defense mechanism and lipid peroxidation in alcoholic liver disease [in Hungarian]. Orv Hetil. 1990;131:863-866.
12 Allain H, Schuck S, Lebreton S, et al. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement Geriatr Cogn Disord. 1999;10:181-185.
13 Giannola C, Buogo F, Forestiere G, et al. A two-center study on the effects of silymarin in pregnant women and adult patients with so-called minor hepatic insufficiency [in Italian]. Clin Ther. 1985;114:129-135.
14 Sonnenbichler J, Scalera F, Sonnenbichler I, et al. Stimulatory effects of silibinin and silicristin from the milk thistle Silybum marianum on kidney cells. J Pharmacol Exp Ther. 1999;290:1375-1383.
15 Zi X, Feyes DK, and Agarwal R. Anticarcinogenic effect of a flavonoid antioxidant, silymarin, in human breast cancer cells MDA-MB 468. Clin Cancer Res. 1998;4:1055-1064.
16 Lucena MI, Andrade RJ, de la Cruz JP, et al. 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;40:2-8.
17 Berenguer J, Carrasco D. Double-blind trial of silymarin vs. placebo in the treatment of chronic hepatitis. Munch Med Wochenschr. 1977;119:240-260.
18 Buzzelli G, Moscarella S, Giusti A, et al. A pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB 1016) in chronic active hepatitis. Int J Clin Pharmacol Ther Toxicol. 1993;31:456-460.
19 Lirussi F, Okolicsanyi L. Cytoprotection in the nineties: Experience with ursodeoxycholic acid and silymarin in chronic liver disease. Acta Physiol Hung. 1992;80:363-367.
20 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 [translated from German]. Med Klin. 1978;73:1060-1065.
21 Bode JC, Schmidt U, Durr HK. Silymarin for the treatment of acute viral hepatitis? Report of a controlled trial [translated from German]. Med Klin. 1977;72:513-518.
22 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 [translated from German]. Med Klin. 1978;73:1060-1065.
23 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;17:517-521.
24 Feher J, Desk G, Muzes G, et al. Liver protective action of silymarin therapy in chronic alcoholic liver diseases [in Hungarian]. Orv Hetil. 1989;130:2723-2727.
25 Fintelmann V, Albert A. Proof of the therapeutic efficacy of LegalonŴ for toxic liver illnesses in a double-blind trial [translated from German]. Therapiewoche. 1980;30:5589-5594.
26 Trinchet JC, Coste T, Levy VG, et al. Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients [translated from French]. Gastroenterol Clin Biol. 1989;13:120-124.
27 Bunout D, Hirsch SB, Petermann MT, et al. Controlled study of the effect of silymarin on alcoholic liver disease [translated from Spanish]. Rev Med Chil. 1992;120:1370-1375.
28 Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol. 1989;9:105-113.
29 Benda L, Dittrich H, Ferenzi P, et al. The influence of therapy with silymarin on the survival rate of patients with liver cirrhosis [translated from German]. Wien Klin Wochenschr. 1980;92:678-683.
30 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;28:615-621.
31 Brinker F. Herb Contraindications and Drug Interactions: With Appendices Addressing Specific Conditions and Medicines. 2nd ed. Sandy, OR: Eclectic Medical Publications; 1998:103.
32 Palasciano G, Portincasa P, Palmieri V, et al. The effect of silymarin on plasma levels of malon-dialdehyde in patients receiving long-term treatment with psychotropic drugs. Curr Ther Res. 1994;55:537-545.
33 Allain H, Schuck S, Lebreton S, et al. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement Geriatr Cogn Disord. 1999;10:181-185.
34 Schandalik R, Gatti G, Perucca E. Pharmacokinetics of silybin in bile following administration of silipide and silymarin in cholecystectomy patients. Arzneimittelforschung. 1992;42:964-968.
35 Barzaghi N, Crema F, Gatti G, et al. Pharmacokinetic studies on IdB 1016, a silybin-phosphatidylcholine complex in healthy human subjects. Eur J Drug Metab Pharmacokinet. 1990;15:333-338.
36 Awang D. Milk thistle. Can Pharm J. 1993;126:403-404.
37 Albrecht M, Frerick H, Kuhn U, et al. Therapy of toxic liver pathologies with Legalon [in German]. Z Klin Med. 1992;47:87-92.
38 Adverse Drug Reactions Advisory Committee. An adverse reaction to the herbal medication milk thistle ( Silybum marianum ). Med J Aust. 1999;170:218-219.
39 Giannola C, Buogo F, Forestiere G, et al. A two-center study on the effects of silymarin in pregnant women and adult patients with so-called minor hepatic insufficiency [in Italian]. Clin Ther. 1985;114:129-135.
40 Kim DH, Jin YH, Park JB, et al. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull. 1994;17:443-445.
41 Lucena MI, Andrade RJ, de la Cruz JP, et al. 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;40:2-8.
42 Lang I, et al. Hepatoprotective and immunological effects of antioxidant drugs. Tokai J Exp Clin Med. 1990;15:123-127.
43 Lang I, et al. Immunomodulatory and hepatoprotective effects of in vivo treatment with free radical scavengers. Ital J Gastroenterol. 1990;22:283-287.
44 Gordon A, Hobbs DA, Bowden DS et al. Effects of Silybum marianum on serum hepatitis C virus RNA, alanine aminotransferase levels and well-being in patients with chronic hepatitis C. J Gastroenterol Hepatol. 2006;21:275-80.
45 Angulo P, Patel T, Jorgensen RA et al. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology. 2000;32:897-900.
46 Torres M, Rodriguez-Serrano F, Rosario DJ et al. Does Silybum marianum play a role in the treatment of chronic hepatitis C? P R Health Sci J. 2006;23:69-74
47 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 Oct 30. [Epub ahead of print]
48 Kroll DJ, Shaw HS, Oberlies NH. Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integr Cancer Ther. 2007;6:110-119.
49 Rambaldi A, Jacobs B, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev. 2007;CD003620.
50 Berardesca E, Cameli N, Cavallotti C, et al. Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation. J Cosmet Dermatol. 2008;7:8-14.
51 Saller R, Brignoli R, Melzer J, et al. An updated systematic review with meta-analysis for the clinical evidence of silymarin. Forsch Komplement Med. 2008;15:9-20.
52 Sayyah M, Boostani H, Pakseresht S, Malayeri A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(2):362-365.
53 El-Kamary SS, Shardell MD, Abdel-Hamid M, et al. 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.
54 Hutchinson C, Bomford A, Geissler CA. The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr. 2010;64(10):1239-1241.
55 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.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2013 -
- Update Date: 08/22/2013 -
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