- What other names is Milk Thistle known by?
- What is Milk Thistle?
- How does Milk Thistle work?
- Are there safety concerns?
- Are there any interactions with medications?
- Dosing considerations for Milk Thistle.
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.
Milk 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, and South America. The plant grows up to 2 meters high and has large, bright purple flowers.
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. The above ground parts and seeds are used to make medicine. The seeds are more commonly used.
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 phalloides (death cap) mushroom poisoning, jaundice, chronic inflammatory liver disease, cirrhosis of the liver, and chronic hepatitis.
Milk thistle is also taken by mouth for loss of appetite, heartburn (dyspepsia), gallbladder complaints, enlarged prostate (benign prostatic hyperplasia), a blood disorder called beta-thalassemia, and infertility.
Some people take milk thistle by mouth for diabetes, kidney damage caused by diabetes, hangover, diseases of the spleen, prostate cancer, inflammation in the lungs and chest, malaria, depression, uterine complaints, increasing breast milk flow, allergy symptoms, starting menstrual flow, obsessive-compulsive disorder (OCD), Alzheimer's disease, Parkinson's disease, multiple sclerosis, high cholesterol, and menopausal symptoms.
People apply milk thistle to the skin for skin toxicity caused by radiation.
People use milk thistle intravenously (by IV) for Amanita phalloides (death cap) mushroom poisoning.
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).
Possibly Effective for...
- Diabetes. Some research shows that taking silymarin, a chemical found in milk thistle, along with conventional treatment can decrease blood sugar, total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglycerides in people with diabetes. Other early research suggests that taking silymarin three times daily reduces insulin resistance in people with diabetes and liver disease caused by alcoholism. But talking silybin, another chemical found in milk thistle, daily for 4 weeks does not seem to affect blood sugar levels in people with diabetes.
- Heartburn (dyspepsia). When used daily for 4 weeks, a specific combination product (Iberogast, Medical Futures, Inc) that contains milk thistle plus peppermint leaf, German chamomile, caraway, licorice, clown's mustard plant, celandine, angelica, and lemon balm seems to reduce the severity of acid reflux, stomach pain, cramping, nausea, and vomiting.
Insufficient Evidence to Rate Effectiveness 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. Early research suggests that taking milk thistle by mouth might improve liver function and reduce risk of death. However, other research suggests it may not have an effect.
- Seasonal allergies. Some research shows that taking milk thistle extract by mouth three times daily along with the allergy medication cetirizine (Zyrtec) for one month reduces seasonal allergies more than taking the medication alone.
- Alzheimer's disease. Early research suggests that taking a combination supplement containing silymarin, a chemical found in milk thistle, improves mental function in people with Alzheimer's disease.
- Amanita mushroom poisoning. Early research shows that giving silibinin, a chemical found in milk thistle, intravenously (by IV) and then by mouth may lessen liver damage caused by Amanita phalloides mushroom (death cap) poisoning. However, it is hard to obtain silibinin in the US.
- Enlarged prostate (benign prostatic hyperplasia). Early research suggests that taking a specific combination of silymarin and selenium (Favea, Koprivnice, Czech Republic) by mouth three times daily for 6 months might improve symptoms of enlarged prostate in men.
- Blood disorder called beta-thalassemia. Early research in people 12 years or older with the blood disorder beta-thalassemia suggests that taking a specific silymarin product (Legalon, Madaus GmbH, Cologne, Germany) by mouth three times daily for 3 months, along with conventional medicine, does not improve symptoms. But, another study found that it might provide some benefits when taken for 9 months.
- Chemotherapy toxicity. Early research suggests that taking a milk thistle product containing the chemical silibinin beginning at the start of chemotherapy treatment does not significantly reduce liver toxicity caused by chemotherapy.
- Liver scarring (cirrhosis). Early research suggests that milk thistle or silymarin, a chemical found in milk thistle, might reduce the risk of death and improve liver function in people with cirrhosis. However, milk thistle does not seem to benefit all patients with liver disease when those without cirrhosis are also considered.
- Kidney disease in people with diabetes. Early research shows that taking silymarin, a chemical found in milk thistle, together with conventional treatment might help treat kidney disease in people with diabetes.
- Hepatitis. Research on the effects of milk thistle in people with hepatitis is not consistent. Some research suggests that taking silymarin (Legalon, Madaus GmbH, Cologne, Germany) by mouth three times daily for 4 weeks reduces hepatitis symptoms, such as dark urine and jaundice, but does not improve liver function tests. But taking a milk thistle product called IdB 1016 (Silipide, Inverni della Beffa Research and Development Laboratories) by mouth daily for 2 weeks to 3 months might improve some liver function tests.
- Hepatitis B. Research on the effects of milk thistle in people with hepatitis B is not consistent. Early research suggests that taking milk thistle extracts silymarin (Legalon, Madaus GmbH, Cologne, Germany) by mouth three times daily for 28 days to one year, or a silybin-phosphatidylcholine combination called IdB 1016 (Silipide, Inverni della Beffa Research and Development Laboratories) by mouth twice daily for 7 days improves liver function tests. But other research shows that taking silymarin by mouth three times daily for 5 to 25 days does not improve liver function in people with hepatitis B.
- Hepatitis C. Research on the effects of milk thistle in people with hepatitis C is inconsistent. Early research suggests that taking milk thistle extracts silymarin (Legalon, Madaus GmbH, Cologne, Germany) by mouth three times daily for 28 days to one year, or a silybin-phosphatidylcholine combination called IdB 1016 (Silipide, Inverni della Beffa Research and Development Laboratories) by mouth twice daily for 7 days improves liver function tests. But other research shows that taking milk thistle does not improve hepatitis C virus levels.
- High cholesterol. Evidence about how milk thistle affects cholesterol is inconsistent. Early research suggests that taking silymarin, a chemical found in milk thistle, does not affect cholesterol levels in people with high cholesterol. However, other research shows that taking the same chemical can reduce total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglycerides in people with diabetes and high cholesterol.
- Infertility. Early research shows that taking silymarin, a chemical found in milk thistle, along with fertility hormones might provide some benefits for women undergoing in vitro fertilization due to male infertility.
- Menopausal symptoms. Research suggests that taking a specific combination product containing milk thistle (Phyto-Female, SupHerb, Netanya, Israel) by mouth twice daily for 3 months reduces hot flashes by 73% and night sweats by 69% in people with menopausal symptoms. Sleep quality also improves. The effect of taking milk thistle by itself is not known.
- Multiple sclerosis. Early research suggests that taking a combination supplement containing silymarin, a chemical found in milk thistle, can improve mental function and promote disease stabilization in people with multiple sclerosis.
- Nonalcoholic fatty liver disease (NAFLD). Early research suggests that taking a combination of the milk thistle chemical silybin, along with phosphatidylcholine and vitamin E (Realsil, Instituto Biochimico, Italiano) by mouth twice daily for 12 months improves liver function tests in people with liver disease not caused by alcoholism.
- Obsessive-compulsive disorder (OCD). Early research suggests 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's disease. Early research suggests that taking a combination supplement containing silymarin, a chemical found in milk thistle, improves mental function and promotes 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 suggests that taking a supplement containing silymarin, soy isoflavones (Novasoy, ADM), lycopene (Lyc-O-Mato, LycoRed Natural Products Industries, Ltd.), vitamins, minerals and antioxidants by mouth daily can delay the rise in PSA levels in men with a history of prostate cancer. But the effects of milk thistle alone are not clear.
- Skin toxicity caused by radiation. Early research suggests that applying a specific product containing the milk thistle chemical silymarin (Leviaderm, Madaus GmbH, Cologne, Germany) reduces the effect of radiation on the skin in women being treated for breast cancer.
- Liver damage caused by chemicals. Research on the effect of milk thistle on liver damage caused by chemicals is inconsistent. Taking silymarin (Legalon, Madaus GmbH, Cologne, Germany) by mouth daily for up to one month improves liver function tests in people who have been exposed to the chemicals toluene or xylene. But taking silymarin by mouth daily for 3 months does not seem to prevent liver damage associated with the drug tacrine (Cognex) in people with Alzheimer's disease.
- Spleen disorders.
- Gallbladder problems.
- Swelling of the lungs (pleurisy).
- Pain in the uterus.
- Menstrual problems.
- Low breast milk.
- Other conditions.
Milk thistle seed might protect liver cells from toxic chemicals and drugs. It also seems to have antioxidant and anti-inflammatory effects.
Milk thistle extract is LIKELY SAFE when taken by mouth 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.
There isn't enough reliable information available to know if milk thistle is safe to apply to the skin or inject into the body.
Special Precautions & Warnings:Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking milk thistle if you are pregnant or 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.
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.
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
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 (Cytochrome P450 2D6 (CYP2D6) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
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 imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); and others.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Milk thistle might affect how quickly the liver breaks down some medications. Taking milk thistle along with some medications that are broken down by the liver might increase or decrease the effects of some medications. Before taking milk thistle, talk to your healthcare provider if you take any medications that are changed by the liver.
Medications changed by the liver (Glucuronidated drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
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 (Tylenol, others) and oxazepam (Serax), haloperidol (Haldol), lamotrigine (Lamictal), morphine (MS Contin, Roxanol), zidovudine (AZT, Retrovir), and others.
Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Silymarin, a chemical found in milk thistle, can decrease blood sugar levels. Diabetes medications are also used to lower blood sugar. Taking milk thistle along with diabetes medications might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.
Raloxifene (Evista)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking milk thistle might decrease how well the body breaks down raloxifene (Evista) in the intestines. This could increase the effects and side effects of raloxifene (Evista). Before taking milk thistle, talk to your healthcare provider if you are taking raloxifene (Evista).
Sirolimus (Rapamune)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking milk thistle might decrease how well the liver breaks down sirolimus (Rapamune). This could increase the effects and side effects of sirolimus (Rapamune). Before taking milk thistle, talk to your healthcare provider if you are taking sirolimus (Rapamune).
Tamoxifen (Nolvadex)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Milk thistle might increase how much tamoxifen (Nolvadex) is absorbed by the body. This might increase the effects and side effects of tamoxifen (Nolvadex). Before taking milk thistle, talk to your healthcare provider if you are taking tamoxifen (Nolvadex).
EstrogensInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.
Milk thistle might decrease the effects of estrogen pills by blocking how estrogen works in the body.
Indinavir (Reyataz)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Indinavir (Reyataz) is a medication that is changed and broken down by the liver. Milk thistle might increase how quickly the liver breaks down some medications. But milk thistle does not seem to affect how quickly the body breaks down indinavir (Reyataz).
Medications used for lowering cholesterol (Statins)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Theoretically, milk thistle might change the levels of some medications used for lowering cholesterol (statins). This could 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: 200 mg of a specific product (Legalon, Madaus GmbH, Cologne, Germany) has been taken three times daily for 4 months to one year. 200 mg of a different silymarin product (Luna Co., Cairo, Egypt) has been daily for 120 days.
- For upset stomach (dyspepsia): 1 mL of a specific combination product (Iberogast, Medical Futures, Inc) containing milk thistle and several other herbs has been used three times daily for 4 weeks.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
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