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Milk Thistle: Herbal Medications, What Works


A bristly plant native to the Mediterranean, milk thistle (Silybum marianum) has a long history of medicinal use in Europe. It was used in Greco-Roman times for a variety of ailments, particularly liver problems.


Milk thistle must be prepared in standardized, concentrated form to protect the liver. Preparations of milk thistle are generally standardized to a concentration of 70 to 80 percent of several substances known collectively as silymarin. This concentration of silymarin is required to avoid destruction by gastric fluids.


Germany's Commission E recommends daily doses equivalent to 200 to 400 mg of silymarin, and approves the use of silymarin to treat toxic liver damage, and as supportive treatment in chronic inflammatory liver disease and hepatic cirrhosis. Some 120 clinical studies have been done.


Milk thistle changes the structure of the outer membrane of liver cells, preventing toxins from entering the cells. It also stimulates the formation of new liver cells.


Milk thistle extract has been shown in clinical studies to be effective for hepatitis, alcoholic cirrhosis, and liver damage from exposure to harmful chemicals. It has also been successfully employed to prevent or treat poisoning by the death cap mushroom.


  • A review of European clinical studies dating from 1971 to 1988, by Hikino and Kiso, concludes that silymarin is effective not only for toxic and metabolic liver damage, but also for acute and chronic hepatitis.


Treatment of liver damage due to alcohol is one of the most effective uses of silymarin.


  • During a study by Fintelmann and Albert of 66 patients, most of whom had alcohol-induced toxic liver disease, 31 patients received the standardized milk thistle preparation legalon, and showed significant improvement in liver enzyme levels.


Some forms of hepatitis have responded to treatment with silymarin.


  • In a 1971 study by Poser, 67 subjects were treated for toxic metabolic liver damage, chronic hepatitis, and bile duct inflammation. After three months of treatment with silymarin, chronic hepatitis was significantly improved, with bile duct inflammation particularly responsive to the treatment.


  • Silymarin was evaluated in the treatment of liver cirrhosis in an RCT by Ferenci and associates. Eighty-seven of 170 patients received silymarin and 83 received placebo. Survival rate for the silymarin group was 58 ?} 9 percent, whereas in the placebo group it was 39 ?} 9 percent.


Milk thistle has become a popular dietary supplement in the United States. Milk thistle extracts are being used by many people to promote proper liver function and to aid detoxification. Future research may explore the use of milk thistle extract as an adjunct to cancer chemotherapy.





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