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Milk thistle (Silybum marianum) is a plant native to Europe that was brought to North America by early colonists. It seems to help lower blood sugar.
Milk thistle is now found throughout the eastern United States, California, South America, Africa, Australia, and Asia. Its seed might protect liver cells from toxic chemicals and drugs. It also seems to have antioxidant and anti-inflammatory effects.
People commonly take milk thistle by mouth for diabetes. It is also commonly used for liver disorders, including liver damage caused by alcohol, nonalcoholic fatty liver disease, cirrhosis of the liver, chronic hepatitis, and many other conditions, but there is no good scientific evidence to support many of these other uses.
Don't confuse milk thistle with blessed thistle (Cnicus benedictus).
- Diabetes. Oral milk thistle extracts of silymarin seem to improve glycemic control in diabetic patients.
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- Acne. It is unclear if oral milk thistle is beneficial in patients with acne when used alone or in combination with doxycycline.
Login for details - Alcohol-related liver disease. It is unclear if oral milk thistle is beneficial in patients with alcohol-related liver disease, as evidence is conflicting.
Login for details - Allergic rhinitis (hay fever). It is unclear if oral milk thistle is beneficial in patients with allergic rhinitis.
Login for details - Alzheimer disease. Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Amanita mushroom poisoning. While an intravenous milk thistle constituent, silibinin, has been studied for treating Amanita mushroom poisoning, this product is not readily available in the U.S.
Login for details - Benign prostatic hyperplasia (BPH). Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Beta-thalassemia. Small studies in children with beta-thalassemia suggest that oral silymarin, a constituent of milk thistle, may reduce serum ferritin levels.
Login for details - Chemotherapy-induced acral erythema. It is unclear if topical milk thistle is beneficial in patients with acral erythema due to capecitabine.
Login for details - Chemotherapy-induced hepatotoxicity. Small clinical studies suggest that oral milk thistle may not prevent chemotherapy-induced hepatotoxicity.
Login for details - Chemotherapy-induced nephrotoxicity. It is unclear if oral milk thistle is beneficial for the prevention of cisplatin-induced nephrotoxicity.
Login for details - Cirrhosis. It is unclear if oral milk thistle extracts of silymarin are beneficial for cirrhosis from various causes.
Login for details - Contrast induced nephropathy. It is unclear if oral milk thistle is beneficial for reducing the risk of nephropathy from contrast agents.
Login for details - Critical illness (trauma). It is unclear if oral milk thistle is beneficial in critically ill patients with trauma-induced liver injury.
Login for details - Diabetic nephropathy. It is unclear if oral milk thistle is beneficial for improving kidney function in patients with this condition.
Login for details - Dyspepsia. Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Hepatitis. Small clinical studies suggest that oral milk thistle extracts of silymarin may improve hepatitis symptoms. It is unclear whether these products can improve liver function in these patients.
Login for details - Hepatitis B. Small clinical studies suggest that oral milk thistle extracts may improve liver function in people with hepatitis B, although it is unclear if these products can improve disease-related complications.
Login for details - Hepatitis C. Small clinical studies suggest that oral milk thistle extracts may improve liver function but do not seem to reduce hepatitis C virus (HCV) RNA levels.
Login for details - Hypercholesterolemia. Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Hyperlipoproteinemia. It is unclear if oral milk thistle is beneficial in patients with hyperlipoproteinemia secondary to liver disease.
Login for details - Hypoxic liver injury. It is unclear if oral milk thistle is beneficial for reducing liver injury in patients with hypoxia.
Login for details - Infertility. It is unclear if oral milk thistle is beneficial for patients undergoing in vitro fertilization.
Login for details - Lactation. It is unclear if oral milk thistle is beneficial for increasing milk production.
Login for details - Melasma. It is unclear if topical milk thistle is beneficial in patients with melasma.
Login for details - Menopausal symptoms. It is unclear if oral milk thistle reduces menopausal symptoms such as hot flashes.
Login for details - Multiple sclerosis (MS). Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Nonalcoholic fatty liver disease (NAFLD). Small clinical studies suggest that oral milk thistle extracts of silymarin may slightly improve markers of liver function patients with NAFLD.
Login for details - Nonalcoholic steatohepatitis (NASH). It is unclear if oral milk thistle is beneficial in patients with NASH.
Login for details - Obsessive-compulsive disorder (OCD). It is unclear if oral milk thistle is beneficial in patients with OCD.
Login for details - Parkinson disease. Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Prostate cancer. Oral milk thistle has only been evaluated in combination with other ingredients; its effect when used alone is unclear.
Login for details - Radiation dermatitis. It is unclear if topical milk thistle is beneficial in patients with dermatitis due to radiation.
Login for details - Radiation mucositis. It is unclear if oral milk thistle is beneficial for preventing or treating mucositis due to radiation.
Login for details - Toxin-induced liver damage. Most small clinical studies suggest that oral milk thistle extracts or constituents may reduce liver injury in people exposed to some, but not all, toxins and medications known to cause liver damage.
Login for details - Trichotillomania. It is unclear if oral milk thistle is beneficial in patients with this condition.
Login for details - Ulcerative colitis. It is unclear if oral milk thistle is beneficial in patients with this condition.
Login for details - Vitiligo. It is unclear if oral milk thistle reduces the severity of this condition.
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When taken by mouth: Milk thistle extract is likely safe for most people. While most people tolerate milk thistle well, it can cause some mild side effects including bloating, indigestion, diarrhea, nausea, and gas.
When applied to the skin: Milk thistle extract is possibly safe when used 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 for up to 9 months in children 1 year of age and older.
Allergy to ragweed and related plants: Milk thistle might cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae plant family. This includes ragweed, chrysanthemums, marigolds, daisies, and many others. If you have allergies, be sure to check with your healthcare provider before taking milk thistle.
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.
Estrogens
Interaction Rating=Minor Be watchful with this combination.
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 changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating=Moderate Be cautious with this combination.
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)
Interaction Rating=Moderate Be cautious with this combination.
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.
Medications used for lowering cholesterol (Statins)
Interaction Rating=Minor Be watchful with this combination.
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).
Herbs and supplements that might lower blood sugar: Milk thistle might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.
There are no known interactions with foods.
Milk thistle extracts have most often been used by adults in doses of 140 mg by mouth three times daily for up to 4 years. Milk thistle extracts are usually standardized by the amount of silymarin they contain. This typically ranges from 70% to 80%. Milk thistle is also used in various topical gels and creams.
Milk thistle leaves and flowers are also eaten as a vegetable for salads and used as a substitute for spinach. The seeds are sometimes roasted and used as a coffee substitute.
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.
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