Milk thistle
Scientific names: Silybum marianum, Carduus marianus
Family: Asteraceae/Compositae
Alternate names: Artichaut Sauvage, Blessed Milk Thistle, Cardo Lechoso, Cardui Mariae Fructus, Cardui Mariae Herba, Carduus Marianum, Chardon Argenté, Chardon de Marie, Chardon de Notre-Dame, Chardon Marbré, Chardon-Marie, Épine Blanche, Holy Thistle, Khar Maryam, Lady's Thistle, Lait de Notre-Dame, Legalon, Marian Thistle, Mariendistel, Maritighal, Mary Thistle, Our Lady's Thistle, Shui Fei Ji, Silibinin, Silybe de Marie, Silybin, Silybum, Silymarin, Silymarine, St. Mary Thistle, St. Marys Thistle
Actions: Anticancer, Antidiabetic, Anti-inflammatory, Antilipemic, Antioxidant, Antiviral, Dermatologic, Drug metabolizing enzyme, Gastrointestinal, Hepatoprotective, Neuronal/CNS, Psychiatric, Renal protective
Background
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).
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).
Safety Safety definitions
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.
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.
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.
Effectiveness
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Possibly effective Effectiveness definitions
- Diabetes. Taking milk thistle extracts 210-600 mg by mouth daily seems to reduce blood sugar in people with diabetes. Taking milk thistle extract with tree turmeric extract also seems to reduce blood sugar levels in people with diabetes.
Dosing & administration
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.
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.
Interactions with pharmaceuticals
Estrogens
Interaction Rating=Minor Be watchful with this combination.
Milk thistle might decrease the effects of medications providing estrogen by blocking how estrogen works in the body.
Indinavir (Crixivan)
Interaction Rating=Minor Be watchful with this combination.
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.
Ledipasvir
Interaction Rating=Moderate Be cautious with this combination.
Taking milk thistle might decrease how quickly the body breaks down ledipasvir. This might increase the effects and side effects of ledipasvir.
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating=Minor Be watchful with this combination.
Some medications are changed and broken down by the liver. Milk thistle might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating=Minor Be watchful with this combination.
Some medications are changed and broken down by the liver. Milk thistle might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications changed by the liver (Glucuronidated drugs)
Interaction Rating=Moderate Be cautious with this combination.
Some medications are changed and broken down by the liver. Milk thistle might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications for diabetes (Antidiabetes drugs)
Interaction Rating=Moderate Be cautious with this combination.
Milk thistle might lower blood sugar levels. Taking milk thistle along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Medications moved by pumps in cells (P-glycoprotein substrates)
Interaction Rating=Moderate Be cautious with this combination.
Some medications are moved in and out of cells by pumps. Milk thistle might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.
Medications used for lowering cholesterol (Statins)
Interaction Rating=Minor Be watchful with this combination.
Milk thistle might change the levels of some medications used for lowering cholesterol (statins). This might decrease how well these medications work.
Morphine
Interaction Rating=Moderate Be cautious with this combination.
Milk thistle might affect levels of morphine in the blood. This might increase or decrease the effects and side effects of morphine.
Raloxifene (Evista)
Interaction Rating=Moderate Be cautious with this combination.
Taking milk thistle might decrease how well the body breaks down raloxifene in the stomach. This might increase the effects and side effects of raloxifene.
Sirolimus (Rapamune)
Interaction Rating=Moderate Be cautious with this combination.
Taking milk thistle might decrease how well the liver breaks down sirolimus. This might increase the effects and side effects of sirolimus.
Sofosbuvir
Interaction Rating=Moderate Be cautious with this combination.
Taking milk thistle might increase how quickly the body breaks down sofosbuvir. This might decrease the effects of sofosbuvir.
Tamoxifen (Nolvadex)
Interaction Rating=Moderate Be cautious with this combination.
Milk thistle might increase how much tamoxifen is absorbed by the body. This might increase the effects and side effects of tamoxifen.
Warfarin (Coumadin)
Interaction Rating=Moderate Be cautious with this combination.
Warfarin is used to slow blood clotting. Taking milk thistle might increase the effects of warfarin, which could increase the risk of bleeding.
Interactions with herbs & supplements
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.
Interactions with foods
There are no known interactions with foods.
Products
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Per 4 capsules:
- Silybum marianum (St Mary's Thistle) ext. 100 mg equiv. silybin 99 mg
- Resveratrol 260 mg
- Schisandra chinensis ext. 225 mg
- Brassica oleracea var. italica ext. 300 mg
- Brassica oleracea var. italica ext. 200 mg
- Polygonum cuspidatum
- Curcumin (Turmeric) 300 mg equiv. curcuminoids 285 mg
- Punica granatum ext. 200 mg
- Quercetin 100 mg
- N-acetylcysteine (NAC) 200 mg
- Ascorbic acid (Vitamin C) 80 mg
- Citrus bioflavonoids extract 40 mg
- Zinc picolinate equiv. zinc 12 mg
- Selenomethionine equiv. selenium 26 µg
- Methylcobalamin (Activated B12) 4 µg
- Orthosilicic acid (Silica)
Per tablet:
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 29 mg equiv. silybin 24 mg
- Ascorbic acid (Vitamin C) 200 mg
- d-alpha-Tocopheryl acid succinate (Vitamin E) 41 mg equiv. d-alpha-tocopherol 34 mg
- Cholecalciferol 10 μg equiv. vitamin D3 400 IU
- Zinc amino acid chelate 25 mg equiv. zinc 5 mg
- Mecobalamin (Vitamin B12) 500 μg
- Eleutherococcus senticosus ext. 133 mg
- Calcium pantothenate (Vitamin B5) 75 mg
- Citrus bioflavonoids extract 8.3 mg
- Thiamine hydrochloride (Vitamin B1) 50 mg
- Riboflavin (Vitamin B2) 50 mg
- Nicotinamide (Vitamin B3) 50 mg
- Pyridoxine hydrochloride (Vitamin B6) 50 mg
- Choline bitartrate 25 mg
- Inositol 25 mg
- Manganese amino acid chelate 10 mg equiv. manganese 1.6 mg
- Borax 8.8 mg equiv. boron 1 mg
- Beta-carotene (Carotenoids) 5 mg
- Folic acid 500 μg
- Chromium nicotinate 500 μg equiv. chromium 50 μg
- Potassium iodide 65 μg equiv. iodine 50 μg
- Selenomethionine 65 μg equiv. selenium 26 μg
- Biotin 50 μg
- Calcium hydrogen phosphate dihydrate 429 mg equiv. calcium 100 mg
- Magnesium amino acid chelate 150 mg equiv. magnesium 30 mg
- Iron amino acid chelate 25 mg equiv. iron 5 mg
- Potassium phosphate - dibasic 4.5 mg equiv. potassium 2 mg
- Copper gluconate 1.2 mg equiv. copper 170 μg
Per 1 mL:
Per tablet:
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 60 mg
- Foeniculum vulgare ext. 150 mg
- Taraxacum officinale ext. 25 mg
- Brassica oleracea var. italica ext. 35 mg
- Glutamine 100 mg
- Curcuma longa ext. 80 mg
- Schisandra chinensis ext. 20 mg
- Sodium molybdate dihydrate 126 µg equiv. molybdenum 50 µg
- Taurine 150 mg
- Choline bitartrate 100 mg equiv. choline 41 mg
- Inositol 100 mg
- Glycine 50 mg
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 14.3 mg
- Co-methylcobalamin (Vitamin B12) 100 µg
- Ascorbic acid (Vitamin C) 100 mg
- Cholecalciferol 25 µg equiv. vitamin D3 1000 IU
- d-alpha-Tocopheryl acid succinate 41.3 mg equiv. vitamin E 50 IU
- Zinc citrate dihydrate 31.15 mg equiv. zinc 10 mg
- Thiamine hydrochloride (Vitamin B1) 25 mg equiv. thiamine 22.3 mg
- Riboflavin (Vitamin B2) 25 mg
- Nicotinamide (Vitamin B3) 50 mg
- Calcium pantothenate (Vitamin B5) 100 mg equiv. pantothenic acid 91.6 mg
- Pyridoxine hydrochloride (Vitamin B6) 60.8 mg equiv. pyridoxine 50 mg
- Folic acid 200 µg
- Levomefolate calcium (Activated folate) 124 µg equiv. levomefolic acid 100 µg
- Biotin 50 µg
- Choline bitartrate 25 mg
- Citrus bioflavonoids extract 50 mg
- Inositol 25 mg
- Calcium hydrogen phosphate 169.72 mg equiv. calcium 50 mg
- Calcium citrate tetrahydrate 71.09 mg equiv. calcium 15 mg
- Calcium pantothenate 100 mg equiv. calcium 8.4 mg
- Chromium nicotinate 417 µg equiv. chromium 50 µg
- Silica - colloidal anhydrous 42.78 mg equiv. silicon 20 mg
- Copper gluconate 3.57 mg equiv. copper 500 µg
- Ferrous fumarate 16.01 mg equiv. iron 5 mg
- Magnesium amino acid chelate 125 mg equiv. magnesium 25 mg
- Manganese amino acid chelate 10 mg equiv. manganese 1 mg
- Potassium iodide (Iodine) 196 µg equiv. iodine 150 µg equiv. potassium 46 µg
- Selenomethionine 124 µg equiv. selenium 50 µg
- Vitis vinifera ext. 100 mg
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 5 mg
- Glucosamine sulphate potassium chloride 663 mg equiv. glucosamine sulphate 500 mg equiv. potassium chloride 163 mg
- Cholecalciferol 2.5 µg equiv. vitamin D3 100 IU
- Boswellia serrata ext. 57.1 mg
- Nicotinamide (Vitamin B3) 200 mg
- Sodium ascorbate (Vitamin C) 112.5 mg equiv. ascorbic acid 100 mg
- Lecithin 100 mg
- Magnesium orotate dihydrate 103.58 mg equiv. magnesium 6.7 mg
- Manganese amino acid chelate 25 mg equiv. manganese 5 mg
- Vitis vinifera ext. 1 mg
- Curcuma longa ext. 4 mg
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 5 mg
- Cholecalciferol 12.5 μg equiv. vitamin D3 500 IU
- d-alpha-Tocopherol (Vitamin E) 10 mg
- Methylcobalamin (Activated B12) 200 μg
- Zinc citrate 36.6 mg equiv. zinc 12.5 mg
- Beta-carotene (Carotenoids) 3 mg
- Phyllanthus emblica ext. 65 mg
- Menaquinone 7 (Vitamin K2) 40 μg
- Thiamine hydrochloride (Vitamin B1) 6.35 mg equiv. thiamine 5 mg
- Riboflavin 5-phosphate sodium (Activated B2) 1.71 mg equiv. riboflavin 1.25 mg
- Nicotinamide (Vitamin B3) 12.5 mg
- Calcium pantothenate (Vitamin B5) 5.46 mg equiv. pantothenic acid 5 mg
- Pyridoxal 5-phosphate (P5P) 2.03 mg equiv. pyridoxine 1.25 mg
- Levomefolate glucosamine (Activated folate) 463 μg equiv. levomefolic acid 250 μg
- Calcified lithothamnion (Red algae) 28.72 mg equiv. calcium 8.62 mg
- Magnesium 13.13 mg
- Chromium picolinate 201.13 μg equiv. chromium 25 μg
- Copper sulphate 200 μg
- Manganese gluconate 43.86 mg equiv. manganese 5 mg
- Selenomethionine 124.18 μg equiv. selenium 50 μg
- Borax 6.6 mg equiv. boron 750 μg
- Ascophyllum nodosum 18.75 mg
- Lutein 1 mg
- Lycopene 1 mg
- Serenoa repens ext. 25 mg
- Vaccinium macrocarpon ext. 0.25 mg
- Camellia sinensis ext. 5 mg
- Schisandra chinensis ext. 5 mg
- Arthrospira platensis (Spirulina) 5 mg
- Euterpe oleracea (berry) ext. (Acai) 5 mg
- Chlorella vulgaris 5 mg
- Curcumin (Turmeric) 500 μg
- Zingiber officinale ext. 5 mg
- Laminaria digitara (Kelp) 5 mg
- Citrus sinensis ext. 5 mg
- Ultra fruit blend 25 mg
- Cruciferous vegetable blend 25 mg
- Live vegetable blend 22.5 mg
- Multi herb blend 12.5 mg
- Calcium ascorbate (Vitamin C) 38.58 mg equiv. ascorbic acid 32.5 mg equiv. calcium 3.88
- Magnesium ascorbate (Vitamin C) 45.5 mg equiv. ascorbic acid 32.5 mg
Per tablet:
- Silybum marianum (St Mary's Thistle) ext. 5 mg
- Methylcobalamin (Activated B12) 200 μg
- Calcium ascorbate (Vitamin C) 30.25 mg equiv. ascorbic acid 25 mg
- Cholecalciferol 12.5 μg equiv. vitamin D3 500 IU
- d-alpha-Tocopherol (Vitamin E) 10 mg
- Zinc citrate 200 mg equiv. zinc 36.6 mg
- Beta-carotene (Carotenoids) 3 mg
- Thiamine hydrochloride (Vitamin B1) 1.59 mg equiv. thiamine 1.25 mg
- Riboflavin 5-phosphate sodium (Activated B2) 1.71 mg equiv. riboflavin 1.25 mg
- Nicotinamide (Vitamin B3) 12.5 mg
- Calcium pantothenate (Vitamin B5) 5.46 mg equiv. pantothenic acid 5 mg
- Pyridoxal 5-phosphate (P5P) 2.03 mg equiv. pyridoxine 1.25 mg
- Magnesium ascorbate (Vitamin C) 21.87 mg equiv. ascorbic acid 15.33 mg
- Levomefolate glucosamine (Activated folate) 463 μg equiv. levomefolic acid 250 μg
- Phyllanthus emblica ext. 9.35 mg
- Menaquinone 7 (Vitamin K2) 40 μg
- Calcified lithothamnion (Red algae) 31.52 mg equiv. calcium 9.46 mg
- Magnesium 12.5 mg
- Chromium picolinate 1.61 mg equiv. chromium 200 μg
- Copper sulphate 2 mg
- Ascophyllum nodosum 18.75 mg
- Manganese gluconate 21.93 mg equiv. manganese 2.5 mg
- Selenomethionine 124.18 μg equiv. selenium 50 μg
- Borax 6.6 mg equiv. boron 750 μg
- Lutein 1 mg
- Lycopene 1 mg
- Vaccinium macrocarpon ext. 0.25 mg
- Camellia sinensis ext. 5 mg
- Schisandra chinensis ext. 5 mg
- Arthrospira platensis (Spirulina) 5 mg
- Euterpe oleracea (berry) ext. (Acai) 5 mg
- Chlorella vulgaris 5 mg
- Curcumin (Turmeric) 500 μg
- Zingiber officinale ext. 5 mg
- Laminaria digitara (Kelp) 5 mg
- Citrus sinensis ext. 5 mg
- Cruciferous vegetable blend 25 mg
- Ultra fruit blend 25 mg
- Live vegetable blend 22.5 mg
- Multi herb blend 12.5 mg
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This monograph was last reviewed on 22/02/2023 11:00:00 and last updated on 31/12/2020 01:45:34. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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Natural Medicines rates safety based on scientific evidence according to the following scale: Likely Safe, Possibly Safe, Possibly Unsafe, Likely Unsafe, Unsafe, and Insufficient Evidence to Rate. For more information about Natural Medicines’ Safety Rating System, click here.
The Natural Medicines Effectiveness Ratings are assigned for specific indications. A product might be rated "Possibly Effective" for one condition, but be rated "Likely Ineffective" for another condition, depending on the evidence. For more info click here.
