There is always a lot of buzz surrounding herbal remedies. Some patients simply swear by them, while others may find them ineffective. Although unrelated to milk, the milk thistle plant, also known as Silybum marianum, is an herb used by many to both treat and prevent certain ailments. While more scientific studies are needed to prove the efficacy of milk thistle to treat or prevent any condition, there is a fountain of anecdotal evidence to support its use. Read on to learn more about what milk thistle is, its supposed benefits, and the side effects and safety of Silybum marianum.

More About Milk Thistle

The legend of the plant has its roots in early Christianity. Seeing the strange white veins of the plant, the only explanation early people could come up with is that the Virgin Mary let a drop of her milk fall onto the leaves of milk thistle, and it is from this that the plant derives its name. While its scientific name is Silybum marianum, the active ingredients contained in milk thistle are referred to collectively as silymarin, with silybin as the primary ingredient. It is not the plant itself, but its extract that is widely used as an herbal remedy. Marketed as milk thistle extract, it is usually taken by mouth in capsule or powder form as a supplement or can be added to a tea. Milk thistle is most often taken for liver problems, such as hepatitis C or other liver conditions, although it is also consumed by diabetics to aid in lowering blood sugar.

Is Milk Thistle Good for the Liver?

Milk thistle is most commonly taken for liver disorders, ranging from non-alcoholic fatty liver disease to hepatitis. Those with liver cancer also may take milk thistle, as it is thought to protect the liver and increase liver function. There is no evidence to show that milk thistle can protect against any type of liver dysfunction; instead, it is used by those with existing conditions in order to improve liver function. However, studies are also mixed on this claim. 

Two large-scale, long-range studies researched the efficacy of milk thistle in regard to liver disorders, and both studies overwhelmingly found no correlation between milk thistle and a change in virus activity or inflammation. However, patients did self-report milder symptoms of liver-related problems due to liver disease. Because patients self-report their symptoms, it is difficult to discern whether this is due to a placebo effect or if milk thistle is an effective symptom reducer. Many patients with serious liver disease swear by the effects of silymarin, and anecdotally, it appears to be very effective against liver disease. Because neither the 2008 Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) study nor the 2012 National Center for Complementary and Integrative Health (NCCIH) and the National Institute of Diabetes and Digestive and Kidney Diseases study found any firm correlations, patients should take milk thistle and liver disease claims with a grain of salt.

Can Milk Thistle Help People with Diabetes?

Many patients with type 2 diabetes also ingest milk thistle, in the hopes that it will help keep blood sugar low. This claim is similar to the claim that milk thistle protects the liver in that it is largely anecdotal; however, scientific studies have shown a decrease in inflammation and an increase in antioxidant capacity in diabetic patients who took milk thistle, when compared to placebo. It is thought that perhaps milk thistle plays a role in reducing oxidative stress, particularly in diabetic patients. There have been reviews that suggest that fasting blood sugar levels and HbA1c levels were reduced in those taking milk thistle, but this was an umbrella systematic review of scientific studies that were of poorer quality. Similarly to claims of liver protection, patients should also be wary of these claims. 

Other Milk Thistle Health Claims

Fundamentally, more research is needed in all aspects of health to prove the efficacy of milk thistle claims. Anecdotally, however, there are a number of health claims beyond liver disease and diabetes that should be mentioned. Milk thistle is purported to:

  • Help age-related cognitive decline. The ingestion of milk thistle to help diseases such as dementia and Alzheimer’s disease has been studied in both test tubes and animals with relatively positive outcomes. However, because this has not been tested in humans, the claim is unsubstantiated.
  • Treat acne. Because it does appear that milk thistle helps relieve oxidative stress, some patients take it for severe acne, reporting that they have much fewer breakouts.
  • Promote breast milk production. A controlled study did find a correlation between greater breast milk production and milk thistle, but this was only one study.
  • Protect against osteoporosis. Specifically, bone mineralization was studied in both test tubes and animals, but there has not been a clinical trial in humans. 

What Do We Know About Milk Thistle Safety?

Generally speaking, most patients tolerate milk thistle well if they stay within the recommended dosage guidelines. However, it is imperative that you speak with your doctor before beginning any type of treatment, over-the-counter medication, or herbal supplement. This is in part because milk thistle is known to interact with several medications, and can actually be dangerous for diabetics who begin using it. 

The most common side effect of taking milk thistle is mild gastrointestinal upset. However, other side effects may include headaches, joint pain, or sexual dysfunction. It is possible to be allergic to milk thistle as well and have a serious allergic reaction. If you ingest milk thistle and find that you have shortness of breath, swelling, hives, or a rash, go to the emergency room immediately, as this may be a sign of anaphylaxis. While it is rare to have an allergic reaction, it is possible. Those who react allergically to milk thistle usually cannot tolerate plants or supplements that are from the same family. Other plants in the same family as Silybum marianum include ragweed, marigold, daisy, and chrysanthemums. If you are allergic to any of these plants, then it is wise to steer clear of milk thistle.

Because it is unclear whether milk thistle does indeed lower blood sugar, it is suggested not to take milk thistle if you take medication for diabetes expressly to lower blood sugar. Metformin is the most common medication taken to lower blood sugar, but this could include other medications, such as Formate, Glucophage, Glucophage XR, Glumetza, and Riomet (liquid Metformin). 

Milk thistle can also produce estrogenic effects, so those who suffer from endometriosis or uterine fibroids should avoid milk thistle because of the possible contraindication. 

Milk thistle can also change how your body metabolizes certain drugs, and while the drug interaction may not be harmful, milk thistle can reduce the efficacy of your medication. Some of these drugs include azithromycin, warfarin or other anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or statin drugs like lovastatin or fluvastatin. 

Keep in mind that the Food and Drug Administration (FDA) does not regulate herbal supplements, so if you purchase milk thistle, be sure to purchase from an accredited vendor. Also, because the supplement is not regulated, the dosage is merely a suggestion. If you do plan on ingesting milk thistle, it is best always to discuss it with your doctor first as well as the proper dosage for yourself and your health issues.  

If you need more information on milk thistle, herbal supplements, or how to protect your liver, request an appointment at GI Associates and Endoscopy Center. We have three locations to help keep you and your family healthy.

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