Milk thistle, also knwon as Silybum marianum and Cardus marianus, is a highly recommended plant for its liver-protective function. We can find it easily, they are everywhere around the world, North and south america, africa, austrailia, asia, even your backyard. Europeans traditionally have used milk thistle seeds and flowers for many centuries. It is very useful for protecting liver cells against any kinds of harmful things, like alcohol, mushroom poisons, medications you are taking daily, and even snake bites. Today, we are gonna talk about milk thistle and its uses and take a look at its side effects.

Silymarin 

For the use of milk thistle, pharmacists extract milk thistle’s seed and flowers to get helpful ingredients. This is called silmarin. Silymarin is a mixed compound in the milk thistle extract. it consists of flavonolignans (silybin A, silybin B…) and flavonoid (taxifolin). So many chemicals are very helpful to liver protection. They are silibin, silidianin, and silichristin; all of these are phytochemicals, which means plant-originated stuff. In another term, flavonolignan, but forget about it; no need to know. Anyway, mixtures in silymarin have powerful anti-oxidants that can be used for hepatoprotective; Hepato- means liver-, so liver-protective. For a long time, silymarin has been used as an herbal remedy because of these live-protective compounds. Silymarin can be used for liver disease, cirrhosis, jaundice, hepatitis, and gallbladder disorders. So, we need to understand what milk thistle does through silymarin. 

What can silymarin do?

1. Detoxification. Silymarin can eliminate toxic matter from our bodies. The liver is a mighty organ that drains bad materials out. How does it happen? This process gets help by a special enzyme called glutathione-S-transferase, known as GST. When this GST attaches to foreign substances, then it is ready to go outside. This process is called detoxification. Silymarin can significantly increase and activate GST in the liver when taken orally, so Silymarin is a very, very powerful detox material. 
2. Anti-inflammation. Milk thistle is a very powerful against inflammation. Silymarin strongly supress inflammation in liver cells. This can manage liver cells by metabolic, stress, and repair pathways. Anti-inflammation happens by many mechanism, like NF-kB pathways. As a result silymarin shows great performance in inhibiting inflammation of liver cell. In this anti-inflammatory reason, milk thistle could be used in fibrosis, end stage of inflammation.
3. Hepatocelluar regeneraiton. Liver cell revived! Silymarin has strong evidence of liver cell regeneration in animal tests. The liver of the rats treated with silymarin even shows a block to the growth of liver cancer. But, it still needs further studies to be more comprehensive. Its anti-inflammatory effect may help liver cells regenerate.

Milk thistle can actually treat diseases?

But there still conflicting debate on the uses of silymarin. It looks like have protective action on the liver, and even can crue other diseases. But many experts want evidences to compresensive. Some studies show milk thistle can help people with severe diseases, and silymarin might has its own therapeutic effects like anticancer, anti-Alzheimer disease, anti-Parkinson disease, and anti-diabetes. Recently, milk thiscle and silymarin are studies to provide benefits for high cholesterol patients. But there is not enough data in clinical trials.

• anti-Alzheimer
• anti-diabetes
• anti-dermatitis
• anti-cancer
• hepatoprotective
• anti-Parkinson

Any harmful effects?

1. Risks. Milk thistle could have some allergic reactions to individuals. Those who have allergies, please check to your doctor, pharmacist or any medical adviser. For pregnancy, there are not enough studies, but safe, but one clinical trial showed safe. Milk thisle can do affect female hormone, estrogen. If you have breast- or ovalry cancer, or pregnancy, be aware of it. And also milk thistle is not recommended to children.
2. Side effects. In the clinical trials with healthy people and patients with many diseases, silymarin was safe at its use of therapeutic doses in human. Only gastrointestinal disorders were seen in some cases. For healthy people, there are no major reported toxicity and no side effects. But patients with liver disease, hepatitis C, no adverse effects reported. But some symptoms (weight loss, muscle pain, irritaions, hyperglycemia, joint pain, hypercholesterolemia). moderate adverse reactions (abdominal pain, vomiting, diarrhea, heat sensation). Patients with Nonalcoholic fatty liver disease. some side effects like diarrhea, pruritus, dysqeusia.
3. Interactions. Many drugs could be interacted by milk thistle. Some of them are for treatment of high cholesterol, infections, and blood pressure. Milk thistle could lower sugar in your blood, so check before taking milk thistle if you have diabetes. Silymarin has low-drug interactions, no major effects on CYP-450, enzyme to metabolite substances com from outside of the body. Silybin A/B and silibinin in silymarin had inhibitory effect on CYP2C9/3A4, 2C9 effect role in warfarin metabolism, But silymarin did not have major effect on drug metabolism, but wafarin should be usesed with cautions. Milk thistle can be concluded as safe for human for its use at therapeutic doses. It does have side effect, but few and little, mostly in stomach and intestine. Milk thistle has low-drug interactions, but just be warned when you take some certain drugs.

Controversial papers on the effectiveness of Silymarin exist. Although the mechanism is not clear, there have been studies showing that AST/ALT has been reduced by using Silymarin in nonalcoholic fatty live disorder, and studies showing that the use of Silymarin can be considered with abstinence by promoting mitochondrial metabolic processes and reducing the activity of monoamine oxidase. In addition, hepatocellular protection and antifibrotic action have indications for cirrhosis..

References

Phytotherapy Research, 2019, 33 ,1627

Planta Med . 1989 Oct;55(5):420-2. doi: 10.1055/s-2006-962056.

Antioxidants (Basel). 2015 Mar; 4(1): 204–247.

Adv Ther (2020) 37:1279–1301