From the Guidelines
Milk thistle is not recommended for patients with liver dysfunction due to potential interactions with certain medications and lack of strong evidence for its effectiveness. The active ingredient silymarin has antioxidant and anti-inflammatory properties that can protect liver cells from damage and promote liver regeneration, but its benefits are not well established 1. For patients with chronic HCV infection, the use of herbal remedies, including milk thistle, is common, but the benefit of silymarin or other herbal therapies has not been well studied or established 1. In fact, some herbal mixtures have been associated with severe hepatotoxicity, fulminant hepatitis, and death 1. Additionally, milk thistle may interact with certain medications metabolized by the liver, such as simeprevir, and is contraindicated in patients receiving this drug 1. Therefore, patients with liver dysfunction should consult their healthcare provider before taking milk thistle or any other herbal remedy.
Some key points to consider:
- Milk thistle may interact with certain medications, such as simeprevir, and is contraindicated in patients receiving this drug 1
- The benefit of silymarin or other herbal therapies for patients with chronic HCV infection has not been well established 1
- Some herbal mixtures have been associated with severe hepatotoxicity, fulminant hepatitis, and death 1
- Patients with liver dysfunction should consult their healthcare provider before taking milk thistle or any other herbal remedy
- Conventional medical treatment for liver disease should not be replaced with milk thistle or any other herbal remedy 1
From the Research
Milk Thistle and Liver Dysfunction
- Milk thistle, also known as Silybum marianum, is a medicinal plant that has been used for centuries to treat liver diseases 2, 3, 4, 5.
- The major constituent of milk thistle extract is silymarin, which has been shown to have hepatoprotective effects, as well as anticancer, anti-Alzheimer, anti-Parkinson, and anti-diabetic properties 2, 3.
- Studies have demonstrated that silymarin is safe in humans at therapeutic doses and is well tolerated, even at high doses 2.
- However, caution should be exercised during pregnancy, and more studies are needed to fully understand its effects 2.
- Milk thistle has been suggested as a potential adjunct therapy in patients with cancer to prevent or treat liver dysfunction 4.
- The chemistry, pharmacological, and nutraceutical uses of milk thistle in liver diseases have been reviewed, highlighting its anti-inflammatory, immunomodulating, antifibrotic, antioxidant, and liver-regenerating properties 5.
Efficacy and Safety of Milk Thistle
- A systematic review and meta-analysis of 14 trials found that milk thistle was safe and well tolerated, but there was no significant reduction in mortality, improvements in histology, or biochemical markers of liver function among patients with chronic liver disease 6.
- The frequency of adverse effects was low and indistinguishable from placebo 6.
- However, some studies have suggested that milk thistle may have a role in the prevention or treatment of liver dysfunction in patients undergoing anticancer therapy 4.
- Further well-designed randomized clinical trials are needed to fully substantiate the value of milk thistle preparations in liver diseases 5.