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Milk Thistle
Other Names
Silybum Marianum
Holy thistle, Marian thistle, St. Mar'sy thistle, Our Lady’s thistle, St. Mary thistle, wild artichoke, Mariendistel (German), and Chardon-Marie (French).
Constituents - The Plant Chemistry
Silybum marianum contains silymarin, which is composed of the flavanolignans silybin, silydianin, and silychristine, with silybin being the most biologically active. Silymarin is found in highest concentrations in the fruit portion of the plant but is also found in the leaves and seeds. The seeds also contain betaine, trimethylglycine and essential fatty acids, which may contribute to silymarin’s hepatoprotective and anti-inflammatory effects.
Silymarin- powerful antioxidant that protects liver from toxicity.
Anti-inflammatory
Repairs damaged cells. Used in the treatment of viral hepatitis, liver damage from caused by toxins, alcohol and drugs.
Used in the treatment for poisoning by the death cap mushroom which contains poisons that cause irreversible liver damage and death.
Description
Annual or biennial plant indigenous to Europe and is also found in some parts of the United States. It grows in rocky soils to a height of three to ten feet with an erect stem that bears large, alternating, prickly-edged leaves. The common name, milk thistle, is derived from the “milky white” veins on the leaves, which, when broken open, yield a milky sap. Flowering season is from June to August, and each stem bears a single, large, purple flower ending in sharp spines. The fruit portion of the plant is glossy brown or grey with spots.
Actions
Silymarin’s hepatoprotective effects are accomplished via several mechanisms including antioxidation, inhibition of lipid peroxidation, enhanced liver detoxification via inhibition of Phase I detoxification and enhanced glucuronidation, and protection of glutathione depletion. Silymarin exhibits several anti-inflammatory effects, including inhibition of leukotriene and prostaglandin synthesis, Kupffer cell inhibition, mast cell stabilization, and inhibition of neutrophil migration. In addition, silymarin has been shown to increase hepatocyte protein synthesis, thereby promoting hepatic tissue regeneration. Animal studies have also demonstrated silybin reduces the conversion of hepatic stellate cells into myofibroblasts, slowing or even reversing fibrosis.
Stabilizing cell membranes of the liver cells. It alters the structure of the membranes so that toxins are prevented from entering the cells. Silymarin has been shown to reduce the growth of human breast, cervical and prostate cancer cells.
Pharmacokinetics
Silymarin is not water soluble, making tea preparations ineffective. Because absorption of silymarin from the gastrointestinal tract is only moderate (23-47%), it is best administered as a standardized extract of 70-80 percent silymarin. In animals and humans, peak plasma levels are reached in four to six hours after an oral dose. Silymarin is excreted primarily via the bile but some clearance is also achieved via the kidneys. The clearance half-life of silymarin is six to eight hours.
Dosage/Contraindications
Silybum marianum is usually given as a standardized extract (70-80% silymarin) in encapsulated form, 100-300 mg three times daily being the typical adult dose.
Both animal and human studies have shown silymarin to be non-toxic. At high doses (>1500 mg per day) a laxative effect is possible due to increased bile secretion and flow. Mild allergic reactions have also been noted but were not serious.
Caution when taking statins, allergy drugs, anti-anxiety drugs, blood thinners, dilantin and halothane.
There are mixed data regarding milk thistle's ability to exert inhibitory or inductive activity on cytochrome P450 (CYP-450) 1A2, 2C19, 2D6, 2E1, and 3A4, as well as P-glycoprotein. Therefore, close monitoring is warranted when drugs metabolized by these enzymes are given concomitantly with milk thistle.
Milk thistle is contraindicated in patients with allergy to any plant in the Asteraceae family. Avoid use of the aboveground parts of the plant in women with hormone-sensitive conditions (eg, breast, uterine, and ovarian cancers; endometriosis; uterine fibroids) unless under the supervision of a physician, due to the extract's possible estrogenic effects. The more commonly used milk thistle seed extracts are not known to have estrogenic effects.
Clinical Indications
Hepatitis - Studies have shown silymarin to be effective in the treatment of both acute and chronic hepatitis. In acute viral hepatitis, administration of silymarin shortened treatment time and lowered serum bilirubin, AST, and ALT. In patients with chronic hepatitis, 420 mg silymarin per day for six months also yielded improved serum liver enzymes.
Alcoholic Liver Disease and Cirrhosis Studies conducted in Austria and Hungary have demonstrated silymarin administration resulted in a normalization of serum liver enzyme and total bilirubin levels in patients with alcoholic liver disease, in addition to improved liver tissue histology.27 In patients with cirrhosis, long-term (41 months) administration of silymarin at 420 mg per day resulted in a significant increase in survival compared to the placebo group.
Hypercholesterolemia An animal study found silymarin given to rats with diet-induced hypercholesterolemia demonstrated an anticholesterolemic effect similar to probucol, with an increase in HDL cholesterol and a decrease in total and biliary cholesterol.
Psoriasis The value of silymarin in the treatment of psoriasis may be due to its ability to improve endotoxin removal by the liver, inhibit cAMP phosphodiesterase, and inhibit leukotriene synthesis. Abnormally high levels of cAMP and leukotrienes have been observed in patients with psoriasis and normalization of these levels may improve the condition.13,
Edible
The plant flavors milk when eaten by cows.
All thistles that are large enough to gather are edible. They are boiled until tender and eaten like an artichoke. The young leaves, stalks and roots can be soaked overnight in salted water and then cooked and eaten. The thistle heads are best when picked just at the height of flowering, boiled, and the heart dissected out.
Sources
Alternative Medicine Review ◆ Volume 4, Number 4 ◆ 1999 Page 273 Copyright©1999 Thorne Research, Inc. All Rights Reserved . Website: http://www.e-lactancia.org/media/papers/Cardo_Mariano_Silimarina-AltMedRev1999.pdf