Thread: Milk Thistle Profile
07-01-2004, 08:34 PM #1
Milk Thistle Profile
Phytochemicals: Apigenin, beta-carotene, fumaric acid, kaempferol, naringenin, quercetin, silandrin, silybin, silychristin, silydianin, silymarin, silymonin, and taxifolin.
Nutrients: Calcium, fatty acids, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc.
Protects the liver from toxins by preventing free radical damage and stimulates the production of new liver cells. Also protects the kidneys. Good for gallbladder and adrenal disorders, inflammatory bowel disorders, psoriasis, weakened immune system, and all liver disorders. Has shown anti-cancer effects against prostate cancer and breast cancer.
Extracted from the seeds of the herb milk thistle, silymarin has been used for centuries to treat liver disease. The active ingredients in Milk Thistle are several types of flavonoids known as silymarin. Silymarin guards the liver from oxidative damage. It also protects the liver from drugs, toxins, and the effects of alcohol, and promotes the growth of new liver cells. In addition silymarin increases the levels of glutathione, a potent antioxidant enzyme produced in the liver.
Recommended dosage: 1000mg (80% Silymarin ED) on and off cycle.
Last edited by Lozgod; 07-01-2004 at 09:05 PM. Reason: misspelling
07-01-2004, 08:49 PM #2
where can you buy milk thistle? is it percription, over the counter? or mexico? aslo, how much does it run?
07-01-2004, 08:49 PM #3Originally Posted by slitsoul13
07-01-2004, 09:00 PM #4
Botanical: Silybum Marianum Family: N.O. Compositae
Description Medicinal Action and Uses
Synonym: Marian Thistle.
Parts Used: Whole herb, root, leaves, seeds and hull.
The Marian, or Milk Thistle, is perhaps the most important medicinally among the members of this genus, to which all botanists do not, however, assign it, naming it Silybum Marianum.
It is a fine, tall plant, about the size of the Cotton Thistle, with cutinto root-leaves, waved and spiny at the margin, of a deep, glossy green, with milkwhite veins, and is found not uncommonly in hedgebanks and on waste ground, especially by buildings, which causes some authorities to consider that it may not be a true native. In Scotland it is rare.
This handsome plant is not unworthy of a place in our gardens and shrubberies and was formerly frequently cultivated. The stalks, like those of most of our larger Thistles, may be eaten, and are palatable and nutritious. The leaves also may be eaten as a salad when young. Bryant, in his Flora Dietetica, writes of it: 'The young shoots in the spring, cut close to the root with part of the stalk on, is one of the best boiling salads that is eaten, and surpasses the finest cabbage. They were sometimes baked in pies. The roots may be eaten like those of Salsify.' In some districts the leaves are called 'Pig Leaves,' probably because pigs like them, and the seeds are a favourite food of goldfinches.
The common statement that this bird lines its nest with thistledown is scarcely accurate, the substance being in most cases the down of Colt's-foot (Tussilago), or the cotton down from the willow, both of which are procurable at the building season, whereas thistledown is at that time immature.
Westmacott, writing in 1694, says of this Thistle: 'It is a Friend to the Liver and Blood: the prickles cut off, they were formerly used to be boiled in the Spring and eaten with other herbs; but as the World decays, so doth the Use of good old things and others more delicate and less virtuous brought in.'
The heads of this Thistle formerly were eaten, boiled, treated like those of the Artichoke.
There is a tradition that the milk-white veins of the leaves originated in the milk of the Virgin which once fell upon a plant of Thistle, hence it was called Our Lady's Thistle, and the Latin name of the species has the same derivation.
Medicinal Action and Uses
The seeds of this plant are used nowadays for the same purpose as Blessed Thistle, and on this point John Evelyn wrote: 'Disarmed of its prickles and boiled, it is worthy of esteem, and thought to be a great breeder of milk and proper diet for women who are nurses.'
It is in popular use in Germany for curing jaundice and kindred biliary derangements. It also acts as a demulcent in catarrh and pleurisy. The decoction when applied externally is said to have proved beneficial in cases of cancer.
Gerard wrote of the Milk Thistle that: 'the root if borne about one doth expel melancholy and remove all diseases connected therewith. . . . My opinion is that this is the best remedy that grows against all melancholy diseases,' which was another way of saying that it had good action on the liver. He also tells us: 'Dioscorides affirmed that the seeds being drunke are a remedy for infants that have their sinews drawn together, and for those that be bitten of serpents:' and we find in a record of old Saxon remedies that 'this wort if hung upon a man's neck it setteth snakes to flight.' The seeds were also formerly thought to cure hydrophobia.
Culpepper considered the Milk Thistle to be as efficient as Carduus benedictus for agues, and preventing and curing the infection of the plague, and also for removal of obstructions of the liver and spleen. He recommends the infusion of the fresh root and seeds, not only as good against jaundice, also for breaking and expelling stone and being good for dropsy when taken internally, but in addition, to be applied externally, with cloths, to the liver. With other writers, he recommends the young, tender plant (after removing the prickles) to be boiled and eaten in the spring as a blood cleanser.
A tincture is prepared by homoeopathists for medicinal use from equal parts of the root and the seeds with the hull attached.
It is said that the empirical nostrum, antiglaireux, of Count Mattaei, is prepared from this species of Thistle.
Thistles in general, according to Culpepper, are under the dominion of Jupiter.
Source: A Modern Herbal, by Mrs. M. Grieve
Encyclopedia of Natural Medicine Michael Murray,
N.D. and Joseph Pizzorno, N.D.
MILK THISTLE (Silybum marianum)
The common milk thistle contains some of the most potent liver protective substances known, a mixture of three flavanolignins colelctively referred to as silymarin. (30-33) The concentration of silymarin is highest in the fruit, but it is also found in the seeds and leaves.
Silymarin's effect in preventing liver destruction and enhancing liver function relates largely to its ability to inhibit the factors that are responsible for hepatic damage, i.e., free radicals and leukotrienes, coupled with an ability to stimulate liver protein synthesis. (30-33)
Silymarin prevents free radical damage by acting as an antioxidant.
Silymarin is many times more potent in antioxidant activity than vitamin E. Silymarin not only prevents the depletion of glutathione (GSH) induced by alcohol and other liver toxins, but it was shown to increase the basal GSH of the liver by 35 per cent over controls in one study. This is extremely useful when exposure to toxic substances is high, due to glutathione's vital role in detoxification reactions.
The protective effect of silymarin against liver damage has been demonstrated in a number of experimental and clinical studies. (30-38)
Experimental liver damage in animals can be produced by such diverse toxic chemicals as carbon tetrachloride, amanita toxin, galactosamine and praseodymium nitrate. Silymarin has been shown to protect against liver damage by all of these agents. (30-33)
Another way in which the liver can be damaged is by the action of leukotrienes. These compounds are produced by the transfer of oxygen to a polyunsaturated fatty acid. This reaction is catalysed by the enzume lipoxygenase. Silybum components inhibit this enzyme, thereby inhibiting the formation of these damaging compounds.
Perhaps the most interesting effect of silybum components on the liver is their ability to stimulate protein synthesis. (30-33) The result is an increase in the production of new liver cells to replace the damaged old ones. This demonstrates that silymarin exerts both a protective and restorative effect on the liver.
In human studies, silymarin has been shown to have positive effects in treating liver diseases of various kinds, including cirrhosis, chronic hepatitis, fatty infiltration of the liver (chemical and alcohol induced fatty liver) and inflammation of the bile duct. (32-38)
The therapeutic effect of silymarin in all of these disorders has been confirmed by histological (biopsy), clinical and laboratory data. Silymarin is especially effective in the treatment and prevention of toxic chemical or alcohol induced liver damage. (32-38)
30. Hikino, H. Kiso, Y., Wagner, H. and Fiegig, M., "Antihepatotoxic actions of flavonolignans from Silybum marianum fruits", Planta Medica, 1984, 50, pp 248-50
31. Vogel, G., Trost, W., Braatz, R., et al., "Studies on pharmacodynamics, site and mechanism of action of silymarin the antihpatotoxic principle from Silybum marianum (L.) Gaert"., Arzneim-Forsch, 1975, 25, pp 179-85
32. Wagner, H., Antihepatotoxic flavonoids", in Cody, V., Middleton, E. and Harbourne, J.D. (eds), Plant flavinoids in Biology and Medicine: Biochemical, Pharmacological and Structure-Activity relationships, Alan R. Liss, New York, NY 1986, pp545-58
33. Wagner, H., "Plant constituents with antihepatotoxic activity", in Beal, J.L. and Reinhard, E. (eds) Natural Products as Medicinal Agents, Hippokrates-Verlang, Stuttgart, 1981
34. Sarre, H., "Experience in the treatment of chronic hepatopathies with silymarin", Arzneim-Forsch, 1971, 21, pp 1,209-12
35. Canini, F., Bartolucci, A., Cristallini, E., et al., "Use of silymarin in the treatment of alcoholic hepatic stenosis", Clin. Ther., 1985, 114, pp 307-14
36. Salmi, H.A., and Sarna, S., "Effect of silymarin on chemical, functional, and morphological alteration of the liver. A double-blind controlled study" Scand.J.Gastroenterol., 1982, 17, pp 417-21
37. Scheiber, V., and Wohlzogen, F.X., "Analysis of a certain type of 2 x 3 tables, exemplified by biopsy findings in a controlled clinical trial", Int.J.Clin.Pharmacol., 1978, 16, pp 533-5
38. Boari, C., Montanari, M., Galleti, G.P., et al., "Occupational toxic liver diseases. Therapeutic effects of silymarin", Min.Med., 1985, 72, pp 2,679-88.
07-01-2004, 09:01 PM #5
Evidence Report/Technology Assessment: Number 21
Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects
Under its Evidence-based Practice Program, the Agency for Healthcare Research and Quality (AHRQ) is developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. Contractor institutions review all relevant scientific literature on assigned clinical care topics and produce evidence reports and technology assessments, conduct research on methodologies and the effectiveness of their implementation, and participate in technical assistance activities.
Overview / Reporting the Evidence / Methodology / Findings / Future Research / Availability of Full Report
This evidence report details a systematic review summarizing clinical studies of milk thistle in humans. The scientific name for milk thistle is Silybum marianum. It is a member of the aster or daisy family and has been used by ancient physicians and herbalists to treat a range of liver and gallbladder diseases and to protect the liver against a variety of poisons.
Two areas are addressed in the report:
Effects of milk thistle on liver disease of alcohol, viral, toxin, cholestatic, and primary malignancy etiologies.
Clinical adverse effects associated with milk thistle ingestion or contact.
The report was requested by the National Center for Complementary and Alternative Medicine, a component of the National Institutes of Health, and sponsored by the Agency for Healthcare Research and Quality.
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Reporting the Evidence
Specifically, the report addresses 10 questions regarding whether milk thistle supplements (when compared with no supplement, placebo, other oral supplements, or drugs):
Alter the physiologic markers of liver function.
Reduce mortality or morbidity, or improve the quality of life in adults with alcohol-related, toxin-induced, or drug-induced liver disease, viral hepatitis, cholestasis, or primary hepatic malignancy.
One question addresses the constituents of commonly available milk thistle preparations, and three questions address the common and uncommon symptomatic adverse effects of milk thistle.
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Eleven electronic databases, including AMED, CISCOM, the Cochrane Library (including DARE and the Cochrane Controlled Trials Registry), EMBASE, MEDLINE, and NAPRALERT, were searched through July 1999 using the following terms:
An update search limited to PubMed was conducted in December 1999. English and non-English citations were identified from these electronic databases, references in pertinent articles and reviews, drug manufacturers, and technical experts.
Preliminary selection criteria regarding efficacy were reports on liver disease and clinical and physiologic outcomes from randomized controlled trials (RCTs) in humans comparing milk thistle with placebo, no milk thistle, or another active agent. Several of these randomized trials had dissimilar numbers of subjects in study arms, raising the question that these were not actually RCTs but cohort studies. In addition, among studies using nonplacebo controls, the type of control varied widely. Therefore, qualitative and quantitative syntheses of data on effectiveness were limited to placebo-controlled studies. For adverse effects, all types of studies in humans were used to assess adverse clinical effects.
Data Collection and Analysis
Abstractors (physicians, methodologists, pharmacists, and a nurse) independently abstracted data from trials; a nurse and physician abstracted data about adverse effects. Data were synthesized descriptively, emphasizing methodologic characteristics of the studies, such as populations enrolled, definitions of selection and outcome criteria, sample sizes, adequacy of randomization process, interventions and comparisons, cointerventions, biases in outcome assessment, and study designs. Evidence tables and graphic summaries, such as funnel plots, Galbraith plots, and forest plots, were used to examine relationships between clinical outcomes, participant characteristics, and methodologic characteristics. Trial outcomes were examined quantitatively in exploratory meta-analyses that used standardized mean differences between mean change scores as the effect size measure.
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Mechanisms of Action
Evidence exists that milk thistle may be hepatoprotective through a number of mechanisms: antioxidant activity, toxin blockade at the membrane level, enhanced protein synthesis, antifibriotic activity, and possible anti-inflammatory or immunomodulating effects.
Preparations of Milk Thistle
The largest producer of milk thistle is Madaus (Germany), which makes an extract of concentrated silymarin. However, numerous other extracts exist, and more information is needed on comparability of formulations, standardization, and bioavailability for studies of mechanisms of action and clinical trials.
Benefit of Milk Thistle for Liver Disease
Sixteen prospective trials were identified. Fourteen were randomized, blinded, placebo-controlled studies of milk thistle's effectiveness in a variety of liver diseases. In one additional placebo-controlled trial, blinding or randomization was not clear, and one placebo-controlled study was a cohort study with a placebo comparison group.
Seventeen additional trials used nonplacebo controls; two other trials studied milk thistle as prophylaxis in patients with no known liver disease who were starting potentially hepatotoxic drugs. The identified studies addressed alcohol-related liver disease, toxin-induced liver disease, and viral liver disease. No studies were found that evaluated milk thistle for cholestatic liver disease or primary hepatic malignancy (hepatocellular carcinoma, cholangiocarcinoma).
There were problems in assessing the evidence because of incomplete information about multiple methodologic issues, including etiology and severity of liver disease, study design, subject characteristics, and potential confounders. It is difficult to say if the lack of information reflects poor scientific quality of study methods or poor reporting quality or both.
Detailed data evaluation and syntheses were limited to the 16 placebo-controlled studies. Distribution of durations of therapy across trials was wide (7 days to 2 years), inconsistent, and sometimes not given. Eleven studies used Legalon®, and eight of those used the same dose. Outcome measures varied among studies, as did duration of therapy and the followup for which outcome measures were reported.
Among six studies of milk thistle and chronic alcoholic liver disease, four reported significant improvement in at least one measurement of liver function (i.e., aminotransferases, albumin, and/or malondialdehyde) or histologic findings with milk thistle compared with placebo, but also reported no difference between groups for other outcome measures.
Available data were insufficient to sort six studies into specific etiologic categories; these were grouped as chronic liver disease of mixed etiologies. In three of the six studies that reported multiple outcome measures, at least one outcome measure improved significantly with milk thistle compared with placebo, but there were no differences between milk thistle and placebo for one or more of the other outcome measures in each study. Two studies indicated a possible survival benefit.
Three placebo-controlled studies evaluated milk thistle for viral hepatitis. The one acute viral hepatitis study reported latest outcome measures at 28 days and showed significant improvement in aspartate aminotransferase and bilirubin. The two studies of chronic viral hepatitis differed markedly in duration of therapy (7 days and 1 year). The shorter study showed improvement in aminotransferases for milk thistle compared with placebo but not other laboratory measures. In the longer study, milk thistle was associated with a nonsignificant trend toward histologic improvement, the only outcome measure reported.
Two trials included patients with alcoholic or nonalcoholic cirrhosis. The milk thistle arms showed a trend toward improved survival in one trial and significantly improved survival for subgroups with alcoholic cirrhosis or Child's Group A severity. The second study reported no significant improvement in laboratory measures and survival for other clinical subgroups, but no data were given.
Two trials specifically studied patients with alcoholic cirrhosis. Duration of therapy was unclear in the first, which reported no improvement in laboratory measures of liver function, hepatomegaly, jaundice, ascites, or survival. However, there were nonsignificant trends favoring milk thistle in incidence of encephalopathy and gastrointestinal bleeding and in survival for subjects with concomitant hepatitis C. The second study, after treatment for 30 days, reported significant improvements in aminotransferases but not bilirubin for milk thistle compared with placebo.
Three trials evaluated milk thistle in the setting of hepatotoxic drugs: one for therapeutic use and two for prophylaxis with milk thistle. Results were mixed among the three trials.
Exploratory meta-analyses generally showed positive but small and nonsignificant effect sizes and a sprinkling of significant positive effects.
No studies were identified regarding milk thistle and cholestatic liver disease or primary hepatic malignancy.
Available evidence does not establish whether effectiveness of milk thistle varies across preparations. One Phase II trial suggested that effectiveness may vary with dose of milk thistle.
Adverse effects associated with oral ingestion of milk thistle include:
Gastrointestinal problems (e.g., nausea, diarrhea, dyspepsia, flatulence, abdominal bloating, abdominal fullness or pain, anorexia, and changes in bowel habits).
Skin reactions (pruritus, rash, urticaria, and eczema).
Neuropsychological events (e.g., asthenia, malaise, and insomnia).
However, causality is rarely addressed in available reports. For randomized trials reporting adverse effects, incidence was approximately equal in milk thistle and control groups.
Clinical efficacy of milk thistle is not clearly established. Interpretation of the evidence is hampered by poor study methods and/or poor quality of reporting in publications. Problems in study design include heterogeneity in etiology and extent of liver disease, small sample sizes, and variation in formulation, dosing, and duration of milk thistle therapy. Possible benefit has been shown most frequently, but not consistently, for improvement in aminotransferases and liver function tests are overwhelmingly the most common outcome measure studied. Survival and other clinical outcome measures have been studied least often, with both positive and negative findings. Available evidence is not sufficient to suggest whether milk thistle may be more effective for some liver diseases than others or if effectiveness might be related to duration of therapy or chronicity and severity of liver disease. Regarding adverse effects, little evidence is available regarding causality, but available evidence does suggest that milk thistle is associated with few, and generally minor, adverse effects.
Despite substantial in vitro and animal research, the mechanism of action of milk thistle is not fully defined and may be multifactorial. A systematic review of this evidence to clarify what is known and identify gaps in knowledge would be important to guide design of future studies of the mechanisms of milk thistle and clinical trials.
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The type, frequency, and severity of adverse effects related to milk thistle preparations should be quantified. Whether adverse effects are specific to dose, particular preparations, or additional herbal ingredients needs elucidation, especially in light of equivalent frequencies of adverse effects in available randomized trials. When adverse effects are reported, concomitant use of other medications and product content analysis should also be reported so that other drugs, excipients, or contaminants may be scrutinized as potential causal factors.
Characteristics of future studies in humans should include:
Longer and larger randomized trials.
Clinical as well as physiologic outcome measures.
Detailed data about compliance and dropouts.
Systematic standardized surveillance for adverse effects.
Attention to specific study populations (e.g., patients with hepatitis B virus [HBV], or hepatitis C virus [HCV], or mixed infection or coinfection with human immunodeficiency virus [HIV]), comorbidities, alcohol consumption, and potential confounders.
There also should be detailed attention to preparation, standardization, and bioavailability of different formulations of milk thistle (e.g., standardized silymarin extract and silybin-phosphatidylcholine complex).
Precise mechanisms of action specific to different etiologies and stages of liver disease need explication. Further mechanistic investigations are needed and should be considered before, or in concert with, studies of clinical effectiveness. More information is needed about effectiveness of milk thistle for severe acute ingestion of hepatotoxins, such as occupational exposures, acetaminophen overdose, and amanita poisoning.
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Availability of Full Report
The full evidence report from which this summary was derived was prepared by the San Antonio Evidence-based Practice Center based at The University of Texas Health Science Center at San Antonio and the Veterans Evidence-based Research, Dissemination, and Implementation Center (VERDICT), a Veterans Affairs Health Services Research and Development Center of Excellence under contract No. 290-97-0012. Printed copies may be obtained free of charge from the AHRQ Publications Clearinghouse by calling 800-358-9295. Requesters should ask for Evidence Report/Technology Assessment Number 21, Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects (AHRQ Publication No. 01-E025).
The Evidence Report is available online at http://hstat.nlm.nih.gov/hq/Hquest/...tAccess/db/3146 or can be downloaded as a zipped file at: http://www.ahrq.gov/clinic/evrptfiles.htm#thistle.
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AHRQ Publication Number 01-E024
Current as of September 2000
Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/milktsum.htm
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AHRQ Home Page
Department of Health and Human Services
07-01-2004, 09:01 PM #6
Thanks Bull, I'll Fed Ex you a Pats Cheesesteak.
07-01-2004, 09:03 PM #7Senior Member
- Join Date
- Apr 2004
Hey Loz you might want to add this, on the back of the bottle where the ingredients are list you will 80% silymarin 175mg or whatever yours might read, it could be different depending on the manufacturer(use the active ingredient silymarin to get the 1000mg not what is printed on the front of the bottle).
07-01-2004, 09:05 PM #8Originally Posted by kronik
07-01-2004, 09:26 PM #9
07-01-2004, 09:31 PM #10
07-01-2004, 10:16 PM #11Originally Posted by Lozgod
The 1000mg softgels at vita.com is cheap, but that is a 4:1 extract, not 80% Silymarin. I would want to stick with the 80% extract.
07-01-2004, 10:19 PM #12
Well I been dealing with them for years, and with no guarantee that it is what it sais on the bottle, because that isnt mandatory with herbs believe it or not, I would rather stick to a more reputable company.
07-01-2004, 10:31 PM #13
You may be thinking of the fact that it isnt mandatory to perform safety studies on dietary supplements before marketing. However, misbranding, (saying something on your label that is not true) is covered under DSHEA and is absolutely illegal. I am not saying that it does not happen, but it is mandatory that supplement labels accurately represent the actual contents of the bottle. That being said, you are correct that it is important to have trust in the products and manufacturers that you use.
07-01-2004, 10:37 PM #14Originally Posted by Cousin Eddie
07-01-2004, 10:39 PM #15
I use them. Check out the page on the KN site called "friends". There are a few familiar names on there, one in particular.
07-01-2004, 11:51 PM #16Originally Posted by Cousin Eddie
BTW, good, comprehensive thread here.
07-02-2004, 07:09 AM #17Originally Posted by einstein1905
07-02-2004, 11:59 AM #18Originally Posted by Cousin Eddie
07-02-2004, 12:57 PM #19Originally Posted by einstein1905
07-02-2004, 06:16 PM #20
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