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The use of milk thistle as a medicinal plant dates back to ancient times. The herbaceous plant has many hidden talents and can help with a wide variety of ailments. Researchers are discovering more and more positive properties of this plant. In some cases, its active ingredients can even be real lifesavers.
Milk thistle is a plant belonging to the thistle family. This large herbaceous plant is known by various names:
Milk thistle got its name in early Christianity from a legend. According to this legend, the Virgin Mary lost a drop of breast milk while breastfeeding Jesus. This drop fell on the milk thistle, which is said to have caused the characteristic white spots on the leaves of the medicinal plant.
Milk thistle belongs to the Asteraceae family, the family of composite flowers. This makes it a distant relative of sunflowers, daisies, marguerites, and dandelions. It belongs to the subfamily Carduoideae.
This subfamily comprises about 83 genera. In addition to some genera of thistles, other well-known plants such as artichokes and cornflowers also belong to this subfamily.
Silybum marianum is an annual to biennial herbaceous plant. It reaches a height of 20 to 200 cm. The plant has a conical shape and becomes narrower towards the tip. At the base, it has a diameter of up to 160 cm.
The leaves of the milk thistle are usually hairless and light green with white spots around the veins. The leaves, which are up to 50 cm long and 25 cm wide, are elongated to lanceolate in shape and lobed or pinnate. They often have small spines about 8 mm long on the edges.
The milk thistle is simple to slightly branched. In larger plants, the stem can sometimes be hollow and is covered with a cobweb-like to cotton-like down.
The flower heads of the milk thistle stand alone and have the typical shape of composite flowers. They are 4 to 12 cm in diameter and reddish to purple in color. The bracts around the flower heads have sharp thorns and spines.
The flowering period depends on the region. In the northern hemisphere, milk thistles bloom from June to August. In the south, however, the flowering period is between December and February.
The history of milk thistle goes back a long way. It is said to have been known to humans as a medicinal plant for over 2000 years. Pliny the Elder, a Roman scholar, is said to have written about the effectiveness of milk thistle in his famous work Naturalis Historia.
The ancient Greeks are also said to have used milk thistle as a medicinal plant. Ancient records describe milk thistle tea as a remedy for snake bites and other symptoms of poisoning.
In the Middle Ages, the plant was used to treat liver disease. Shortly thereafter, in the 16th century, English botanist John Gerard wrote in his work Anatomy of Plants that milk thistle could help with depression and other mental illnesses of this kind.
In the 17th century, English physician, pharmacist, and astrologer Nicholas Culpeper published his work 'The Complete Herbal and English Physician'. In it, he described around 350 medicinal plants of the time, including milk thistle. He recommended using the medicinal plant for liver disease and jaundice.
Native Americans are also said to have used milk thistle in their natural medicine. They used it primarily to treat various skin diseases such as boils.
Silybum marianum was originally widespread in the southern regions of the world. These include the Mediterranean region, southern Russia, but also the Middle East and North Africa. Today, its distribution area is significantly larger.
Milk thistle now also grows in parts of North America, South America, and southern Australia. The plant generally thrives in temperate, mild to warmer climates and prefers nutrient-rich soils.
It often grows wild on rubbish dumps, roadsides, pastures, and other ruderal sites. Silybum marianum is cultivated on a large scale for the pharmaceutical industry in Austria, Germany, Hungary, Poland, and China.
The seeds of milk thistle are dispersed by the wind, similar to dandelions and other composite flowers. Another method of dispersal is by harvest ants, which are attracted by the oil-rich seeds of the plant. Milk thistle is therefore often found near ant nests.
The main active ingredients in milk thistle belong to the flavonoid family. The plant is therefore classified as a flavonoid drug. This group also includes other medicinal plants such as chamomile, ginkgo, St. John's wort, and arnica.
The active complex in Silybum marianum is a lipophilic extract. This is found mainly in the seeds of the plant. The juice from the crushed seeds is called milk thistle extract. The therapeutically active components of milk thistle seeds are three isomeric flavonolignans:
These are collectively referred to as silymarin. Dried seeds contain about 4% silymarin. It is also found in other parts of the plant, but is most concentrated in the fruits and seeds of milk thistle.
The main component of silymarin is silybin. Approximately 50% to 70% of silymarin consists of silybin. It is considered the component with the highest biological activity.
The seeds also contain other flavonolignans such as betaine, apigenin, and silybonol. They also contain proteins and free fatty acids. It is therefore reasonable to assume that these active ingredients may also contribute to the health-promoting effects of milk thistle seeds.
Silymarin is absorbed into the body via the gastrointestinal tract. It reaches its maximum concentration in the blood after about 2 to 4 hours. The half-life is 6 hours. It is therefore advisable to spread the intake over the day to achieve a lasting effect.
About 80% of silymarin is excreted via the bile. Researchers have shown that sylibinin is the most effective component in silymarin. Its concentration in bile is 60 times higher than that of the other components.
The therapeutic and health-promoting effects of milk thistle seeds involve a variety of molecular mechanisms. The active ingredient silymarin has numerous effects in the human body:
Antioxidant and protective effect against free radicals and associated cell protection Anti-hepatotoxic: Some fungi, such as the green death cap mushroom, contain toxins that destroy the cell membrane of hepatocytes (liver cells) and inhibit protein synthesis. This can lead to severe liver damage and even death. Silymarin prevents this by blocking the binding sites of the toxin and at the same time increasing the regenerative capacity of the liver cells. Anti-inflammatory Regulates cholesterol levels in the liver and blood Possible anti-carcinogenic and growth-inhibiting effect on various types of tumors Neuroprotective Protects the cardiovascular system Blood sugar-lowering Immunomodulatory effect
More details on the various mechanisms of action and functions are provided in the following sections.
One of the most common uses of milk thistle is the treatment of liver problems.
The active ingredient in milk thistle, silymarin, acts as an antioxidant by reducing the production of free radicals. Scientists believe that this has a detoxifying effect, which is why silymarin may be beneficial for the treatment of various liver diseases, such as:
Scientists refer to the positive properties of silymarin as a functional triad, as it has anti-inflammatory, antioxidant, and apoptotic effects. Many of the currently known studies refer to animal experiments. Its effectiveness in humans still needs to be verified in larger, more structured studies.
The active ingredients in milk thistle not only have a positive effect on the liver, but probably also on the kidneys.
Silymarin concentrates in kidney cells and supports cell regeneration by increasing protein and nucleic acid synthesis. Silymarin is believed to increase cell replication by 30%. This is due to the two components of silymarin (silybin and silychristin).
Bile is produced in the liver and stored in the gallbladder. The greenish-yellow fluid consists of cholesterol, water, bile salts, and pigments. It supports the digestive process and removes certain waste products from the body.
Therefore, promoting healthy, unimpeded flow and production of bile is an ideal preventive approach for the proper elimination of toxins and for the health of the gallbladder, liver, and digestive system. Cholagogue, also known as cholagogue, can be helpful in this regard. A distinction is made between choleretics and cholekinetics.
Choleretics stimulate the production of bile in the liver, whereas cholekinetics facilitate the contraction of the gallbladder and thus promote bile flow. Some plants contain active ingredients that can trigger or promote these effects:
The special thing about milk thistle is that its ingredients have both cholekinetic and choleretic effects. Silymarin induces the production of bile acids in the liver without hindering bile acid-independent flow. These effects are mainly due to the stimulation of bile acid synthesis and an increase in the endogenous pool of bile acids, rather than increased reabsorption of bile acids from the intestine.
When bile acids accumulate in liver cells, silibinin facilitates the inhibition of bile acid synthesis and directs synthesis towards more hydrophilic and less toxic types of bile acids. It can thus alleviate the metabolic burden on hepatocytes. Silibinin also prevents the failure of the bile salt export pump.
Milk thistle is used in combination with other herbal remedies to relieve the symptoms of heartburn, stomach cramps, and indigestion. Its detoxifying properties also have a positive effect on the digestive system.
In addition to silymarin, milk thistle also has other beneficial properties. It contains important digestive bitter compounds and tannins. These can further support digestion.
Milk thistle can stimulate the appetite and, as already mentioned, support the production and regulation of bile and stomach acid. These fluids are important for healthy digestion.
High cholesterol levels can lead to problems and endanger heart health. This factor also increases the likelihood of a stroke.
A study from 2006 suggests that milk thistle may play an important role in maintaining cholesterol levels. It was found that cholesterol levels in people who took milk thistle to treat diabetes were lower than in patients who took a placebo.
Several studies have shown that silymarin can inhibit the development of hypercholesterolemia. This is usually a lipid metabolism disorder caused by an unhealthy, high-fat diet. The result is high cholesterol levels in the blood.
Hypercholesterolemia can cause serious health problems such as arteriosclerosis, kidney disease, stroke, heart attack, and other coronary artery diseases. The studies mentioned above yielded the following overall results:
Glutathione is often referred to as the body's main antioxidant. It consists of the three amino acids cysteine, glycine, and glutamate and is found in almost every cell in the human body. The highest concentration of glutathione is found in the liver, making it crucial for the body's detoxification process.
Glutathione is also an essential component of the body's natural defense system. Viruses, bacteria, heavy metal toxicity, radiation, certain medications, and even the normal aging process can damage healthy cells and deplete glutathione. This can result in reduced immune function and an associated increased susceptibility to infections.
The antioxidant effect of silymarin protects against the breakdown of glutathione. Studies have shown that the active ingredient can even stimulate the body's own synthesis of glutathione in the liver.
Milk thistle can be a useful complementary therapy for treating type II diabetes. Scientists discovered that the silibinin contained in milk thistle can act similarly to some diabetic medications by improving insulin sensitivity and lowering blood sugar. Researchers suspect that silymarin can lower blood sugar levels without affecting insulin production.
In addition, the antioxidant and anti-inflammatory properties of milk thistle may help reduce the risk of diseases associated with diabetes. These include kidney disease, for example.
Scientists examined data from 83 studies on silymarin and its effect on the treatment of diabetes. They selected five representative studies with a total of 270 participants and analyzed the results. With regular use, a significant reduction in fasting blood sugar levels and HbA1c, a measure of blood sugar control, was observed.
However, the researchers pointed out that the quality of the available studies is insufficient. This is due, among other things, to the small group size in some cases. Other factors that make it difficult to compare the studies are the different dosages and forms of administration.
The researchers therefore advocate further research and standardized studies to better demonstrate the effectiveness of milk thistle extract in type II diabetes.
A study in mice has shown that milk thistle extract can help reduce insulin resistance. Insulin resistance is a known problem in people with type II diabetes.
Although these research results suggest that milk thistle may play a role in the treatment of diabetes, further studies are needed to make a significant statement as to whether the medicinal plant reduces insulin resistance and also supports diabetes management in humans.
The 2016 trials on insulin resistance described above have yielded further positive effects. Researchers fed mice a particularly high-fat diet to trigger the development of fatty liver, which is associated with severe obesity.
However, the addition of silymarin led to significant weight loss in the mice. This observation suggests that the active ingredients in milk thistle may have a positive effect on dieting. However, further studies on the effect of milk thistle on weight loss in humans are needed to confirm this.
The antioxidant properties of milk thistle extract can have a positive effect as an anti-aging agent. They protect cells from oxidative stress and premature aging.
A study investigated the effect of a cream emulsion containing 4% milk thistle extract on the skin. The researchers concluded that the active cream had a positive effect on skin moisture.
They also explain that flavonoids are able to increase collagen in the skin and protect it from UV radiation. Skin wrinkles are directly related to the loss of collagen. Increasing water loss from the epidermis leads to less water being retained. This ultimately leads to the degeneration of collagen.
Milk thistle can help strengthen a person's immune response and fight off infections. A 2016 study conducted on an animal model found that milk thistle extract can improve immunity.
A 2002 in vitro study on mouse lymphocytes showed that milk thistle extract has a positive effect on the immune response and can stimulate the immune system. To learn more about the underlying mechanisms, scientists need to conduct further studies with human participants.
Osteoporosis is a common metabolic bone disease characterized by low bone mass. This results in weak bones that are prone to fractures. The disease often affects women after menopause. Type II osteoporosis is another form of this disease and is observed equally in men and women over the age of 75.
Milk thistle can play an important role in supporting bone health. A study from 2013 found that milk thistle can prevent bone loss. The study specifically examined bone loss caused by estrogen deficiency.
The researchers found that the osteoprotective effect of milk thistle extract was comparable to that of estrogenic isoflavones. They therefore believe that silymarin, and particularly the silibinin it contains, could be a possible alternative treatment for the prevention of postmenopausal osteoporosis. It is not yet clear whether milk thistle has the same beneficial effects on other forms of osteoporosis.
Milk thistle can help promote healthy skin. A 2015 study found that when applied to the skin of mice, milk thistle helped improve inflammatory skin conditions.
Acne is one of the most common skin conditions in the world. Most people struggle with chronic skin inflammation at some point in their lives. This is often not only very painful: in severe cases, it can leave deep scars, which can cause severe psychological distress for those affected.
Researchers have discovered a link between oxidative stress and the development of acne. They compared various parameters indicative of oxidative stress in the blood serum of acne patients with those of a healthy control group.
Based on this knowledge, a research group investigated the effects of three different antioxidants on the number of acne-related skin lesions. The effects of silymarin, N-acetylcysteine, and selenium were tested. A total of 56 men and women participated in the study over a period of eight weeks.
After use over this period, oral intake of silymarin reduced the number of skin lesions by 53%. N-acetylcysteine showed a significant reduction of 50%, whereas selenium did not produce any significant results. Silymarin thus showed the best results compared to the other two antioxidants.
Oxidative stress not only affects the skin, but can also have a negative impact on brain function. A 2017 research paper looked at the neuroprotective properties of silymarin.
Overall, the researchers found that silymarin:
However, there are currently no human studies investigating the effect of milk thistle in patients with Alzheimer's disease or other neurodegenerative diseases such as Parkinson's disease. Furthermore, researchers are unsure whether the concentrations required to cross the blood-brain barrier can be achieved in the human body. .
Nevertheless, they believe that herbal active ingredients such as silymarin could be a promising alternative for the treatment of neurodegenerative diseases.
Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder. There are a variety of pharmaceutical drugs available, but these are often not well tolerated due to side effects.
An Iranian research group therefore presented a study in 2010 in which they compared the effects of fluoxetine and silymarin. Fluoxetine is a well-known active ingredient from the group of antidepressants and is prescribed for the treatment of depression, obsessive-compulsive disorder, and bulimia.
The study was conducted over a period of 8 weeks as a pilot double-blind study. Thirty-five outpatients with proven obsessive-compulsive disorder participated. One group received a capsule containing 600 mg of silymarin daily for the duration of the study, while the other group received 30 mg of fluoxetine.
The study found that there were no significant differences between the plant extract and the pharmaceutical drug in the treatment of obsessive-compulsive disorder. No differences in side effects were observed in either group.
Silymarin could therefore potentially be a good herbal alternative for the treatment of OCD. Larger studies would therefore be appropriate to further investigate its effectiveness.
Prostate cancer is the second most commonly diagnosed cancer in men. Researchers have long seen a link between certain dietary factors and the onset of the disease. This has led to several studies on dietary modification and dietary supplements as preventive measures.
Researchers suggest that naturally occurring polyphenolic antioxidants are among the most effective classes of cancer-preventive agents. They show no systemic toxicity and reduce oxidative stress, which is a major factor in the development of cancer. In this context, several studies have investigated the effectiveness of flavonoids, such as those found in silymarin.
The flavonoids from silymarin were able to influence the signaling and subsequent growth of cancer cells. Silibins, especially isosilybin B, showed the strongest growth-inhibiting effect. The study was conducted in vitro on human prostate carcinoma cells.
Further research in this area is needed to confirm the positive effect in vivo. The results available so far are at least promising.
Silymarin may also prevent skin cancer, as the active ingredient in milk thistle protects the skin from UV damage.
Researchers found that silymarin can reduce UV-induced sunburn cell formation. They assume that an antioxidant mechanism must be responsible for this effect. Silymarin was also able to prevent UVB-induced immunosuppression and oxidative stress.
Several studies show that milk thistle seed extract, especially the phytochemicals silibinin and silymarin, can protect sensitive kidney cells and tubules from damage caused by chemotherapy.
The researchers discovered that kidney damage occurs primarily within an hour after chemotherapy with the platinum-based drugs cisplatin, carboplatin, and oxaliplatin, which are administered intravenously for a variety of cancers. Silymarin appears to reduce the high level of oxidative stress that contributes to kidney cell damage.
The active ingredients in milk thistle can not only alleviate the side effects of chemotherapy, they can even increase the effectiveness of the drugs. This is because cancer cells can develop chemoresistance, which means that chemotherapy is no longer as effective.
Milk thistle can also reduce the side effects of radiation therapy. Patients often suffer from inflammatory bowel disease after radiation therapy. A study from 2017 showed that silibinin was able to improve radiation-induced intestinal damage.
There are only a few, mainly smaller studies that have looked at the effect in humans. Therefore, there is currently no conclusive clinical evidence for its use in human medicine. Further studies are therefore still needed.
Milk thistle preparations are often recommended to patients before surgery to help them cope with the negative effects of anesthesia. Silymarin extracts (420 mg per day) prevented liver damage attributable to general anesthetics in patients undergoing major surgery in controlled clinical trials.
Antibiotic resistance is one of the main problems facing modern medicine. The pathogen Staphylococcus aureus is one of the best known and most common causes of wound infections. Iranian researchers have developed a drug based on milk thistle extract.
The researchers tested the effect of free silymarin and nanoliposomes loaded with the active ingredient in vivo on infected mice. The results of the research show that the antibacterial properties of nanoliposomes with silymarin are higher than those of the free form of the drug in similar time periods. Therefore, the nanoformulation produced can be used for the treatment of infections caused by Staphylococcus aureus due to its high efficiency.
According to the researchers, the minimum inhibitory effect of silymarin in the two forms of free and encapsulated nanoliposomes is 500 and 125 mg/l, respectively. In addition, the antibacterial effect of nanoliposomes containing silymarin was higher than that of the free form of the drug.
The scientists concluded that silymarin with nanotransporters could be an effective treatment for MRSA infections. Further studies need to be conducted to substantiate this hypothesis.
Candida albicans is a yeast fungus that occurs naturally in the human body. In some cases, however, it can develop into a fungal infection known as candidiasis. This then affects the mucous membranes in the throat or genital area.
A study from 2016 found that silybin can induce cell death in yeast fungi. The researchers concluded that silybin has an antifungal effect. However, further studies are needed to prove its effectiveness in the body.
Milk thistle and its main active ingredient, silymarin, are available in various forms and for various applications. Their effectiveness can vary greatly and should be chosen individually depending on the symptoms.
Milk thistle is available as a tea. The above-ground parts of the plant are cut off and dried. Alternatively, the dried fruits can be finely crushed and used. Both are steeped in hot water to make tea.
The actual effectiveness of milk thistle in the form of a tea preparation for the liver is scientifically controversial. Since silymarin is lipophilic (fat-soluble), its absorption in the body in this form is less suitable for the treatment of liver complaints.
However, in combination with other plants and herbs that are also said to have a positive effect on the liver and digestive system, the use of milk thistle tea may also be beneficial. Since the tea tastes very bitter in its pure form, it can also be combined with the following plants:
Milk thistle preparations are available in the form of tablets, capsules, powder, or extract. Capsules and tablets are usually standardized to 70–80% silymarin. The preparations generally contain 200 to 400 mg of silymarin.
In addition to oral administration, the active ingredient can also be administered via infusion. This form of treatment is useful, for example, in cases of mushroom poisoning to remove the toxin from the body more quickly.
In addition to oral intake, the beneficial active ingredients of milk thistle are also available in the form of essential oils. The cold-pressed oil is extracted from the ripe seeds and is rich in sterols, essential fatty acids, antioxidants, and vitamin E. These nutrients give the oil its nutritional and skin-protecting properties.
Milk thistle oil is used in cosmetics because of its high linoleic acid content. Due to its short shelf life, the oil is mixed with more stable carrier oils such as jojoba. There it can help alleviate skin problems such as acne or eczema.
The exact dosage and application should be discussed with a doctor, pharmacist, or naturopath beforehand, as different dosages may be recommended depending on the symptoms. The following information is based on studies and research results and should not be used as the sole guideline, as general health and other individual factors also play a role. The correct dosage may vary if milk thistle extract is combined with other active ingredients.
Silymarin can be administered either as capsules or tablets containing silymarin extract or as an infusion of milk thistle fruit. The German Commission E recommends a daily dose of 12 to 15 g of raw herbs or 200 to 400 mg of silymarin, calculated as silybin.
Adult patients with cirrhosis of the liver, regardless of whether it is caused by alcohol abuse or concomitant hepatitis C infection, can take up to 420 mg of silymarin per day. It should ideally be taken before a meal. Alcohol should be avoided so as not to undermine the positive effects on the liver.
Silybin dihemisuccinate, a derivative of silybin, is used as a clinical antidote for acute Amanita mushroom poisoning. The initial dose should be 5 mg per kg body weight of silybindihemisuccinate by intravenous infusion within one hour, followed by 20 mg/kg/day by continuous infusion over 6 days.
The consumption of Silybum marianum during pregnancy, breastfeeding, and for children is permitted with restrictions. To date, there are no well-founded studies demonstrating the side effects of the plant extract for pregnant women, breastfeeding women, and children. It is recommended for the treatment of itching associated with bile duct obstruction in pregnant women and may therefore be useful in such cases.
For pregnant women, nursing mothers, and children, the benefits of taking it should generally outweigh the potential risks. Therefore, it is essential to consult with your doctor, pharmacist, or healthcare professional in these cases.
Silymarin studies in humans have shown minimal side effects in several large studies. Silymarin is well tolerated, with only rare reports of a mild laxative effect. Mild allergic reactions have been observed at high doses (1500 mg/day), although the details of these allergic reactions have not been reported.
However, the active ingredients in milk thistle are generally well tolerated. Caution is advised if you have a known allergy to composite flowers. In these cases and in the event of overdose, the following side effects may occur in rare cases:
However, the symptoms usually subside quickly after discontinuing milk thistle and do not cause any lasting damage.
As already mentioned, Silybium marianum has a blood sugar-lowering effect. Therefore, diabetics should monitor their blood sugar levels more closely and coordinate their intake with their doctor.
It is suspected that the estrogen-like effect of silymarin may stimulate the growth of estrogen-sensitive tumors, especially when taken over a long period of time. However, there are currently no sufficient studies to confirm this suspicion.
Silymarin can interact with various medications. It may affect certain enzymes in the body, such as cytochrome P450. This could have an effect on other medications, such as oral contraceptives, lipid-lowering drugs, or protease inhibitors.
Researchers are investigating the extent to which milk thistle affects the absorption of various medications. The active ingredients may interact with the following medications. This can either increase, decrease, or even cancel out the effect:
In general, if you have a known pre-existing condition and take medications regularly, it is advisable to consult a doctor, pharmacist, or other knowledgeable person about possible risks and discuss whether you should take milk thistle.
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