Milk Thistle
Silybum marianum

What is Milk Thistle?
A nice review by students from the University of North Carolina School of Pharmacy

Milk Thistle's Liver-Protective Properties
Nutrition Science News (October 1999)
Millions of compounds are detoxified within each liver cell, or hepatocyte. Inevitably, this wear and tear compromises liver cells and surrounding connective tissue. Hepatotoxicity is fast becoming a major health issue. In fact, many practitioners believe poor liver function caused by toxin accumulation or by liver-function decline may contribute to other seemingly unrelated illnesses, such as rheumatoid arthritis, eczema, migraine headaches and premenstrual syndrome, and may manifest symptoms of its own. As a result, milk thistle (Silybum marianum) is widely prescribed by herbalists throughout Europe and the Americas for liver protection.

Can Cirrhosis Be Prevented?
Nutrition Science News (January 1999)
The liver is the body's recycling center, where thousands of compounds are taken apart and put together again as useful and essential body chemicals. Its several detoxification techniques include filtering large toxins from the blood, synthesizing and secreting bile to carry many impurities out of the body, and neutralizing unwanted chemical compounds in a two-step enzymatic process generally referred to as Phase I and Phase II detoxification. Toxins such as alcohol, urea from amino acid breakdown and environmental invaders are turned into benign by-products that are either used or excreted. Small wonder that when the liver fails, the only effective treatment is a transplant. With all that at stake, it is important to understand and avoid the risk factors that contribute to cirrhosis. Whether a person is trying to prevent cirrhosis or manage the condition, understanding the roles of alcohol consumption, hepatitis and toxic exposure is critical.

Milk Thistle Monograph: (Silybum marianum)
Alternative Medicine Review 1999 (Aug);   4 ( 4):   272–274 ~ FULL TEXT
Silybum marianum (milk thistle) has been used for centuries as an herbal medicine for the treatment of liver disease. Its use for liver disorders dates back to Pliny the Elder, a Roman naturalist, who described milk thistle as being "excellent for carrying off bile." [1]

A Review of Plants Used in the Treatment of Liver Disease: Part I
Alternative Medicine Review 1998 (Dec);   3 (6):   410–421 ~ FULL TEXT
Botanicals have been used traditionally by herbalists and indigenous healers worldwide for the prevention and treatment of liver disease. Clinical research in this century has confirmed the efficacy of several plants in the treatment of liver disease. Basic scientific research has uncovered the mechanisms by which some plants afford their therapeutic effects. Silybum marianum (milk thistle) has been shown to have clinical applications in the treatment of toxic hepatitis, fatty liver, cirrhosis, ischemic injury, radiation toxicity, and viral hepatitis via its antioxidative, anti-lipid peroxidative, antifibrotic, anti-inflammatory, immunomodulating, and liver regenerating effects.

Silymarin Inhibits the Development of Diet-Induced
Hypercholesterolemia in Rats
Planta Med 1998 (Mar);   64 (2):   138–142
Silybin was not so effective as silymarin suggesting that either other constituent(s) of silymarin may be responsible for its anticholesterolemic effect or the bioavailability of silybin alone might be lower than that of silybin as a compound of silymarin.

Milk Thistle (Silybum marianum) for the Therapy of Liver Disease
Am J Gastroenterol 1998 (Feb); 93 (2): 139–43
Silymarin, derived from the milk thistle plant, Silybum marianum, has been used for centuries as a natural remedy for diseases of the liver and biliary tract. As interest in alternative therapy has emerged in the United States, gastroenterologists have encountered increasing numbers of patients taking silymarin with little understanding of its purported properties.

Long-term (12 months) Treatment with an Anti-oxidant Drug
(Silymarin) is Effective on Hyperinsulinemia, Exogenous
Insulin Need and Malonfdialdehyde Levels in
Cirrhotic Diabetic Patients
J Hepatol 1997; 26 (4) Apr: 871–95
These results show that treatment with silymarin may reduce the lipoperoxidation of cell membranes and insulin resistance, significantly decreasing endogenous insulin overproduction and the need for exogenous insulin administration.

Pharmacokinetics of Silybin in Bile Following Administration of
Silipide and Silymarin in Cholecystectomy Patients
Arzneimittelforschung 1992 (Jul); 42 (7): 964–8
These data indicate that the bioavailability of silybin is much greater after administration of silipide than after administration of silymarin. This results in increased delivery of the compound to the liver, which represents the target organ for pharmacological action.

Effect of the Bioflavonoid Silymarin on the In Vitro Activity and
Expression of Superoxide Dismutase (SOD) Enzyme
Acta Physiol Hungarica 1991; 78 (1): 3–9
These results indirectly indicate that the scavenger silymarin is able to increase the antioxidant protection of the cells by ameliorating the deleterious effects of free radical reactions.

Selectivity of Silymarin on the Increase of the Glutathione Content
in Different Tissues of the Rat
Planta Med 1989 (Oct); 55 (5): 420–422
Silymarin, a flavonoid extracted from the seeds of the milk thistle, Silybum marianum, increases the redox state and the total glutathione content of the liver, intestine, and stomach of the rat. The same treatment does not affect the levels of the tripeptides in the kidney, lung, and spleen. This selective effect of the flavonoid on the digestive organs is ascribed to its pharmacokinetics on the digestive track, where the biliary concentration of silymarin is increased and maintained via the entero-hepatic circulation.

Randomized Controlled Trial of Silymarin Treatment in Patients
with Cirrhosis of the Liver
J Hepatol 1989 (Jul); 9 (1): 105–13
The 4-year survival rate was 58 +/- 9% (S.E.) in silymarin-treated patients and 39 +/- 9% in the placebo group (P = 0.036). Analysis of subgroups indicated that treatment was effective in patients with alcoholic cirrhosis (P = 0.01) and in patients initially rated 'Child A' (P = 0.03). No side effects of drug treatment were observed.

Silymarin Protection Against Hepatic Lipid Peroxidation Induced
by Acute Ethanol Intoxication in the Rat
Biochem Pharmacol 1985 (Jun 15); 34 (12): 2209–12
These results suggest that a higher content of glutathione in the liver, in conditions in which its redox state is kept constant, would afford the tissue a better protection against an oxidative stress, thus contributing to the abolishment of ethanol-induced lipid peroxidation. This is supported by the lack of changes in the GSH/GSSG ratio following ethanol administration in silymarin-pretreated rats compared to the drastic decrease (68%) found when ethanol was given alone. The mechanism of silymarin-induced enhancement of hepatic glutathione content is currently under study in our laboratory.

Effect of Silymarin on Chemical, Functional, and Morphological
Alterations of the Liver: A Double-blind Controlled Study
Scand J Gastroenterol 1982 (Jun); 17 (4): 517–521
Serum total and conjugated bilirubin decreased more in the treated than in controls, but the differences were not statistically significant. BSP retention returned to normal significantly more often in the treated group. The mean percentage decrease of BSP was also markedly higher in the treated. Normalization of histological changes occurred significantly more often in the treated than in controls.