Milk Thistle

Aka: Milk Thistle, Silybum marianum, Silymarin

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II. Indications

  1. Type 2 Diabetes Mellitus
    1. Possibly effective in small studies lowering Fasting Blood Sugar and Hemoglobin A1C
  2. Liver disease (Cirrhosis, Hepatitis, NAFLD)
    1. Mixed results in clinical trials
  3. Amanita phalloides Poisoning
    1. Insufficient evidence to date
  4. Other Investigational uses
    1. Cytoprotection (environmental hazards, Chemotherapy)
    2. Anticarcinogen

III. Contraindications

  1. Ragweed Allergy
    1. Risk of Allergic Reaction
  2. Hormone sensitive conditions (e.g. Breast Cancer)
    1. Milk Thistle may have Estrogenic effects

IV. Adverse Effects

  1. Mild gastrointestinal upset or Dyspepsia

V. Safety

  1. Avoid in pregnancy (unknown safety)
  2. Avoid in Lactation (unknown safety)

VI. Drug Interactions

  1. No significant interactions
  2. Possible CYP2C9 Inhibitor, CYP3A4 Inhibitor, P-Glycoprotein Inhibitor depending on Genotype
    1. However does not appear to result in Clinically Significant interactions in humans

VII. Dosing

  1. Optimal dosing not yet established
  2. Study doses vary from 210 to 600 mg daily

VIII. References

  1. (2023) Presc Lett 30(8): 48
  2. Rainone (2005) Am Fam Physician 72:1285-8 [PubMed]

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