Milk Thistle

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Silybum marianum, Carduus marianus, silybin, silymarin, milk thistle, holy thistle, lady's thistle, Marian thistle, St. Mary thistle, silybum, silibinin

What is milk thistle?

The milk thistle plant grows 5 to 10 feet tall and has large prickly leaves. When broken, the leaves and stem produce a milky sap. Silymarin is a chemical extracted from the seeds.

What is it used for?

Milk thistle has been used to:

• help decrease cholesterol levels slightly
• prevent and treat liver disease such as hepatitis and jaundice
• protect against cirrhosis of the liver caused by long-term and excessive use of alcohol
• reduce liver damage from long-term treatment with antipsychotic drugs, pain relievers, sedatives, and tranquilizers (if you are taking any of these, check with your healthcare provider).
• treat breast, prostate, and skin cancer
• treat diabetes
• treat depression
• treat heartburn
• treat menstrual problems

There is no evidence to show that milk thistle is an effective cancer treatment.

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Milk thistle may be taken as tablets, capsules, liquid extracts, tinctures, or by eating the seed. Follow the directions printed on the product label or given by your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Do not take milk thistle if you are allergic to ragweed, chrysanthemums, marigolds, chamomile, yarrow, or daisies.

Milk thistle may have effects similar to estrogen. Before taking milk thistle, consult your healthcare provider if you have:

• breast or ovarian cancer
• endometriosis
• uterine fibroids.

Females of childbearing age: Do not take this remedy if you are pregnant or breast-feeding.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Other: Stomach pain, gas, bloating, nausea, vomiting, diarrhea, loss of appetite.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Before taking this remedy, talk to your healthcare provider if you are taking:

• acetaminophen
• amitriptyline
• anticancer medicines such as cisplatin (Platinol) and ifosfamide (Ifex)
• antifungal medicines such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• benzodiazepines such as lorazepam (Ativan), triazolam (Halcion), oxazepam (Serax), and diazepam (Valium)
• birth control pills and estrogen replacement therapy
• medicine that reduces the chance of blood clots forming such as clopidogrel (Plavix) and warfarin (Coumadin)
• cholesterol-lowering medicines such as lovastatin (Mevacor), atorvastatin (Lipitor), fluvastatin (Lescol), and simvastatin (Zocor)
• digoxin (Lanoxin)
• entacapone (Comtan)
• lamotrigine (Lamictal)
• medicines to treat HIV such as indinavir (Crixivan), amprenavir (Agenerase), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Fortovase, Invirase)
• natural remedies such as soy, topical progesterone, black cohosh, red clover, chasteberry, evening primrose oil, dong quai, ginseng, St. John's wort, and wild yam
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Motrin IB, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), ketoprofen, nabumetone (Relafen), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), piroxicam (Feldene), diclofenac (Voltaren, Cataflam), and oxaprozin (Daypro)
• verapamil (Calan, Isoptin)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all health care providers who treat you about all the products you are taking.

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Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.

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