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Milk thistle

 
Food and Nutrition: milk thistle
Home > Library > Food & Cooking > Food and Nutrition

An annual or biennial thistle, Silybum marianum (Carduus marianus) that has been used as a vegetable; the flower receptacle can be eaten like globe artichoke. Traditionally used for treatment of inflammatory liver disease and cirrhosis with some evidence of efficacy, but by injection rather than eaten.

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Drug Info: Milk Thistle, Silybum marianum
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Brand names: Legalon®, ThistleComp™, ThistlePlex™

Chemical formula:



Milk Thistle, Silybum marianum tablets and capsules

What is milk thistle?

MILK THISTLE, also called Silybum marianum, (Legalon®, Thisylin® and many others) is a dietary supplement (herbal remedy) that is being promoted to maintain healthy liver function. This herb is not FDA approved at this time. Evidence suggests milk thistle may be helpful for some people with liver disease, but it should be used under the prescription of a health care prescriber. Milk thistle is not a cure for liver disease. Many different products containing milk thistle in combination with other herbs are available, including Thistleplex(TM) and ThistleComp(TM).

What should I tell my health care provider before I take this medicine?

It is important for you to tell your prescriber or other health care professional that you are using milk thistle. Some herbs exert potent effects and may interact with other drugs you are taking.

You should discuss milk thistle with your health care professional BEFORE taking it if you have any of these conditions:
• are a frequent drinker of alcoholic beverages
• jaundice
• kidney disease
• liver disease
• an unusual or allergic reaction to milk thistle, ragweed, other herbs, plants, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

This herb should be taken orally (i.e., swallowed), with a full glass of liquid, prior to a meal. Follow the directions on the package labeling, or talk to your health care professional.

Contact your pediatrician or health care professional regarding the use of this herb in children. Special care may be needed.

What if I miss a dose?

Missing a dose is probably not harmful. If you miss a dose, simply resume taking it on your previous schedule. Do not take double doses to catch up, however.

What drug(s) may interact with milk thistle?

• alcohol and alcoholic beverages

For many herbs, interactions with other medications are unknown. That is why you should always be careful when mixing herbal remedies with traditional medications. If you take any other medications, consult with your health care professional prior to taking milk thistle.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking milk thistle?

Since milk thistle is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash or any other unusual reaction. You may want to see your health care professional, or inform them that this occurred.

If you are taking milk thistle for liver disease, you should notify your health care professional immediately if you develop a dark or brown color to the urine, if the size of the abdomen increases or you gain weight suddenly, if you have yellowing of the skin or eyes, or if you experience shortness of breath. These symptoms may indicate a worsening of the liver problem. Self-treatment of the symptoms of hepatic disease with milk thistle may delay proper medical treatment.

Different brands of milk thistle might contain different amounts of active ingredient so be careful to use the same brand. It is recommended that you use a brand from a reliable manufacturer and one that has been standardized. A standardized product is more likely to contain the same amount of herb from dose to dose. Your health care professional or pharmacist can assist you in finding a standardized product.

If you are scheduled to have surgery, let your surgeon know you are taking milk thistle.

What side effects may I notice from using milk thistle?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• abdominal pain
• diarrhea that continues or gets worse
• difficulty breathing or shortness of breath
• skin rash, itching, or bruising
• sweating
• weakness
• vomiting
• any other unusual symptoms

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• mild diarrhea or laxative-like effect
• nausea or upset stomach

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature; do not freeze. Protect from light. Throw away any unused medicine after the expiration date.

GENERAL INFORMATION REGARDING DIETARY SUPPLEMENTS:
Dietary supplements include amino acids, vitamins, minerals, herbs, botanicals, and other plant-derived substances, and extracts of these substances. These products are easy to identify as they must state "Dietary Supplement" on the label. A "Supplement Facts" panel is provided on the label for most products. Supplements are not drugs and are not regulated like drugs. You should note that rigid quality control standards are not required for dietary supplements. Big differences in potency and purity of these products can occur. Scientific data to support the use of a dietary supplement for a certain disease or ailment may not be available. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:
• Always read product labels and follow directions.
• "Natural" doesn't mean a product is safe for humans to take.
• Look for products containing ingredients with the "USP" notation. This indicates the manufacturer followed the standards of the US Pharmacopoeia.
• Supplements produced or distributed by a nationally known food or drug company are more likely to be made under tight controls as these companies have standards in place for their other products. You can write to the company for more information about how the product was made.


Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Alternative Medicine Encyclopedia: Milk Thistle
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Description

Milk thistle (Silybum marianum or Cardus marianum) is a plant used for treating liver disorders, breast-feeding problems, and other illnesses. The active ingredient of the herb, silymarin, is found in the ripe seeds of the plant. The milk thistle plant has a long stem, green leaves with white spots, and pink to purple spiky flowered head (which true to its name, resembles a thistle). The plant is native to Europe and grows in the wild in the United States and South America. Other common names for the plant include Mary thistle, St. Mary thistle, Marian thistle, and lady's thistle.

The medicinal benefits of milk thistle have been valued for more than 2,000 years. Written records show that as early as the first century, Romans were using the plant as a liver-protecting agent. The plant was also frequently used throughout the Middle Ages, and it is in the herbal literature of this period that the medicinal properties of milk thistle seeds are first noted. Nicholas Culpepper, a British herbalist, wrote about the value of the herb in treating diseases of the liver and spleen in the late eighteenth century, and by the end of the next century, records show that American physicians were also prescribing the substance. Silymarin was first isolated from the milk thistle plant by German scientists in the 1960s.

The leaves and stem of the milk thistle plant are edible, and can be used in salads or eaten raw. The plant was cultivated as a vegetable in Europe through the end of the nineteenth century.

General Use

Milk thistle is prescribed for a number of medicinal uses, including liver disease treatment and prevention, HIV treatment, lactation problems, gallbladder disorders, mushroom poisoning, and psoriasis, a chronic skin disease characterized by reddish patches.

Liver Disease

Milk thistle is thought to promote the growth of new liver cells, and to prevent toxins from penetrating through healthy liver cells by binding itself to the cell membranes. It is prescribed for cirrhosis, hepatitis, and other liver disorders. Several clinical studies have demonstrated that individuals with cirrhosis who take daily doses of milk thistle extract have a lower mortality rate than those who took a placebo (or sugar pill). While further research needs to be completed, a 2001 article reports that clinical trials show that milk thistle (at 140 mg three times per day) did indeed improve survival among cirrhosis patients.

In addition, milk thistle may have a protective effect on the liver, and is sometimes prescribed for patients who take medications that can cause liver damage (e.g., Thorazine, Haldol), or those who are exposed to liverdamaging substances such as lead. A large, controlled trial sponsored by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institutes of health (NIH) of milk thistle's medicinal value in the treatment of hepatitis and liver injury was scheduled to begin in the year 2000.

Hiv Treatment

Milk thistle is sometimes prescribed for HIV-positive patients to protect the liver from diseases such as hepatitis and from the hepatotoxic effects of other medications prescribed for HIV treatment.

Lactation Problems

Milk thistle is frequently prescribed for breastfeeding mothers to promote increased breast milk secretion. Although the herb is considered safe for nursing mothers, it should be acquired from a reputable source and prescribed by an herbalist, naturopathic physician, or other healthcare professional familiar with its use.

Cancer Prevention

The active chemical components of the milk thistle, silymarin (a complex of flavonoids) and its constituent, silibin, act as antioxidants. These substances have been shown to slow cell growth in some types of cancer.

Gallbladder Disorders

Milk thistle may prevent inflammation of the gall-bladder ducts and clear up jaundice.

Death Cap Mushroom Poisoning

Milk thistle is the only known antidote for death cap mushroom (Amanita phalloides) poisoning. Ingesting this deadly mushroom can destroy the liver by shutting down protein production in liver cells. Milk thistle neutralizes these toxins and protects the liver. Milk thistle may also be helpful in acetaminophen overdosage.

Psoriasis

Because the liver neutralizes certain toxins associated with psoriasis attacks, milk thistle is believed to help prevent psoriasis outbreaks by promoting proper liver function.

Several other dermatological uses for the herb are currently under investigation. The antioxidant properties of the herb may have a healing effect on skin wounds and burns. Milk thistle has also been proposed as a cosmetic agent to retain skin tone and quality. Further studies are needed to prove the efficacy of the herb for these applications.

Preparations

Milk thistle is available in seed form, in capsules, and in extracts and tinctures. A tincture is an herbal preparation made by diluting the herb in alcohol. Tinctures of milk thistle can be taken in 1 or 2 ml doses three times a day.

Milk thistle seed has a low level of water solubility, so infusions (or teas) made from the herb are weaker than milk thistle tinctures and extracts. An infusion of milk thistle can be prepared by pouring a cup of boiling water over one teaspoon of seeds that have been ground to a fine texture. After the mixture steeps for 10-20 minutes, the herb is strained out and the mixture can be drunk. Instead of straining, the herb can also be placed into an infuser ball, tea bag, or a piece of cheesecloth or muslin and removed after steeping. Individuals can drink two to three cups of the infusion daily.

Milk thistle seed can also be taken by mouth in a dose of 1 tsp of fresh ground seeds daily. The herb should always be stored in an airtight container in a cool location away from bright light to maintain its potency.

Precautions

Individuals who suspect they have a liver disorder should always seek care from a healthcare professional.

Milk thistle should always be obtained from a reputable source that observes stringent quality control procedures and industry-accepted good manufacturing practices. Consumers should look for the designations "U.S.P." (U.S. Pharmacopeia) or "NF" (National Formulary) on milk thistle labeling. Herbal preparations prepared under USP or NF guidelines meet nationally recognized strength, quality, purity, packaging, and labeling standards as recommended by the U. S. Food and Drug Administration (FDA).

Botanical supplements are regulated by the FDA; however, they currently do not have to undergo any approval process before reaching the consumer market, and are classified as nutritional supplements rather than drugs. Legislation known as the Dietary Supplement Health and Education Act (DSHEA) was passed in 1994 in an effort to standardize the manufacture, labeling, composition, and safety of botanicals and supplements, and in January 2000, the FDA's Center for Food Safety and Applied Nutrition (CFSAN) announced a 10-year plan for establishing and implementing these regulations by the year 2010.

Pregnancy

Milk thistle is considered safe to use during pregnancy and in women who breastfeed. However, there are currently no long-term studies on use of the herb during pregnancy or lactation. A woman should speak with her healthcare practitioner before taking any herbs and/or medications during pregnancy.

Side Effects

Milk thistle may cause mild nausea and diarrhea, or loose stools. The herb may also cause an allergic reaction in some individuals, particularly those with known allergies to plants in the Asteraceae family (thistles, daisies, artichokes). No other widely reported side effects are known when milk thistle is taken in proper therapeutic dosages. However, people with chronic medical conditions should consult with their healthcare professionals before taking the herb.

Interactions

There are no reported negative interactions between milk thistle and other medications and herbs, although certain drugs with the same therapeutic properties as milk thistle may enhance the effect of the herb. Again, individuals should consult their healthcare provider if they are taking other medications concurrently with milk thistle.

Resources

Books

Medical Economics Corporation. The PDR for Herbal Medicines. Montvale, NJ: Medical Economics Corporation, 1998.

Hoffman, David. The Complete Illustrated Herbal. New York: Barnes & Noble Books, 1999.

Periodicals

Tyler, Varro. "This weed is a potent healer; protect your body from environmental toxins with milk thistle." Prevention 50, no. 1 (October 1998):79.

Walsh, Nancy. "Milk Thistle for Liver Disease (Alternative Medicine: An Evidence-Based Approach." Internal Medicine News (January 1, 2002): 10.

Organizations

Office of Dietary Supplements. National Institutes of Health. Building 31, Room 1B25, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086. (301) 435-2920 Fax: (301) 480-1845. http://odp.od.nih.gov/ods.

[Article by: Paula Ford-Martin; Teresa G. Odle]

Annuals Dictionary: Silybum
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Daisy family
Compositae

Sil-ly'bum. Annual or biennial herbs, comprising only 2 species, natives of the Mediterranean region. The species below grown as an ornamental plant for its silvery leaves. Also grown as a vegetable, since its roots, leaves, and flowerheads are edible.

Description
Leaves alternate, with white spots and veins on the upper side, the margins lobed and spiny. Flowerheads purplish, solitary and nodding. Many bracts surround the head, forming a globe-shaped receptacle.

How to Grow
Easy to grow from seeds. Sow outdoors in ordinary garden soil. Will bloom the first year if sown early. Can become a troublesome weed. Prefers cool weather.

Silybum Marianum
Holy Thistle ; Lady's-Thistle ; Milk Thistle . To 4 ft. (120 cm) high. Flowerheads rose to purplish red, to 2 in. (6 cm) across. Bracts surrounding heads curved and spiny. Mediterranean region, naturalized in Calif. Hardy annual, sometimes biennial.


Wikipedia: Milk thistle
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This article is about the true milk thistles. For another plant that is sometimes referred to as a milk thistle, see Sow thistle.
Milk Thistle
Silybum marianum
Scientific classification
Kingdom: Plantae
(unranked): Angiosperms
(unranked): Eudicots
(unranked): Asterids
Order: Asterales
Family: Asteraceae
Subfamily: Carduoideae
Tribe: Cynareae
Genus: Silybum
Adans.
Species
Thistle flower
Dried thistle flowers at the end of summer

Milk thistles are thistles of the genus Silybum Adans., flowering plants of the daisy family (Asteraceae). They are native to the Mediterranean regions of Europe, North Africa and the Middle East. The name "milk thistle" derives from two features of the leaves: they are mottled with splashes of white and they contain a milky sap.[1] However, it is the seeds of milk thistle that herbalists have used for 2000 years to treat chronic liver disease and protect the liver against toxins.[2][3] Increasing research is being undertaken on the physiological effects, therapeutic properties and possible medical uses of milk thistle. [4]

Contents

Description and classification

Members of this genus grow as annual or biennial plants. The erect stem is tall, branched and furrowed but not spiny. The large, alternate leaves are waxy-lobed, toothed and thorny, as in other genera of thistle. The lower leaves are cauline (attached to the stem without petiole). The upper leaves have a clasping base. They have large, disc-shaped pink-to-purple, rarely white, solitary flower heads at the end of the stem. The flowers consist of tubular florets. The phyllaries under the flowers occur in many rows, with the outer row with spine-tipped lobes and apical spines. The fruit is a black achene with a white pappus.
Only two species are currently classified in this genus:

  • Silybum eburneum Coss. & Dur., known as the Silver Milk Thistle, Elephant Thistle, or Ivory Thistle
    • Silybum eburneum Coss. & Dur. var. hispanicum
  • Silybum marianum (L.) Gaertner, the Blessed Milk Thistle, which has a large number of other common names, such as Variegated Thistle.

The two species hybridise naturally, the hybrid being known as Silybum × gonzaloi Cantó , Sánchez Mata & Rivas Mart. (S. eburneum var. hispanicum x S. marianum)

A number of other plants have been classified in this genus in the past but have since been relocated elsewhere in the light of additional research.

S. marianum is by far the more widely known species. Milk thistle is believed to give some remedy for liver diseases (e.g. viral hepatitis) and the extract, silymarin, is used in medicine. Mild gastrointestinal distress is the most common adverse event reported for milk thistle. The incidence is the same as for placebo.[5] A laxative effect for milk thistle has also been reported infrequently. [6]

Nomenclature

Traditional milk thistle extract is made from the seeds, which contain approximately 4-6% silymarin.[7] The extract consists of about 65-80% silymarin (a flavonolignan complex) and 20-35% fatty acids, including linoleic acid.[8] Silymarin is a complex mixture of polyphenolic molecules, including seven closely related flavonolignans (silybin A, silybin B, isosilybin A, isosilybin B, silychristin, isosilychristin, silydianin) and one flavonoid (taxifolin).[9] Silibinin, a semipurified fraction of silymarin, is primarily a mixture of 2 diasteroisomers, silybin A and silybin B, in a roughly 1:1 ratio.[10] [11] In clinical trials silymarin has typically been administered in amounts ranging from 420-480 mg per day in two to three divided doses.[12] However higher doses have been studied, such as 600 mg daily in the treatment of type II diabetes and 600 or 1200 mg daily in patients chronically infected with hepatitis C virus.[13][14]. An optimal dosage for milk thistle preparations has not been established.

Health benefits

For many centuries extracts of milk thistle have been recognized as "liver tonics.".[15] Research into the biological activity of silymarin and its possible medical uses has been conducted in many countries since the 1970s, but the quality of the research has been uneven.[4] Milk thistle has been reported to have protective effects on the liver and to greatly improve its function. It is typically used to treat liver cirrhosis, chronic hepatitis (liver inflammation), toxin-induced liver damage (including the prevention of severe liver damage from Amanita phalloides (death cap) mushroom poisoning), and gallbladder disorders.[16].[17] Reviews of the literature covering clinical studies of silymarin vary in their conclusions. A review using only studies with both double-blind and placebo protocols concluded that milk thistle and its derivatives "does not seem to significantly influence the course of patients with alcoholic and/or hepatitis B or C liver diseases."[18] A different review of the literature, performed for the U. S. Department of Health and Human Services, found that, while there is strong evidence of legitimate medical benefits, the studies done to date are of such uneven design and quality that no firm conclusions about degrees of effectiveness for specific conditions or appropriate dosage can yet be made. [19]

A review of studies of silymarin and liver disease which are available on the web shows an interesting pattern in that studies which tested low dosages of silymarin concluded that silymarin was ineffective[20], while studies which used significantly larger doses concluded that silymarin was biologically active and had therapeutic effects.[21]

Toxin-induced liver damage

Research suggests that milk thistle extracts both prevent and repair damage to the liver from toxic chemicals and medications. Workers who had been exposed to vapors from toxic chemicals (toluene and/or xylene) for 5-20 years were given either a standardized milk thistle extract (80% silymarin) or placebo for 30 days.[22] The workers taking the milk thistle extract showed significant improvement in liver function tests (ALT and AST) and platelet counts vs. the placebo group.

The efficacy of silymarin in preventing drug-induced liver damage in patients taking psychotropic drugs long-term has been investigated .[23] This class of drugs is known to cause liver damage from oxidation of lipids. Patients taking silymarin in the study had less hepatic damage from the oxidation of lipids than patients taking the placebo.

Amanita mushroom poisoning

The efficacy of thirty different treatments was analyzed in a retrospective study of 205 cases of Amanita phalloides (death cap) mushroom poisoning.[24] Both penicillin and hyperbaric oxygen independently contributed to a higher rate of survival. When silybin [silibinin] was added to the penicillin treatment, survival was increased even more. In another 18 cases of death cap poisoning, a correlation was found between the time elapsed before initiation of silybin therapy, and the severity of the poisoning.[25] The data indicates that severe liver damage in Amanita phalloides poisoning can be prevented effectively when administration of silybin begins within 48 hours of mushroom intake. In a recent 2007 event, a family of six was treated with milk thistle and a combination of other treatments to save them from ingested poisonous mushrooms. While five of the six made a full recovery, the grandmother showed liver recovery but was overcome by kidney failure related to the poisonous mushrooms. [26]

Other uses

Beside benefits for liver disease and treatment claims include:

Use as food

Around the 16th Century this plant became quite popular and almost all parts of it were eaten. The roots can be eaten raw or boiled and buttered or par-boiled and roasted. The young shoots in spring can be cut down to the root and boiled and buttered. The spiny bracts on the flower head were eaten in the past like globe artichoke, and the stems (after peeling of course) can be soaked overnight to remove bitterness and then stewed. The leaves can be trimmed of prickles and boiled and make a good spinach substitute, they can also be added raw to salads.[32]

See also

Footnotes

  1. ^ Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.
  2. ^ Tamayo C, Diamond S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative Cancer Therapies.6:146-157.
  3. ^ Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.
  4. ^ a b Gazák R, Walterová D, Kren V (2007). "Silybin and silymarin--new and emerging applications in medicine". Curr. Med. Chem. 14 (3): 315–38. doi:10.2174/092986707779941159. PMID 17305535. 
  5. ^ Rainone F. (2005). Milk thistle. American Family Physician72:1285-1288.
  6. ^ Greenlee H, Abascal K, Yarnel E, Ladas E. (2007). Clinical applications of Silybum marianum in oncology. Integrative Cancer Therapies 6:158-165.
  7. ^ Greenlee HG, Abascal K, Yarnell E, Ladas E. (2007). Clinical applications of Silybum marianum in oncology. Integrative Cancer Therapies. 6:158-165.
  8. ^ Kroll DJ, Shaw HS, Oberlies NH.(2007). Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integrative Cancer Therapies.6:110-119.
  9. ^ Kroll DJ, Shaw HS, Oberlies NH.(2007). Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integrative Cancer Therapies.6:110-119.
  10. ^ Kroll DJ, Shaw HS, Oberlies NH. (2007). Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integrative Cancer Therapies. 6:110-119.
  11. ^ Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.
  12. ^ Rainone F. (2007). Milk thistle. American Family Physician. 72:1285-1288.
  13. ^ Huseini HF, Larijani B, Heshmat R et al. (2006). The efficacy of Silybum marianum (L.)Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res.20:1036-1039.
  14. ^ Gordon A, Hobbs DA, Bowden DS et al. (2006). Effects of Silybum marianum on serum hepatitis C virus RNA alanine aminotransferase levels and well-being in patients with chronic hepatitis C. J Gastroenterol Hepatol 21:275-280.
  15. ^ Kroll DJ, Shaw HS, Oberlies NH.(2007). Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integrative Cancer Therapies.6:110-119.
  16. ^ Greenlee H, Abascal K, Yarnel E, Ladas E. (2007). Clinical applications of Silybum marianum in oncology. Integrative Cancer Therapies 6:158-165.
  17. ^ Tamayo C, Diamond S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative Cancer Therapies.6:146-157.
  18. ^ Rambaldi A, Jacobs BP, Iaquinto G, Gluud C (2005). "Milk thistle for alcoholic and/or hepatitis B or C liver diseases--a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials". Am. J. Gastroenterol. 100 (11): 2583–91. doi:10.1111/j.1572-0241.2005.00262.x. PMID 16279916. 
  19. ^ Lawrence, Valerie MD, MSc et al. (2000). "Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects". AHRQ Publication No. 01-E025. 
  20. ^ Angulo P, Patel T, Jorgensen RA, Therneau TM, Lindor KD (2001). "Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid". Hepatology. 2001 Feb;33(2):483-4. 32: 897. doi:10.1053/jhep.2000.18663. PMID 11050036. 
  21. ^ Lieber CS, Leo MA, Cao Q, Ren C, DeCarli LM. (2003). "Silymarin retards the progression of alcohol-induced hepatic fibrosis in baboons". Journal of Clinical Gastroenterology. 2003 Oct;37(4):336-9.. PMID 14506392. 
  22. ^ Szilard S, Szentgyorgyi G, Dhanalakshmi S et al. (1988). Protective effect of Legalon in workers exposed to organic solvents. Acta Med Hung. 45:249-256.
  23. ^ Palasciano G, Portincasa P, Palmieri V et al. (1994). The effect of silymarin on plasma levels of malon-dialdehyde in patients receiving long-term treatment with psychotropic drugs. Curr Ther Res Clin Exp. 55:537-545.
  24. ^ Floersheim GL, Weber O, Tschumi P et al. [Clinical death-cap (Amanita phalloides) poisoning: prognostic factors and therapeutic measures. Analysis of 205 cases]. Schweiz Med Wochenschr.112:1164-1177.
  25. ^ Hruby K, Fuhrmann M, Csomos G et al. [Pharmcotherapy of Amanita phalloides poisoning using silybin].Wein Klin Wochenschr.95:225-231.
  26. ^ American Botanical Council (2007). "Intravenous Milk Thistle Compound Used to Save Victims of Poisonous Mushrooms". HerbalGram (74): 16. 
  27. ^ http://www.webmd.com/heart-disease/milk-thistle-benefits-and-side-effects
  28. ^ http://www.webmd.com/heart-disease/milk-thistle-benefits-and-side-effects
  29. ^ http://www.chiro.org/nutrition/ABSTRACTS/Silymarin_is_Effective_on_Hyperinsulinemia.shtml
  30. ^ National Center for Complementary and Alternative Medicine. "Milk Thistle". National Institutes of Health. http://nccam.nih.gov/health/milkthistle/.  - General information on milk thistle
  31. ^ http://www.femalefirst.co.uk/health/Avoid+hangover+hell+with+milk+thistle-1336.html
  32. ^ http://www.edible-plants.com

References

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Food and Nutrition. A Dictionary of Food and Nutrition. Copyright © 1995, 2003, 2005 by A. E. Bender and D. A. Bender. All rights reserved.  Read more
Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Alternative Medicine Encyclopedia. Encyclopedia of Alternative Medicine. Copyright © 2005 by The Gale Group, Inc. All rights reserved.  Read more
Annuals Dictionary. Taylor's Guide for Annuals, by Norman Taylor, revised and edited by Gordon P. DeWolf, Jr. Copyright © 1986 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.  Read more
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