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Milk Thistle: Liver Protection

MILK THISTLE (Silybum marianum, Carduus marianum)

CLINICAL SUMMARY
Derived from the seed, pod, or fruit of the plant. Milk thistle is used primarily to manage various liver diseases. Placebo-controlled clinical studies show efficacy in reducing aminotransferases in alcoholic liver disease, but studies in other types of hepatic disease have been flawed. Animal models suggest that flavonoids in milk thistle have antioxidant and anticancer effects. Flavonoids isolated from milk thistle have been shown to inhibit colon and prostate cancer cells in rats. To date there is no evaluation of survival or quality of life. One case report regarding toxicity (sweating, nausea, vomiting, and weakness) was uncovered in the literature, but there are no other reports of toxicity or significant adverse events. Milk thistle inhibits cytochrome p450 3A4. Therefore, increased levels of medications metabolized via this enzyme may occur.
SCIENTIFIC NAME
Silybum marianum, Carduus marianum. Also known as: Holy thistle, lady’s thistle, Mary thistle, Marian thistle
PURPORTED USES
Alcoholism
Cancer prevention
Cirrhosis
Drug-induced hepatotoxicity
Food poisoning
Hepatitis
Indigestion
Liver disease
CONSTITUENTS
Flavolignan: 1.5% silymarin; a mixture of three compounds silybinin, silidyanin, and silychristin. Also dehydrosilybin, siliandrin, silybinome, and silyhermin
Tocopherol sterols: Cholesterol, capesterol, stigmasterol, and sitosterol
Other constituents: Taxifolin, quercetin, dihydrokaempferol, kaempferol, apigenin, naringin, eriodyctiol, chrysoeriol, linoleic acid, palmitic acid. (1)
MECHANISM OF ACTION
Milk thistle provides hepatocellular protection by stabilizing hepatic cell membranes. It alter the structure of the outer cell membrane of the hepatocytes in such a way as to prevent the penetration of the liver toxins into interior of the cell. The stimulation effect on nucleolar polymerase A results

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