Milk Thistle
Milk Thistle LATIN NAME: Silybum marianum
FAMILY NAME: Asteraceae
I take milk thistle to prevent or slow the deterioration of the liver, that overworked organ that detoxifies the blood. Although better known in Europe than here in the United States, "milk thistle can't be beat as a liver protector," says Varro E. Tyler, Ph.D., Sc.D., professor emeritus of pharmacognosy at Purdue University and co-author of Tyler's Honest Herbal. I agree. And there are times when I need the best of liver protectors.
When the Christmas holiday approaches, I'm much more likely to take some of the herbs in my geriatric dozen. With all the traditional traveling, visiting, and feasting, there's bound to be more bending of the elbow. That's when I rely on the biblical milk thistle.
And when I'm on the road any time of year, I always take milk thistle capsules with me. This herb can protect my liver from pollution in the airplane, at the airport, on the road to the hotel, and in the hotel itself (the toxic building syndrome is no myth). In the hotel bar, of course, there is more travel-related wining and dining to protect against, too.
I get a lot of mail from people who tell me that milk thistle really helped them with serious health problems. I really think it is one of the most effective herbs.
| HERB LORE AND MORE In folklore, there are references to the white marks on milk thistle leaves as splashes of the Virgin Mary's milk. And in fact, this herb has a traditional use of helping mothers produce milk to breastfeed their babies. The January 1997 Review of Natural Products, a respected newsletter, pointed out that milk thistle has been used for liver problems for over 2,000 years, and that's why it is still my liver-protecting herb of choice. In ancient Rome, Pliny suggested that it carries off bile. Premier English herbalist Culpepper suggested it was good for jaundice and for removing liver obstructions. (They were right!) The liver "purifies" the blood, and that's why the herbalists of old considered all the liver tonics to be blood purifiers, sometimes using the archaic word (at least in my vocabulary) depurative. My Dorland's Illustrated Medical Dictionary defines depurative as "tending to purify or cleanse." I can't quibble about the depurativity of the milk thistle. milk thistle also has a history of use as an alterative (something that helps the body return to its normal state), laxative, purgative, and stimulant. It has been traditionally used to purge bile, soothe mucous membranes, regulate menses, expel phlegm, stop the flow of blood, and promote sweating. milk thistle has also been mentioned as a folkloric remedy for anthrax, asthma, bladder stones, cancer, catarrh, chest ailments, dropsy, fever, bleeding from the lungs or bronchia, hepatitis, rabies, jaundice, vaginal discharge, malaria, melancholy, piles, plague, pleurisy, spasms, and spleen and uterus problems. In the Middle East, a flower infusion is used as an alterative, a cooling remedy, and a tonic. Boiled in vinegar, the leaves are used for skin ailments and tonics. The astringent root is used for hemorrhoids and worms. The Lebanese also used the seed infusion for stones of the gallbladder and liver, to promote the flow of milk, and as a stimulant and tonic. Albrecht von Haller, Swiss anatomist, surgeon, and botanist, suggested milk thistle for liver ailments back in 1755. |
What Milk Thistle Is and What It Can Do
milk thistle is native to the warm, dry areas of southern Europe and northern Africa. It is a beautiful, sturdy plant with shiny, spiny, mottled foliage. My milk thistle plants have a very attractive pattern of white veins two to three millimeters wide separated by light green interspaces. The flowers are fuzzy, soft, and purplish.
Incredibly Edible
All parts of the milk thistle are said to be edible, and this plant has long been used for food in the countries surrounding the Mediterranean. Young leaves can be trimmed of prickles and added to salads or steamed for a vegetable. They taste a little bitter and astringent and sort of get gummy as you chew.
The roots can be prepared and cooked like salsify or eaten raw. The young flower buds can be steamed and eaten like those of the globe artichoke, a close relative. (In fact, just this morning I picked and ate some buds from a six-foot plant.)
Like many members of the daisy family, the scorched roots and seeds of milk thistle have been used as a coffee substitute, the seed cake is used for cattle fodder, and the seed oil for food or lubrication.
I have enjoyed munching the seeds like sunflower seeds and can see a great potential for the seeds as beer nuts to serve in bars where the drinkers are worried about their livers but don't have enough sense to taper off. Birds like the seeds, too.
milk thistle is not on the Food and Drug Administration's (FDA's) "generally recognized as safe" (GRAS) list, but it is what I call "generally recognized as food" (GRAF). In my subjective scoring, milk thistle rates safer than coffee. To remind the FDA that milk thistle is a food, perhaps we should call it the "milk artichoke."
Traditionally, a tea made from various parts of the plant has been used to improve the appetite, alleviate indigestion, and as a liver tonic. And true to its name, milk thistle also has a long folk history of helping nursing mothers increase milk secretion.
Only recently, however, has science begun to investigate the chemistry and physiologic effects of this plant. Commercial preparations of the seed extracts are manufactured in Europe and are currently used to treat jaundice, cirrhosis, hepatitis, and liver poisoning from chemicals or from drug and alcohol abuse.
If you are the gardening type, you can buy milk thistle seeds from an herb catalog and grow the plants, but I wouldn't advise trying to harvest the seeds yourself. This thistle's spines can be a real challenge, even if you arm yourself with long gloves and pruners.
I must also caution that milk thistle can be invasive. It's becoming a weed here in my Green Farmacy Garden where it is refusing to stay in its four assigned plots: aging and senescence, alcohol and addictions, hepatitis and liver problems, and ulcers. It is a very attractive weed, however.
| DR. DUKE'S NOTES The fatty acid composition of the oil produced from milk thistle seeds is similar to sunflower seed oil and can be substituted in some pharmaceutical and cosmetic formulations. |
How Milk Thistle Can Help
In reviewing the literature on herbs that protect the liver, I concluded that silymarin from the milk thistle, Silybum marianum, seems to be the most promising natural compound both for preventing damage to the liver and for correcting a damaged liver. And even if you have a healthy liver, milk thistle can help it remove toxins more effectively.
Meet Your Liver
Few vital organs are so vital as the liver. About the same color and size as a football, the liver is your body's chemical factory.
It produces important proteins for blood plasma. These include albumin, which regulates the exchange of water between blood and tissues; complement, a group of proteins crucial to the immune system; coagulation factors; and globin for hemoglobin, which carries oxygen in the blood. The liver also produces cholesterol.
After a meal, the liver converts amino acids to glucose, proteins, or urea, which is excreted by the kidneys in the urine. The liver's bile also enables better digestion of the fats (some of them toxic) you may have consumed.
The liver is also your blood's filtration system. It extracts drugs and poisons, such as alcohol or pollutants, alters their chemical structure, and excretes them in the bile. If the filter doesn't work properly, dangerous toxins may remain in the body.
Here's what milk thistle can do to help.
Alcoholism. There are an estimated 11 million alcoholics in the United States, with 200,000 dying from the disease every year. In urban areas, alcoholic liver disease is the fourth leading cause of death in 25- to 64-year-old men. Chronic consumption of alcohol increases enzyme activities in the liver, which leads to malnutrition and ethanol toxicity as well as an increase in ethanol-induced free radicals.
As an antioxidant and a cell protector, the silymarin in milk thistle can protect the liver from chemical damage, including ethanolic damage, and that's the main reason I'm taking it.
| FROM MY SCIENCE NOTEBOOK With the recent surge of interest in alternative therapies in the United States, doctors began to notice that more and more of their patients were taking the herb milk thistle. To find out why, a group of researchers in the Gastroenterology Division of Oregon Health Sciences University in Portland conducted a study of milk thistle's history, pharmacology, and properties. They also looked at clinical trials pertaining to patients with acute and chronic liver disease. They found indications that silymarin, milk thistle's main active compound, is an antioxidant that protects cells and inhibits the growth of tumors. They also found studies to suggest that silymarin protects and promotes the regeneration of liver cells. In another instance of Europe being more herbally advanced, Commission E, the German government's expert panel that judges the safety and effectiveness of medicinal herbs, has already approved milk thistle seeds or seed extracts as supportive treatment for cirrhosis and chronic inflammatory liver conditions such as hepatitis. In the 1960s, German scientists identified a group of active ingredients in milk thistle, found mainly in its seeds, which collectively is called silymarin. The four main, closely related compounds are isosilybinin, silychristin, silydianin, and silybinin. The later accounts for about 50 percent of a plant's silymarin. silymarin protects the liver in two ways. It strengthens the outer membranes of liver cells, which prevents toxins from penetrating. It also stimulates an enzymatic action that in turn increases protein synthesis, which stimulates the ability of the liver to form new cells and repair itself. The silybinin component of silymarin has been shown to reduce cholesterol in bile. And because silymarin increases bile solubility, it can help prevent or alleviate gallstones. Many European studies have investigated the effects of silymarin on liver diseases. One Finnish study showed a significant decrease of elevated enzymes after patients took milk thistle capsules. More recently, an Italian study showed that as an antioxidant, silymarin reduced damage to liver cells caused by chronic use of some prescription drugs. |
Cirrhosis. Alcohol abuse or viral hepatitis can damage the healthy cells of the liver and replace them with scar tissue. The result is a group of serious, chronic, degenerative diseases called cirrhosis. The impaired liver cannot carry out its many important functions, such as storing and filtering blood or producing bile. Even liver cancer may ensue.
Researchers at the University of Vienna in Austria studied the effects of silymarin on patients with cirrhosis of the liver due to alcohol. They found that patients who took milk thistle extract lived significantly longer, with no negative side effects.
Hepatitis. An inflammation of the liver, there are various types of hepatitis. Most are caused by viral infection, but hepatitis may also be caused by an overdose of drugs, such as acetaminophen, the active ingredient in Tylenol. Exposure to certain chemicals, such as dry cleaning agents, or alcohol abuse may result in hepatitis.
Inflammation damages liver cells, and the most severe cases may result in liver failure and death. Hepatitis caused by heavy drinking may result in the cell destruction and scarring that leads to liver cirrhosis.
Infection can be flu-like, with nausea and vomiting. Jaundice, a yellowish hue to the skin, is the most noticeable symptom of hepatitis, but symptoms can be less apparent. Chronic hepatitis may be marked by nothing more than a vague feeling of being unwell.
With its ability to protect and regenerate injured liver cells, milk thistle has been used successfully to treat hepatitis.
I recently heard from a colleague whose sister had been diagnosed with infectious hepatitis. "You could only describe her skin and eye color as 'sunflower yellow'!" she wrote. "Tests showed her liver was functioning at 40 percent. She had a vitamin K shot and started taking milk thistle tablets. When she had a second liver function test three weeks later, it showed the liver functioning at 82 percent! The doctor says it was unbelievable. He told her that recovery time from hepatitis is up to nine months!"
| DR. DUKE'S NOTES Nutrition Reviews reports that cirrhosis is the ninth leading reported cause of death in the United States. Some 70 to 80 percent of the cases are caused by alcohol abuse, and most of the remainder are due to chronic viral hepatitis. |
Pollution. In my travels I meet a lot of pollutants more dangerous and less relaxing than alcohol. milk thistle, in the same way that it protects the liver from alcoholic intoxication, can help prevent damage caused by environmental toxins. Its active ingredient, silymarin, helps strengthen cell membranes to prevent toxic substances from entering liver cells.
German studies have shown that giving rats silymarin beforehand protected them from the effects of pollutants such as carbon tetrachloride, which is sometimes concentrated by industrial use.
| DR. DUKE'S RECIPES Gobo Gumbo One of milk thistle's close relatives is burdock. Borrowing from the Japanese word for burdock, I make something I call "gobo gumbo" using burdock leaf stalks. I usually harvest them in spring, when they are most tender, and store them in the freezer for year-round use. I'll cut them up like celery and simmer them slowly in stock, throwing off the first water to remove the bitterness (and probably some of their beneficial lignans, too, unfortunately). I spice the stew with onions, garlic, and turmeric, all of which are good cancer preventives. Every time I eat these vegetables, I think I'm lowering my chances of the colon cancer that got my dad and two of his brothers. burdock roots contain about 45 percent inulin (not the same thing as insulin), which some people say is good for diabetes. These are edible, too. Boiled in salted water and topped with a little butter or sauce, the roots are mild and palatable, although not quite my favorite. I'm the mashed potato type. |
How to Take It and How Much
silymarin, milk thistle's active ingredient, is concentrated from milk thistle seeds and sold in standardized capsule form or extracts. The capsules I take are standardized at 80 percent silymarin. The recommended average daily dose is 200 to 400 milligrams of silymarin, but I don't take it regularly unless I'm traveling or celebrating.
Some herbalists say that it's better to eat the seeds or capsules than make a tea or infusion of the seeds. silymarin is barely soluble in water and poorly absorbed from the stomach, so it needs to be concentrated and standardized for oral use.
I've never been desperate enough to harvest milk thistle seeds myself, but if I were, I'd get out the scissors and a pair of long, tough gloves. Eating the seeds can be effective, because all sorts of things happen in the stomach that don't happen in water or alcohol extracts. I'd estimate you'd have to eat about half an ounce of seeds to get the equivalent of an average daily dose of silymarin.
| WHAT NEW RESEARCH TELLS US Recent research is uncovering some exciting possibilities for milk thistle. Help for Hepatitis C Hepatitis C is caused by a virus identified in the late 1980s. It is spread in ways similar to the HIV infection. Scientists call it the "silent epidemic" because its symptoms of fatigue and nausea may not appear for decades. Some estimates put the number of infected Americans at more than 4 million. The usual treatment for hepatitis C is interferon, a generic antiviral (and anticancer) drug. Injections of interferon are expensive, have a low success rate, and can cause serious side effects. Here's definitely a case where I'd prefer the herbal alternative. I've had some encouraging reports from therapists who have used milk thistle to treat patients with hepatitis C. My friend Steven Morris, N.D., a naturopathic physician in Seattle, put a patient with hepatitis C on an alcohol-free, liver-cleansing diet and taught him stress management techniques. He also prescribed some daily herbs, including 150 milligrams of Silybum marianum. After three months, the patient's liver enzymes returned to normal limits, and the signs and symptoms of the disease improved. Amanda McQuade Crawford, a British-trained phytotherapist, founding member of the American Herbalists Guild, and founder and director of the National College of Phytotherapy in New Mexico, added silymarin and dandelion to the treatment of one of her hepatitis C patients. She also added a strong diuretic (Lasix) to the usual interferon, an antiviral drug. In three months, her patient no longer needed the Lasix and tests showed improved liver enzymes and viral load. It may be an instance of a gentle diuretic and a gentle antiviral improving the effectiveness and minimizing the side effects of a strong antiviral and a strong diuretic. Crawford cautions that people with hepatitis C respond differently to herbs, drugs, and nutrition, and is hesitant to prescribe any single natural or alternative approach. "Complex humans with equally complex health conditions take a little more than substituting an herb for a prescription," she warns. Treatment for Mushroom Poisoning Each year, thousands of people become ill, and a few even die, from eating poisonous mushrooms. Most of these are children, who don't yet know there are good mushrooms and bad mushrooms. Often the victims of mushroom poisonings are immigrants, who mistake poisonous fungi for edible look-alikes that grow in their native countries. Sometimes it is the so-called mushroom experts who make a mistake. The most serious cases of mushroom poisoning, and more than 90 percent of the deaths, are traced to the death cap mushroom, Amanita phalloides. This species, as well as several others in its genus, contain deadly amatoxin poisons that are not destroyed by heat, water, or drying. These toxins can kill liver cells. The first signs of amanita poisoning are vomiting, cramping, and diarrhea, followed by liver damage, and in the most serious cases, kidney damage and liver failure. Sometimes the only recourse is a liver transplant--unless you live in Europe. While milk thistle is not widely used in the United States, European research suggests that silybinin, one of the compounds in silymarin, a flavonoid component of milk thistle seed, can be used to treat severe amanita mushroom poisoning. In one experiment, every animal given silymarin and/or silybinin treatment before being poisoned with mushrooms survived. And when silybinin was given intravenously to humans who accidentally ate death cap mushrooms, the death rate was dramatically reduced. In 1996, a Netherlands medical journal told of a husband and wife who ate Amanita phalloides mushrooms and developed symptoms of poisoning 18 hours later. When their livers and kidneys began to deteriorate, they were treated intravenously with silybinin, penicillin, and glucose. After three days, organ failure was reversed. Researchers noted that both silybinin and penicillin prevent amatoxin uptake into liver cells, but also noted that the penicillin treatment can have serious side effects if used for more than three days. |
Useful Combinations
Taking silymarin with other food-grade herbs in the same family that have a nice liver protective reputation makes good sense.
Dandelion. Dandelion is one such "family" plant. The flowers of dandelion are very rich in lecithin, a liver protector. In another case of science trying to imitate nature, a new Italian drug combines the antioxidant silybinin with lecithin. Other beneficial plants in the milk thistle family include burdock and artichoke.
Echinacea. If I had hepatitis C, I'd be taking the floral extracts of echinacea (see chapter 5) along with my milk thistle and heavy-duty medications. Flowers of echinacea are the best source I've found for cichoric acid, which, through its reported anti-integrase activity, may slow reproduction of viruses. Some echinacea tablets are now standardized for cichoric acid.
Christopher Hobbs, herbalist, botanist, and author, mixes milk thistle seed into his liver-digestive combo, which also includes artichoke leaf, dandelion root, turmeric rhizome, skullcap, and California coast sage.
| ALL IN THE FAMILY: artichoke Another milk thistle relative, the artichoke is native to the Mediterranean, and it's now widely grown along parts of the U.S. west coast. I'll eat artichokes when I'm in California and they are served up for me. You can find them in almost any supermarket produce section anywhere in the United States, however. What artichoke Is and What It Can Do The artichoke (technically, the globe artichoke as opposed to the rootcrop called Jerusalem artichoke, another good inulin source) is a thistlelike plant grown for its edible flower buds. Globe artichoke flowers are very similar to those of the milk thistle, although globe artichokes do not have all those dangerous spiny bristles. Jerusalem artichokes, on the other hand, more closely resemble a yellow echinacea. The Japanese name for the artichoke, chosen azami, means "Korean thistle." Diabetes. artichoke flower heads are reported to be a source of inulin for diabetics. Liver protection. Artichokes seem to share many flavonoids and lignans that may account for the liver-protective properties of milk thistle. Rheumatism and dropsy. artichoke leaves have been used as a diuretic for treating rheumatism and dropsy. What New Research Tells Us A few recent European studies have looked at the ability of artichoke extracts to promote health. One termed it useful for bile secretion dysfunction. Another study found that artichokes are rich in luteolin, a protective antioxidant. In yet another study, German laboratory experiments looked at how artichoke extracts affected rat liver cells in the test tube. The extract's antioxidant properties protected the liver cells from damage, and also inhibited the formation of cholesterol. How to Take It and How Much artichoke supplements can be found in capsule form, but eating them as a sweet, mild vegetable is to me a much more pleasurable way to benefit from its healthful properties. Caution Some people may be sensitive to artichokes and may develop a rash or other skin irritation after touching them. Christopher Hobbs, herbalist, botanist, and author, suggests you stay away from artichokes if you have ulcerative colitis, gallstones, or allergies. But I'll continue to enjoy them as a vehicle for rich, delicious sauces or melted butter. |
Caution: Contraindications, Interactions, and Side Effects
Germany's Commission E (a panel of experts roughly the equivalent to the U.S. Food and Drug Administration) reports no known contraindications or drug interactions for milk thistle, the fruit. Occasional mild laxative effects have been noted, but if you stick to the recommended dose, there should be no problems.
| ALL IN THE FAMILY: BURDOCK The milk thistle hails from one of the largest plant families, the Asteraceae, formerly known as the Compositae. This family includes everything from lettuce to sunflowers, but there are a couple relatives that share many chemicals and activities with milk thistle. One of them is burdock. To most Americans, burdock is a big, bad weed, but lots of bad weeds can be good plants.
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