Key Constituents

Silymarin (a flavonolignan complex)^{[12, 13]}

The active complex; silybin (silibinin) is the most active component, with silydianin and silychristin.

Silymarin (silybin)

Flavonoids^[13]

Additional antioxidant constituents of the seed.

Flavonoids

Pharmacological Actions

Anti-inflammatory^{[11, 12, 13]}

Anti-inflammatory and antioxidant

Antidiabetic (blood-sugar lowering)^{[10, 14]}

Improves glycemic control in type 2 diabetes - lowers fasting blood glucose and HbA1c

Antioxidant^{[2, 6, 12, 13]}

Anti-inflammatory and antioxidant; Hepatoprotective / liver support (protects liver cells, antioxidant and antifibrotic)

Digestive aid^[12]

Digestive support / mild dyspepsia (traditional)

Hepatoprotective (liver support)^{[1, 2, 3, 4, 6, 7, 9, 12, 13, 15]}

Hepatoprotective / liver support (protects liver cells, antioxidant and antifibrotic); May improve liver enzymes and hepatic fat in non-alcoholic fatty liver disease (NAFLD); Supports liver recovery and 'detox' (traditional framing of the hepatoprotective action)

Traditional & Indicated Uses

Arthritis / joint pain^{[12, 13]}Moderate · 5/10

inferred from anti-inflammatory action

more plants for arthritis / joint pain →detailed sources →

Bloating^[12]Moderate · 5/10

inferred from digestive action

more plants for bloating →detailed sources →

Blood sugar / diabetes support^[14]Good · 7/10

Improves glycemic control in type 2 diabetes - lowers fasting blood glucose and HbA1c

more plants for blood sugar / diabetes support →detailed sources →

Detox / cleansing^[12]Moderate · 5/10

Supports liver recovery and 'detox' (traditional framing of the hepatoprotective action)

more plants for detox / cleansing →detailed sources →

Indigestion^[12]Moderate · 5/10

Digestive support / mild dyspepsia (traditional)

more plants for indigestion →detailed sources →

Inflammation (general)^{[12, 13]}Moderate · 5/10

inferred from anti-inflammatory action

more plants for inflammation (general) →detailed sources →

Liver support^{[12, 13, 15]}Good · 8/10

Hepatoprotective / liver support (protects liver cells, antioxidant and antifibrotic); May improve liver enzymes and hepatic fat in non-alcoholic fatty liver disease (NAFLD)

more plants for liver support →detailed sources →

Metabolic support^[14]Good · 7/10

inferred from antidiabetic action

more plants for metabolic support →detailed sources →

Skin irritation^{[12, 13]}Moderate · 5/10

inferred from anti-inflammatory action

more plants for skin irritation →detailed sources →

Safety, Cautions & Contraindications

Safety note^[12]Info

Very well tolerated, even at high doses; the main effects are mild gastrointestinal upset (nausea, loose stools). As a member of the daisy family (Asteraceae), it can cause allergic reactions in sensitive people.

Safety note^[12]Caution

Has a low potential for drug interactions (little effect on liver CYP enzymes), but use caution with medicines that have a narrow therapeutic window. Human pregnancy data are limited, so use cautiously.

References

REF-1896, REF-1897, REF-1898, REF-1899, REF-1900, REF-1901, REF-1902, REF-1903, REF-1904, REF-1905, REF-1906

References & Sources

Abenavoli, L., Izzo, A.A., Milic, N., Cicala, C., Santini, A. and Capasso, R (2018) 'Milk thistle (Silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases', Phytotherapy Research, 32(11), pp. 2202-2213. doi:10.1002/ptr.6171 Meta-analysis / review
https://doi.org/10.1002/ptr.6171
Bahmani, M., Shirzad, H., Rafieian, S. and Rafieian-Kopaei, M (2015) 'Silybum marianum: Beyond Hepatoprotection', Journal of Evidence-Based Complementary & Alternative Medicine, 20(4), pp. 292-301. doi:10.1177/2156587215571116 Meta-analysis / review
https://doi.org/10.1177/2156587215571116
Wang, X., Zhang, Z. and Wu, S (2020) 'Health Benefits of Silybum marianum: Phytochemistry, Pharmacology, and Applications', Journal of Agricultural and Food Chemistry, 68(42), pp. 11644-11664. doi:10.1021/acs.jafc.0c04791 Meta-analysis / review
https://doi.org/10.1021/acs.jafc.0c04791
Marmouzi, I., Bouyahya, A., Ezzat, S.M., El Jemli, M. and Kharbach, M (2020) 'The food plant Silybum marianum (L.) Gaertn.: Phytochemistry, Ethnopharmacology and clinical evidence', Journal of Ethnopharmacology, 265, pp. 113303. doi:10.1016/j.jep.2020.113303 Meta-analysis / review
https://doi.org/10.1016/j.jep.2020.113303
Greenlee, H., Abascal, K., Yarnell, E. and Ladas, E (2007) 'Clinical applications of Silybum marianum in oncology', Integrative Cancer Therapies, 6(2), pp. 158-165. doi:10.1177/1534735407301727 Meta-analysis / review
https://doi.org/10.1177/1534735407301727
Shaker, E., Mahmoud, H. and Mnaa, S (2009) 'Silymarin, the antioxidant component and Silybum marianum extracts prevent liver damage', Food and Chemical Toxicology, 48(3), pp. 803-806. doi:10.1016/j.fct.2009.12.011 Preclinical
https://doi.org/10.1016/j.fct.2009.12.011
Flora, K., Hahn, M., Rosen, H. and Benner, K (1998) 'Milk thistle (Silybum marianum) for the therapy of liver disease', American Journal of Gastroenterology, 93(2), pp. 139-143. doi:10.1111/j.1572-0241.1998.00139.x Meta-analysis / review
https://doi.org/10.1111/j.1572-0241.1998.00139.x
Csupor, D., Csorba, A. and Hohmann, J (2016) 'Recent advances in the analysis of flavonolignans of Silybum marianum', Journal of Pharmaceutical and Biomedical Analysis, 130, pp. 301-317. doi:10.1016/j.jpba.2016.05.034 Meta-analysis / review
https://doi.org/10.1016/j.jpba.2016.05.034
Ball, K.R. and Kowdley, K.V (2005) 'A review of Silybum marianum (milk thistle) as a treatment for alcoholic liver disease', Journal of Clinical Gastroenterology, 39(6), pp. 520-528. doi:10.1097/01.mcg.0000165668.79530.a0 Meta-analysis / review
https://doi.org/10.1097/01.mcg.0000165668.79530.a0
Tajmohammadi, A., Razavi, B.M. and Hosseinzadeh, H (2018) 'Silybum marianum (milk thistle) and its main constituent, silymarin, as a potential therapeutic plant in metabolic syndrome: A review', Phytotherapy Research, 32(10), pp. 1933-1949. doi:10.1002/ptr.6153 Meta-analysis / review
https://doi.org/10.1002/ptr.6153
Ghahfarrokhi, S.H., Heidari-Soureshjani, S., Sherwin, C.M.T. and Azadegan-Dehkordi, Z (2024) 'Efficacy and Mechanisms of Silybum marianum, Silymarin, and Silibinin on Rheumatoid Arthritis and Osteoarthritis Symptoms: A Systematic Review', Current Rheumatology Reviews, 20(4), pp. 414-425. doi:10.2174/0115733971266397231122080247 Meta-analysis / review
https://doi.org/10.2174/0115733971266397231122080247
Soleimani, V., Delghandi, P.S., Moallem, S.A. and Karimi, G (2019) 'Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review', Phytotherapy Research. doi:10.1002/ptr.6361 Randomized trial
https://doi.org/10.1002/ptr.6361
Fallah, M., Davoodvandi, A., Nikmanzar, S., Aghili, S., Mirazimi, S.M.A., Aschner, M., Rashidian, A., Hamblin, M.R., Chamanara, M., Naghsh, N. and Mirzaei, H (2021) 'Silymarin (milk thistle extract) as a therapeutic agent in gastrointestinal cancer', Biomedicine & Pharmacotherapy. doi:10.1016/j.biopha.2021.112024 Preclinical
https://doi.org/10.1016/j.biopha.2021.112024
Voroneanu, L., Nistor, I., Dumea, R., Apetrii, M. and Covic, A (2016) 'Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials', Journal of Diabetes Research. doi:10.1155/2016/5147468 Meta-analysis / review
https://doi.org/10.1155/2016/5147468
Zhou, J., Chen, Y., Yu, J., Li, T., Lu, Z., Chen, Y., Zhang, X. and Ye, F (2021) 'The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment: A PRISMA-compliant network meta-analysis of randomized controlled trials', Medicine (Baltimore), 100(12). doi:10.1097/MD.0000000000024884 Meta-analysis / review
https://doi.org/10.1097/MD.0000000000024884

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