Milk Thistle

(Silymarin)

ByLaura Shane-McWhorter, PharmD, University of Utah College of Pharmacy
Reviewed/Revised Jan 2023
View Patient Education

Silybum marianum

(See also Overview of Dietary Supplements and National Institutes of Health (NIH): Milk thistle.)

Claims

12), and individual case reports claim fatality reduction in mushroom poisoning (3).

Evidence

4

5). In vitro, silymarin increases levels of intrahepatic glutathione, an antioxidant important for detoxification (6).

27).

In case reports, 2 cases of Amanita mushroom ingestion poisoning (3) showed favorable results after treatment with silybin.

Adverse Effects

No serious adverse effects have been reported.

Drug Interactions

89

(See also table Some Possible Dietary Supplement–Drug Interactions.)

References

  1. 1. Abenavoli L, Izzo AA, Milic N, et alPhytother Res 32(11):2202-2213, 2018. doi: 10.1002/ptr.6171

  2. 2. Hadi A, Pourmasoumi M, Mohammadi H, et al: The effects of silymarin supplementation on metabolic status and oxidative stress in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of clinical trials. Complement Ther Med 41:311-319, 2018. doi: 10.1016/j.ctim.2018.08.010

  3. 3. Ward J, Kapadia K, Brush E, et al: Amatoxin poisoning: case reports and review of current therapies. J Emerg Med 44(1):116-121, 2013.  doi: 10.1016/j.jemermed.2012.02.020

  4. 4. Rambaldi A, Jacobs BP, Gluud CCochrane Database Syst Rev (4)CD003620, 2007. doi: 10.1002/14651858.CD003620.pub3

  5. 5. Yang Z, Zhuang L, Lu Y, et alBiomed Res Int 941085, 2014. doi: 10.1155/2014/941085

  6. 6. Valenzuela A, Aspillaga M, Vial S, et al: Selectivity of silymarin on the increase of the glutathione content in different tissues of the rat. Planta Med 55(5):420-422, 1989. doi: 10.1055/s-2006-962056

  7. 7. Xiao F, Gao F, Zhou S, et al: The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: a meta-analysis. Medicine (Baltimore) 99(40):e22249, 2020. doi:10.1097/MD.0000000000022249

  8. 8. Wu JW, Lin LC, Tsai TH: Drug-drug interactions of silymarin on the perspective of pharmacokinetics. J Ethnopharmacol 121(2):185-193, 2009. doi: 10.1016/j.jep.2008.10.036

  9. 9. Jalloh MA, Gregory PJ, Hein D, et al: Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS 28(1):4-15, 2017. doi: 10.1177/0956462416671087

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  1. National Institutes of Health (NIH), National Center for Complementary and Integrative Health:

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