Milk thistle (Silybum marianum) is a plant that can be used medicinally for liver health. The benefits of milk thistle for liver health may relate to a number of flavonolignan phytochemicals contained particularly within the seeds of the plant. These flavanolignans include silybin, silychristin and silydianin, which are collectively called silymarin. Currently it is unknown which if any of these isomers are responsible for the liver protective effects seen following administration of milk thistle, Although evidence suggests that silymarin has significant health effects and is hepatoprotective, other unidentified compounds within the plant could also be responsible. The effects of milk thistle have been well demonstrated in the nutritional literature, and the hepatoprotective effects of the milk thistle plant in clinical trials corroborate the voluminous literature from traditional medicine describing the use of the plant as a liver tonic.
The effects of milk thistle on liver health are still controversial, with findings from human clinical studies being inconsistent. However, this may relate to the fact that many human studies have not taken into consideration the severity of the condition at baseline. For example, a number of human clinical studies investigating the effects of milk thistle on severe liver disease have found no benefit to mortality rates or liver function with use of milk thistle. However, many of these studies are designed as pharmaceutical studies, and this shows a lack of understanding by the researchers as to the role of herbal medicine in treating disease. The duration of treatment, the dose, and the severity of the original condition must be considered. When these factors are taken into account the evidence firmly suggests that milk thistle is an effective liver tonic that is able to support liver health through natural mechanisms. However, even in some cases of severe liver dysfunction, milk thistle has proved effective at improving survival rates in humans.
Evidence therefore suggests that milk thistle is efficacious at benefiting mild to moderate liver toxicity. However, the benefits of milk thistle cannot be expected to create miracles in those with severe liver disease in a short term clinical trial. Its use in studies investigating its effects on severe alcoholism, toxin-induced liver disease or viral liver disease is perhaps unfair based on its traditional role. The silymarin component of milk thistle may aid the liver by supporting antioxidant function, allowing improvements in detoxification pathways. In its traditional role, milk thistle is best used in those with a healthy liver who require additional support during exposure to xenobiotics that may unduly stress the liver. However, it is important that the cause of the liver toxicity is removed if effective treatment for the liver is to be seen with milk thistle as eventually, exposure to liver toxins will overwhelm the liver antioxidant defences and induce liver damage even with administration of milk thistle.
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