Milk thistle (Silybum marianum), also called holy thistle, Mary’s thistle, and Scotch thistle, has been used as food and medicine in the Mediterranean region for several thousand years. Milk thistle seed extract is best known for its liver protective qualities, but other medicinal uses have been researched more recently, including anti-inflammatory, antioxidant, and hypoglycemic properties.

In patients with liver disease, including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and toxin induced hepatic damage, milk thistle extract increased liver cell regeneration and improved glutathione recycling and synthesis resulting in improved liver function, lower liver enzymes, and reduced inflammation. Isosylibin A, an active constituent of milk thistle extract, has peroxisome proliferator-activated receptor gamma (PPARγ) agonist properties similar to the glitazones family of anti-diabetes medications without the resulting liver toxicity. In clinical trials on patients with diabetes, supplementation with milk thistle extract resulted in reduced fasting blood glucose levels, reduced daily blood glucose levels, and reduced insulin requirements after two months of supplementation; after four months HbA1c decreased. Some clinical trials also showed significant improvement of total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, AST, and ALT levels. Silibin, another active constituent of milk thistle extract, inhibits the enzyme aldose reductase resulting in decreases in the accumulation of sorbitol in tissues and organs under hyperglycemic conditions. This activity reduces fluid accumulation and cellular damage from diabetes and may help prevent and/or treat diabetic neuropathy, nephropathy, retinopathy, and cataracts. In clinical trials on patients with diabetes-related kidney disease, milk thistle reduced protein loss in urine, reduced tumor necrosis factor alpha (TNF-α), improved T-cell activation, and reduced inflammation.

Side-effects are rare but may include gastrointestinal discomfort and headache. Contraindications includes ragweed allergies, acetaminophen, amitriptyline, benzodiazepines, ibuprofen, losartan, morphine, statin drugs, warfarin, and more; people with diabetes should monitor blood glucose levels carefully after taking milk thistle extract.

Standard dosing for diabetes or insulin resistance is 140-200mg of standardized extract three times daily before meals. For liver disease the standard dose is 600-800mg once or twice daily.

Disclaimer: The content herein is not intended to be a substitute for professional medical advice. It is not meant to diagnosis, cure, or treat any medical condition. Always consult a physician or other qualified healthcare provider with questions regarding a medical condition and before starting new diets and dietary supplements. Not all diets or supplements are appropriate for all people or all health conditions.


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