Milk Thistle and Liver Health
What is Milk Thistle: Silybum marianum?
Milk thistle, a purple flower with prickly leaves native to the Mediterranean region, has long been used by alternative medicine physicians to support liver health. Its most researched active compounds, silymarin and silybin, are highly concentrated in the seeds, which are the part most commonly used in treatments. Recent studies have focused on the clinical efficacy of silymarin in addressing Non-Alcoholic Fatty Liver Disease (NAFLD), a condition affecting 20-30% of people in Western countries. NAFLD is hypothesized to be a hepatic manifestation of metabolic syndrome.
What is metabolic syndrome?
Metabolic Syndrome, in simple terms, occurs when the body is exposed to excess calories, particularly from sugar, over an extended period. This leads to insulin resistance, elevated blood sugar levels, abnormal fat levels in the blood, leading to a harmful chain reaction stemming from these imbalances. Excess fats and sugars in the bloodstream eventually overtax the liver, whose main role is to process these substances, leading to fat accumulation in the liver and impaired function. Over time, metabolic syndrome can lead to conditions such as type 2 diabetes, obesity, high cholesterol, and high blood pressure—all of which are among the leading causes of death today.
How can Milk Thistle help?
A 2014 study highlighted several health benefits of silymarin in adults with diabetes. After silymarin administration, patients’ demonstrated reductions in markers such as fasting insulin, fasting blood sugar, and HbA1C (a marker for long-term blood sugar levels). Additionally, blood lipid markers, including cholesterol, triglycerides, and LDL, showed significant declines.
Another study focusing on patients with hepatic steatosis demonstrated a significant decrease in liver enzymes, indicating reduced liver damage.
How does it work?
Milk thistle supports liver health through several powerful actions. As an antioxidant with an affinity for the liver, it protects liver cells from damage caused by free radicals, boosts natural antioxidant levels like glutathione, and helps to safely remove excess iron. Its anti-inflammatory effects work by reducing cytokine pathways that trigger inflammation while increasing compounds that naturally reduce inflammation. Milk thistle also helps prevent liver scarring (fibrosis) by blocking signals that lead to collagen build-up, which is key in protecting the liver from long-term damage. By supporting liver function, milk thistle encourages the gentle flushing of buildup within hepatocytes
The liver is central to metabolism and in one way or another is connected to nearly every system in the body. By supporting liver function, enhancing the production of beneficial proteins, and promoting the excretion of harmful toxins, milk thistle positively influences numerous health markers. Its potential benefits warrant further study and broader consideration for therapeutic use.
Other treatments for Non-Alcoholic Fatty Liver Disease?
1. Weight Management:
Gradual Weight Loss: Aim to lose 5-10% of your body weight, as this can significantly reduce liver fat. Avoid rapid weight loss, as it can worsen liver inflammation.
Caloric Deficit: Focus on a balanced, reduced-calorie diet, avoiding processed foods and sugary beverages.
2. Exercise:
Regular Physical Activity: Engage in at least 150-300 minutes of moderate aerobic exercise (e.g., brisk walking, cycling) or 75 minutes of vigorous exercise (e.g., running) weekly.
Strength Training: Include resistance exercises to improve insulin sensitivity and support weight loss.
3. Dietary Changes:
Mediterranean Diet: This diet, rich in fruits, vegetables, whole grains, and healthy fats like olive oil, has been shown to improve liver health and reduce inflammation.
Limit Carbohydrates and Sugars: Reducing refined carbs (white bread, sugary snacks) helps manage insulin resistance, which is a key driver of NAFLD.
Increase Omega-3 Fatty Acids: Fatty fish like salmon, walnuts, and flaxseeds can help reduce liver fat.
Limiting Alcohol intake: Even moderate alcohol intake can worsen liver function in those with NAFLD.
References
Achufusi TGO, Pellegrini MV, Patel RK. Milk Thistle. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541075/
Mirhashemi, S. H., Hakakzadeh, A., Yeganeh, F. E., Oshidari, B., & Rezaee, S. P. (2022). Effect of 8 Weeks milk thistle powder (silymarin extract) supplementation on fatty liver disease in patients candidates for bariatric surgery. Metabolism open, 14, 100190. https://doi.org/10.1016/j.metop.2022.100190
Rambaldi, A., Jacobs, B. P., & Gluud, C. (2007). Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. The Cochrane database of systematic reviews, 2007(4), CD003620. https://doi.org/10.1002/14651858.CD003620.pub3 Available from: https://pubmed.ncbi.nlm.nih.gov/17943794/
Tamayo, C., & Diamond, S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative cancer therapies, 6(2), 146–157. https://doi.org/10.1177/153473540730194Available from: https://pubmed.ncbi.nlm.nih.gov/17548793/
Paschos, P., & Paletas, K. (2009). Non alcoholic fatty liver disease and metabolic syndrome. Hippokratia, 13(1), 9–19.