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milk thistle

© 2018 Steven Foster

A milk thistle monograph for the home

Latin Name: Silybum marianum


Common Names: milk thistle, Mary thistle, holy thistle.


This milk thistle monograph provides basic information about milk thistle—common names, usefulness and safety, and resources for more information.

Source: https://nccih.nih.gov/

Milk Thistle Basics

  • Milk thistle is native to southern Europe, southern Russia, Asia Minor, and northern Africa. It also grows in North and South America and South Australia.
  • Silymarin is considered to be the main component of milk thistle seeds, but the terms “milk thistle” and “silymarin” often are used interchangeably.
  • Historically, people have used milk thistle for liver disorders, such as hepatitis and cirrhosis, and gallbladder problems.
  • Silymarin is the most commonly used herbal supplement in the United States for liver problems.
  • Milk thistle products are available as capsules, powders, and extracts.

Milk Thistle in Health Research

  • We know little about whether milk thistle is effective in people, as only a few well-designed clinical studies have been conducted.

Milk Thistle Research Summary

  • Results from clinical trials of milk thistle for liver diseases have been mixed, and two rigorously designed studies found no benefit.
  • The 2008 Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) study, sponsored by the National Institutes of Health (NIH), found that hepatitis C patients who used silymarin had fewer and milder symptoms of liver disease and somewhat better quality of life but no change in virus activity or liver inflammation.
  • A 2012 clinical trial, cofunded by the National Center for Complementary and Integrative Health (NCCIH) and the National Institute of Diabetes and Digestive and Kidney Diseases, showed that two higher-than-usual doses of silymarin were no better than placebo for chronic hepatitis C in people who had not responded to standard antiviral treatment.
  • Results from a 2013 clinical study suggest that milk thistle may enhance standard treatment in young people with a particular form of anemia (Cooley’s anemia).

Milk Thistle Safety

  • In clinical trials, milk thistle appears to be well tolerated in recommended doses. Occasionally, people report various gastrointestinal side effects.
  • Milk thistle may produce allergic reactions, which tend to be more common among people who are allergic to plants in the same family (for example, ragweed, chrysanthemum, marigold, and daisy).
  • Compounds in milk thistle may lower blood sugar levels in people with type 2 diabetes. People with diabetes should use caution.

Milk Thistle References

 

PubMed Articles About


Source: National Center for Biotechnology Information (NCBI)[Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; [1988] – [cited 2018 Apr 5]. Available from: https://www.ncbi.nlm.nih.gov/

Brauer, P., Royall, D., Rodrigues, A., (2021) Use of the Healthy Eating Index in Intervention Studies for Cardiometabolic Risk Conditions: A Systematic Review.

Researchers and counselors need diet-assessment tools that characterize diet at baseline and over time in diet counseling and coaching interventions. Among possible tools, the Healthy Eating Index (HEI) is of interest in cardiometabolic treatment as it has undergone significant validation and development. The objective of this study was to systematically review relevant intervention studies using the HEI and its adaptations to examine whether diet interventions improve diet quality as measured by the HEI and the magnitude of change in included diet-quality scores following dietary intervention. Two databases [Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed] were searched for articles published from January 1995 to December 2019. The review included intervention studies in adults presenting with overweight/obesity and obesity-related chronic disease (metabolic syndrome, diabetes, prediabetes, hypertension, dyslipidemia) who received education or counseling, and the HEI was evaluated from baseline to follow-up (US or Canadian version) or Alternate HEI. Study quality was assessed using Cochrane risk of bias for randomized controlled trials (RCTs) or Cochrane Risk of Bias for Nonrandomized interventions (ROBINS-I). A total of 25 studies were included: 15 RCTs, 3 quasi-experimental studies, and 7 pre-post studies. Eight different versions of the HEI were used. Results demonstrated that diet quality assessed by HEI and its adaptations improved to a clinically relevant degree, especially in studies where multiple food behaviors/food-behavior goals were the focus and where an intensive, long-term intervention was compared with a no-treatment control group. There was wide variation in magnitude of change in included diet-quality indicators. Use of the HEI and its adaptations and other diet-quality tools is promising for better characterization of diet-counseling interventions and results when multiple food behaviors are a focus. Additional development is encouraged.

Wang, CX., Wu, D., Yang, PP., Wu, QH., (2020) [Efficacy and safety of non-vitamin K antagonist versus vitamin K antagonist oral anticoagulants in the prevention and treatment of thrombotic disease in active cancer patients: a systematic review and meta-analysis of randomized controlled trials].

We aimed to compare the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOAC) and vitamin K antagonist (VKA) in the prevention and treatment of thrombotic diseases in patients with active cancer. To find randomized controlled trials (RCT) in which NOACs were compared VKAs in active cancer, we searched the electronic databases (PubMed, Web of Science and Clinical Trials) up to May 2019 and and languages restricted to Chinese and English. According to the screening strategy, two researchers independently screened and extracted literature, evaluated the quality of literature, the suitability of collected cross study data for analysis, and tested the heterogeneity. The relative risk () and 95% confidence interval (95%) of major bleeding, clinically related non-major bleeding, VTE, stroke and all-cause mortality in active cancer patients with VTE, active cancer patients with non-valvular atrial fibrillation (NVAF) was calculated and the results were compared between NOAC with VKA. A total of 9 RCTs were included, including 5 cancers with VTE (5/9) and 4 cancers with NVAF (4/9). A total of 5 867 patients were included. After excluding 1 818 (30.99%) patients with cancer history, 4 049 (68.86%) patients with active cancer were statistically analyzed. Among them, 2 278 (56.26%) received NOAC treatment, 1 771 patients (43.74%) received VKA treatment. The quality of the included documents was high (all scores were>5 points), and the data of each included document could be summarized and analyzed (>0.05). The heterogeneity of main outcome events was very low ( = 0). In VTE patients with active cancer, NOACs were more effective in reducing recurrence of VTE (=0.55, 95% 0.36 -0.84; 0.005) and clinically related non-major bleeding (=0.77, 95% 0.60 -0.98; 0.03) than VKAs. In NVAF patients with active cancer, efficacy of NOACs and VKAs was similar in terms of reducing VTE, stroke, clinically related non-major bleeding, major bleeding and all-cause mortality events (>0.05). For patients with active cancer accompanied by VTE, NOAC may has more advantages in efficacy and safety compared to VKA in the prevention and treatment of thrombotic diseases.

Zhang, ZD., Liu, H., Lyu, J., Yu, DD., Sun, MH., (2020) [Systematic review and Meta-analysis of efficacy and safety of Xiangsha Yangwei Pills in treatment of chronic gastritis].

To systematically evaluate the efficacy and safety of Xiangsha Yangwei Pills in the treatment of chronic gastritis. Compu-ter retrieval was performed for Cochrane Library, Medline, EMbase, China Knowledge Network Database(CNKI), China Biomedical Literature Service System(SinoMed), Chongqing Weipu Chinese Science and Technology Journal Database(VIP) and WanFang Database(WanFang) randomized controlled trials about Xiangsha Yangwei Pills combined with Western medicine in the treatment of chro-nic gastritis. The retrieval time ranged from the establishment of the library to April 26, 2019. Meta-analysis was performed by RevMan 5.3 software after two independent researchers conducted literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. A total of 1 720 patients were enrolled in 18 RCT. According to the classification of chronic gastritis, they were divided into three subgroups: chronic gastritis, chronic atrophic gastritis and chronic superficial gastritis. The results of Meta-ana-lysis showed that the efficacy of Xiangsha Yangwei Pills combined with Western medicine in treating chronic gastritis was higher than that of Western medicine. As for the recurrence rate, Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine. And there was no statistical difference about helicobacter pylori(Hp) eradication rate between Xiangsha Yangwei Pills combined with Western medicine as well as Western medicine. In terms of the incidence of adverse reactions, Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine, and no serious adverse reaction was reported. The results of this systematic review showed that compared with the conventional Western medicine group, Xiangsha Yangwei Pills combined with Western medicine can significantly alleviate clinical symptoms of chronic gastritis, with fewer adverse reactions. However, due to the low methodological quality of the included studies and the reliability of the impact conclusions, high-quality multi-center, large-sample, randomized, double-blind controlled trials are needed for validation.

Clifford, T., Jeffries, O., Stevenson, EJ., Davies, KAB., (2020) The effects of vitamin C and E on exercise-induced physiological adaptations: a systematic review and Meta-analysis of randomized controlled trials.

We conducted a systematic review and meta-analysis of randomized controlled trials examining the effect of vitamin C and/or E on exercise-induced training adaptations. Medline, Embase and SPORTDiscus databases were searched for articles from inception until June 2019. Inclusion criteria was studies in adult humans where vitamin C and/or E had to be consumed alongside a supervised exercise training program of ≥4 weeks. Nine trials were included in the analysis of aerobic exercise adaptations and nine for resistance training (RT) adaptations. Vitamin C and/or E did not attenuate aerobic exercise induced improvements in maximal aerobic capacity (O (SMD -0.14, 95% CI: -0.43 to 0.15,  = 0.35) or endurance performance (SMD -0.01, 95% CI: -0.38 to 0.36,  = 0.97). There were also no effects of these supplements on lean mass and muscle strength following RT (SMD -0.07, 95% CI: -0.36 to 0.23,  = 0.67) and (SMD -0.15, 95% CI: -0.16 to 0.46,  = 0.35), respectively. There was also no influence of age on any of these outcomes ( > 0.05). These findings suggest that vitamin C and/or E does not inhibit exercise-induced changes in physiological function. Studies with larger sample sizes and adequate power are still required.

Chen, G., Chen, Y., Chen, Z., Gao, S., Zhang, P., Zhang, H., Huang, Y., Lin, Y., Wei, L., (2021) Sanao decoction for asthma: Protocol of a systematic review.

Asthma is a chronic inflammatory disease characterized by recurrent attacks of breathlessness and wheezing, which often worsen at night or in the early morning and vary from person to person in severity and frequency. Sanao decoction (SAD), as a traditional Chinese medicine compound, has a long history of clinical application in the treatment of respiratory diseases. Whereas neither systematic nor meta-analysis of randomized controlled articles explain the efficacy of SAD in treating asthma. Therefore, we provide a protocol to evaluate the efficacy and safety of SAD for asthma.