Licorice is the natural expectorant herbal supplement and is excellent for protecting liver

This invaluable herb has a strong religious history. The early Christians first dedicated the tall Mediterranean annual to Mary, naming it Marian Thistle. From 23-79 AD Pliny the Elder, an early Roman physician and naturalist, recorded its use as a remedy, documenting Milk Thistle to be a powerful tonic for protecting the liver. Other early accounts report the Greek physician Dioscordes, frequently using an extract of the plant to cure snakebites and mushroom poisoning. In 1150, a medieval herbal journal written by the German theologian and music composer, “Hildegarde of Bingen”, recounted the many uses of the plant. By the early seventeenth century, noted English physician Nicolas Culpepper, again recorded the astounding effects of Milk Thistle on liver and spleen production, his findings published in the late eighteenth century.

The Milk Thistle, or Silymarin as it is often referred to, is native to Southern Europe, the Mediterranean and Northern Africa. It thick stem can sometimes reach as high as 10 feet. Its large, solitary purple-red flower head is easily recognizable and picked while in full bloom during the early summer. The leaves of Milk Thistle are variegated and light to dark green in color, each veined with white and covered in tiny spikes. When this herb, a relative to the sunflower, goes to seed in late summer, it produces hard, black, shiny fruits (pappus or seeds), each leading to a white feathery tuft, similar to seeded dandelion. The stem of this often-invasive plant is filled with a milky white sap, hence its name Milk Thistle. The Christians believed the white veins on the leaves to be representative of Mary’s milk and believed the plant could induce milk in new mothers.

Milk Thistle was brought to eastern America by the early settlers as a food plant and by the1940s, it had spread throughout the northern and central valley of California where today, is it considered a weed. It thrives in sunny open areas such as abandoned fields, pastures and along roadsides. By 1949, results of animal trials concluded, that Milk Thistle had numerous positive effects on poisoning from carbon tetrachlorine (a chemical encountered by Gulf War soldiers).¹

It wasn’t until 1968 however, when German scientist H. Wagner of the University of Munich, actually isolated the first flavonolignan (silybin or silymarin as it is also known) as the active component found in the fruits (seeds) of Milk Thistle. Later, further flavonolignans were found, resulting in over 100 additional clinical trials on the plant’s effectiveness in liver detoxification. Effectively, all of the research today concentrates on the fruit of the plant; however, historical records show the roots, plant and leaves being used in medicinal remedies and as ingredients in various culinary recipes. Today, the seeds are roasted then ground and frequently used as a coffee substitute. Some people even enjoy the boiled flower heads prepared and eaten like artichokes.

Milk Thistle has proven effective for liver damage for over 2000 years. Today, research confirms this theory and according to Ogletree et al. (1997) the process follows three pathways: (1) antioxidant activity, (2) protection of the heptacellular (liver) membrane, and (3) stimulation of the hepatocytes. In layman’s terms, the active components in the fruits (antioxidents) actually alter the outer cell membrane of liver cells so that certain toxins, like the Death Cap mushroom, cannot invade the cells. As well, flavonolignans in the milk thistle extract then stimulate regeneration of new liver cells, essentially reversing the often deadly effects of liver damage.

The US Agency for Healthcare Research and Quality (AHRQ) conducted what is probably the most comprehensive study on Milk Thistle to date. In an effort to thoroughly examine the effects of Silymarin as an alternative treatment for liver disease, 16 separate scientific studies were identified.

Although numerous problems arose throughout the study, ultimately making it difficult to come to any definite conclusions, results in five out of seven trials found significant improvements in liver function in patients with alcohol-related liver disease. The study also postulated that Milk Thistle is most effective when used as a remedy for milder forms of liver disease. Although some results were noticed in cases of Cirrhosis (usually characterized as the final non-reversible stage of liver disease), changes in liver function were not as significant as in those in reversible liver damage.²

In Germany, Milk Thistle is highly recognized as a potent cure for both liver disease and as the only anti-dote for Death Cap mushroom poisoning, a native European mushroom that has also been seen in Oregon, California, Australia and Asia. The German equivalent to the US Federal Drug Administration (FDA), the Commission E, encourages and allows Milk Thistle as a regulated herb for preventative and curative purposes. In fact, in Western Europe, Milk Thistle is regularly found as an antidote in hospitals and medical centers for poisoning form Death Cap mushrooms. It is proven that if given in time, intravenous Milk Thistle will lower the mortality rate of this deadly fungus.

Milk Thistle is also proving beneficial in some cancer-related cases. Laboratory tests suggest that the antioxidents in Milk Thistle may have anti-carcinogenic effects. These studies show that the flavonolignans contained in the fruits can prohibit growth of prostate, breast, and cervical cancer cells in test tubes.³

Studies continue to be encouraging and one such study indicates that the active component, silybin, in Milk Thistle is just as effective in lowering cholesterol levels in animals as a common drug probucol. The study concluded that silybin is also effective for increasing HDL (good) cholesterol levels, all without the side effects commonly associated with prescription drugs.⁴

Silymarin is not well absorbed in water nor is it well absorbed by the gastrointestinal tract, so high standardized concentrations are best to assure sufficient absorption into the blood stream. As well, because Milk Thistle is not water soluble, its effectiveness as a tea is doubtful. Many companies market the Milk Thistle tea, however only 10 percent of the actual active plant ingredients are actually absorbed.

The most effective form of Milk Thistle is by injection but as of yet, North American supplements are only sold in tincture, tablet, liquid, capsule and softgel form. Because Milk Thistle is so poorly absorbed, it is especially important to find a supplement that is standardized as 70-80 percent Silymarin, the active component in Milk Thistle. The recommended dose for all liver problems is 400 – 600 mg of the standardized concentration. Some companies will also market Mil Thistle products that contain ‘Milk Thistle leaves’. These products are not useful since the only active components have been found in the fruits, and as such it is important to make sure you are purchasing only products containing standardized silymarin.

No known side effects exist for Milk Thistle. In fact, in one study of 2,169 people only one percent experienced some stomach upset. If you are planning to use Milk Thistle to treat a liver disease however, it is extremely important to do so under a trained and knowledgeable health practitioner. Liver disease is be serious and should never be monitored without medical intervention.

References:

1. Ogletree et al. (1997).
2. Agency for Healthcare Research and Quality. Milk thistle: effects on liver disease and cirrhosis and clinical adverse effects. Summary, evidence report/technology assessment: number 21, September 2000. Accessed at: http://www.ahrq.gov/clinic/milktsum.htm on April 15, 2002.
3. Jiang C, Agarwal R, Lu J, “Anti-angiogenic potential of a cancer chemopreventive flavonoid antioxidant, Silymairn: inhibition of key attributes of vascular endothelial cells and angiogenic cytokine secretion by cancer epithelial cells”, Biochem Biophys Res Commun. 2000;276:371-378.
4. Krecman V, Skottova N, Walterova D, Ulrichova J, Simanek V, “Silymarin inhibits the development of diet-induced hypercholesterolemia in rats”, Planta Med. 1998;64(2):138-142.