Milk Thistle (PDQ®)–Patient Version
- Milk thistle is a plant whose fruit and seeds are used for liver and bile duct disorders (see Question 1).
- Milk thistle is usually taken in capsules or tablets (see Question 2).
- Studies of milk thistle have been done in acute lymphoblastic leukemia, prostate cancer, breast cancer, and head and neck cancer (see Question 4).
- Side effects from the use of milk thistle or silymarin are mild (see Question 5).
- The U.S. Food and Drug Administration has not approved the use of milk thistle as a treatment for cancer or any other medical condition (see Question 6).
- Milk thistle is available in the United States as a dietary supplement (see Question 6).
Questions and Answers About Milk Thistle
What is milk thistle?
Milk thistle is a plant whose fruit and seeds have been used for more than 2,000 years as a treatment for liver and bile duct disorders. Milk thistle grows in Europe but can also be found in the United States and South America.
Silymarin, found in milk thistle seeds, is a mixture that contains compounds, such as silybin, isosilybin, silychristin and isosilychristin, silydianin, and taxifolin. Most studies have been done in silymarin or silybin, instead of the whole plant.
The botanical name for milk thistle is Silybum marianum. Milk thistle is also called holy thistle, Marian thistle, Mary thistle, St. Mary thistle, Our Lady's thistle, wild artichoke, Mariendistel (German), and Chardon-Marie (French).
- How is milk thistle taken or given?
Have any laboratory or animal studies been done using
In laboratory studies, tumor cells are used to test a substance to find out if it is likely to have any anticancer effects. In animal studies, tests are done to see if a drug, procedure, or treatment is safe and effective in animals. Laboratory and animal studies are done before a substance is tested in people.
Laboratory and animal studies have tested the effects of milk thistle in laboratory experiments. Silymarin, the active substance found in milk thistle seeds, and silybin A and B, the major components of silymarin, have been studied in laboratory research. See the Laboratory/Animal/Preclinical Studies section of the health professional version of Milk Thistle for information on laboratory and animal studies done using milk thistle.
Have any studies of milk thistle been done in people?
Several small studies have looked at whether milk thistle can be used to decrease side effects of cancer treatment.
- A randomized clinical trial in children with acute lymphoblastic leukemia found that silymarin decreased the side effects of chemotherapy on the liver without harming the cancer treatment.
- A randomized clinical trial in men with prostate cancer who had surgery to remove their prostate found that taking silymarin and selenium improved quality of life, lowered cholesterol, and increased the amount of selenium in the blood.
- A randomized clinical trial of 30 patients with head and neck cancer who had radiation therapy found that those who took silymarin for 6 weeks had lower rates of radiation-related mucositis compared to those who did not.
- A nonrandomized observational study in women with breast cancer who had surgery and radiation therapy found that a silymarin-based cream helped prevent patients from having skin rashes from radiation therapy.
A number of clinical trials have studied milk thistle in the treatment of patients with hepatitis, cirrhosis, mushroom poisoning, or bile duct disorders. These trials have used a wide range of doses with mixed results. In a trial of biologic therapy for patients with chronic hepatitis, patients taking silymarin had less symptoms and a better quality of life compared to patients not taking silymarin.
Have any side effects or risks been reported from milk thistle?
Very few side effects from the use of milk thistle or silymarin have been reported. Several large studies in patients with liver disorders have found that taking silymarin may rarely have a laxative effect or cause nausea, heartburn, or stomach upset. At high doses, mild allergic reactions have been seen.
Is milk thistle approved by the U.S. Food and Drug Administration (FDA) for use as a cancer treatment in the United States?
Milk thistle is available in the United States as a dietary supplement. Dietary supplements are products meant to be added to the diet. They are not drugs and are not meant to treat, prevent, or cure diseases. The company that makes the dietary supplements is responsible for making sure they are safe and that the claims on the label are true and do not mislead the public. The FDA does not approve dietary supplements as safe or effective before they are sold.
Current Clinical Trials
About This PDQ Summary
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the use of milk thistle in the treatment of people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
The best way to cite this PDQ summary is:
PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Milk Thistle. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/treatment/cam/patient/milk-thistle-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389281]
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The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
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General CAM Information
Complementary and alternative medicine (CAM)—also called integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.
Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.
Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any type of treatment. Some complementary and alternative therapies may affect their standard treatment or may be harmful when used with conventional treatment.
Evaluation of CAM Therapies
It is important that the same scientific methods used to test conventional therapies are used to test CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to test CAM therapies for use in cancer.
Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have been tested using demanding scientific methods. A small number of CAM therapies that were thought to be purely alternative approaches are now being used in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) meeting in November 1997, acupuncture has been found to help control nausea and vomiting caused by chemotherapy and pain related to surgery. However, some approaches, such as the use of laetrile, have been studied and found not to work and to possibly cause harm.
The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being studied. The program is overseen by the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients’ medical records and related materials to OCCAM. OCCAM carefully reviews these materials to see if any seem worth further research.
Questions to Ask Your Health Care Provider About CAM
When considering complementary and alternative therapies, patients should ask their health care provider the following questions:
- What side effects can be expected?
- What are the risks related to this therapy?
- What benefits can be expected from this therapy?
- Do the known benefits outweigh the risks?
- Will the therapy affect conventional treatment?
- Is this therapy part of a clinical trial?
- If so, who is the sponsor of the trial?
- Will the therapy be covered by health insurance?
To Learn More About CAM
National Center for Complementary and Integrative Health (NCCIH)
The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.
- NCCIH Clearinghouse
- Post Office Box 7923 Gaithersburg, MD 20898–7923
- Telephone: 1-888-644-6226 (toll free)
- TTY (for deaf and hard of hearing callers): 1-866-464-3615
- E-mail: email@example.com
- Website: https://nccih.nih.gov
CAM on PubMed
NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.)
Office of Cancer Complementary and Alternative Medicine
The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website.
National Cancer Institute (NCI) Cancer Information Service
U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.
Food and Drug Administration
The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.
- Food and Drug Administration
- 10903 New Hampshire Avenue
- Silver Spring, MD 20993
- Telephone: 1-888-463-6332 (toll free)
- Website: http://www.fda.gov
Federal Trade Commission
The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:
- Who Cares: Sources of Information About Health Care Products and Services
- Fraudulent Health Claims: Don’t Be Fooled
- Consumer Response Center
- Federal Trade Commission
- 600 Pennsylvania Avenue, NW
- Washington, DC 20580
- Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free)
- TTY (for deaf and hard of hearing callers): 202-326-2502
- Website: http://www.ftc.gov