Milk thistle

Milk thistle: what was it used for?

A food and a liver medicine. Dioscorides knew it as a pot-herb, the young shoots boiled with oil and salt, and its root juice as an emetic. The assessment report of the European Medicines Agency, following the Commission E monograph, records that the leaves were used for a variety of ailments, particularly of the liver, since Greco-Roman times, that American Eclectic physicians of the late nineteenth and early twentieth centuries valued the seeds for congestion of the liver, spleen, and kidneys, and that in Germany it was widely used for “chronic hepatitis of all types.”

Milk thistle: what does modern science say?

The European Medicines Agency’s herbal committee accepts the fruit as a traditional herbal medicine, “exclusively based upon long-standing use,” for the symptomatic relief of digestive disorders, fullness, and indigestion and to support the liver function, after serious conditions have been excluded by a doctor (monograph of 2018). Its assessment report finds 1.3 to 3 per cent of flavonolignans, silibinin, isosilibinin, silicristin, and silidianin, with 20 to 30 per cent of fatty oil. The trials of its use in liver disease are less favourable. A Cochrane review of 2007, of eighteen trials in 1,088 patients with alcoholic or viral liver disease, found no significant effect on mortality, complications, or liver histology, and its results “question the beneficial effects of milk thistle” in these diseases. A Cochrane review of 2025, in metabolic fatty liver disease, found the benefits and harms unclear: silymarin alone may lower liver enzymes against placebo, on low or very low certainty evidence. LiverTox, revised in 2020, likewise records that controlled trials in chronic hepatitis C and fatty liver disease found little or no evidence of benefit, and that intravenous silibinin is approved in Europe for poisoning by the mushroom Amanita phalloides. A 2025 network meta-analysis in type 2 diabetes found that silymarin significantly improved fasting glucose and HbA1c against placebo.

Milk thistle: what did the older authorities say?

Dioscorides, De materia medica 4.159

His silubon, which the modern translators suggest is the milk thistle, is a broad acantha with leaves like the white chamaeleon. Newly sprung up, it is eaten boiled with oil and salt, and the juice of the root, a teaspoonful drunk with honey and water, “encourages vomiting.”