Milk thistle has become, over the last decade, one of the most commonly used herbs in natural veterinary medicine, addressing a whole host of issues most often related to active liver disease, or in hopes of slowing the likelihood of liver problems associated with longterm use of phenobarbitol in epileptic dogs. For humans too, milk thistle is a very popular remedy, used to offset the ill effects of alcohol abuse and acetaminophen and generally support liver health. Its antioxidant properties make it a good herb to consider in both cancer therapy and prevention; there are multiple uses, such as helping to control blood sugar spikes, that are not popularly associated with it but well worth investigation. As with even the safest of plants, some caution should be exercised with sensitive individuals; there are also interactions with certain drugs that should be borne in mind. Many researchers feel that longterm use of milk thistle can actually weaken liver function so recommend staggering the dose – 3- 6 weeks on, 1 – 3 weeks off . I’ve heard argument both for and against this practise and cannot find conclusive evidence, so my tendency is to err on the side of caution; I stagger the dose with all dogs in my care. But Silymarin is one of the best researched herbs we have, its safety and efficacy are well documented. below, a few aspects of this wonderful plant – history, how and when to use, and more.
Family: Asteraceae (Daisy, Sunflower family, sometimes called Compositae)
Distribution: widespread; indigenous to Southern and Western Europe, naturalized to North and South America
Common Names: Holy Thistle, Marian Thistle, St. Mary’s Thistle, Chardon-Marie, Mariendistel. In Chinese Medicine known as shu fei ji. Not to be confused with Blessed Thistle, Cnicus Benedictus.
Energetics: Various descriptions; primarly bitter, warming.
Constituents: Silymarin, a flavonoid complex comprised of silibinin, silidianin and silichristine. Most benefits of milk thistle derive from these three, probably primarily silibinin. Other constituents include sterols, lignans, mucilage, biogenic amines and other flavonoids.
Clinical Actions: Hepatoprotective, demulcent, antioxidant, cholagogue, galactagogue
Parts Used:Seed collected in late summer. Historically the leaves were eaten (in Europe) as a vegetable and the fruit a delicacy like artichoke. History and Traditional Usage:Milk thistle has a history of use that spans two millennia (as far as we know). Often thought of as simply a “liver herb” – and it is unparalleled in that regard – there is a great deal more to this herb than the protective and regenerative support it offers the liver.Mrs. Grieves tell us this: “Westmacott, writing in 1694, says of this Thistle: ‘It is a Friend to the Liver and Blood: the prickles cut off, they were formerly used to be boiled in the Spring and eaten with other herbs; but as the World decays, so doth the Use of good old things and others more delicate and less virtuous brought in.’ “ The use of Milk Thistle dates further back than Westacott. The first references I know of are from circa 25 AD, from the Roman naturalist Pliny the Elder, who tells us that “the juices will carry the bile”- the famed Roman Physician Dioscorides used the seeds “for infants, and against snakebite”. Gerard used milk thistle and considered it “ the best remedy for all melancholy diseases” which physicians at the time considered a liver complaint. Culpepper, the famous British herbalist who practised half a century later, used the name Our Lady’s thistle instead of Milk thistle. He recommended its use in the treatment of disorders affecting the liver and spleen, the kidney’s in provoking the flow of urine, to break and expel stones and also to treat dropsy. By the 19th century Milk thistle was commonly used by German physicians for the treatment of liver and blood problems, as well as for intestinal cleansing. Again the seeds were found to contain the active principle that has the specific effect on the liver. No mention of the plant exists in Native American herbology
Modern Application(human): Published research provides us with the following: Silymarin has the following effects and can be used for any or all of the following: – Antioxidant effect – inhibition of lipid peroxidation in hepatoctye plasma membranes, this inhibiting the action of multiple toxic agents – chelates iron and decreases glutathione destruction in iron overload conditions – stabilizes mast cells – slows calcium metabolism – decreases activity of tumor-promoting factor.Useful for liver disease: Useful in a wide range of hepatic disorders, including toxin and drug induced as well as viral hepatitis, alcoholic liver disease, and cirrhosis. Milk thistle decreases aminotransferase activity and improves clinical parameters consistently with all of these pathologies. Use in all acute and chronic cases with dosage appropriate to condition and duration of use.
Liver Disease: protection against toxins, supports regeneration of healthy cells, anti-inflammatory; useful post-disease, vaccination or drug therapy also for hepatitis, generalized inflammation, toxin recovery, portosystemic shunt – any and all liver disease of the canine
Kidney disease: In vitro, oxidative damage to kidney cells were reduced by silymarin. Worth adding to a renal protocol for human or canine.
Pancreatitis: Induced pancreatitis in rats was significantly ameliorated with silymarin (Soto, 1998). Should be used in cases of cyclosporine use,to protect pancreas from damage.
Cancer: May have value in prevention, especially prostate cancer. Use as a rotated antioxidant with ellagic acid, alpha-lipoic acid and COQ10.
Hyperlipidemia: Susan Wynn writes that “Animal studies have suggested that silymarin can help control blood lipid levels possibly by modulating absorption of cholesterol”. This response has not been noted in humans but it suggests an application for dogs with hyperlipidemia, such as miniature schnauzers and any diabetic dog.
Diabetes: helps prevent diabetic neuropathy in afflicted dogs
Personally, I use Milk Thistle in a variety of ways, both proactively (twice a year, a 6 week round of the standardized extract) and therapeutically, in all liver disorders, and with pancreatitis, cancer (according to type) and renal dysfunction. As always the herb should not be expected to compensate for a diet inappropriate for the condition so, adjustment of fats,carbohydrate and/or protein ,plus an emphasis on specific kinds of these nutrients, is always the bottom line of therapy. I never expect herbs to work optimally if the diet is working against the goals of the individual. Irrespective of diet I do however use MT in all cases of liver toxicity, poisoning, for hepatitis, and post- or during chemotherapy. My own senior dog is on 250 mgs of standardized extract TID and will remain so for the rest of her life, with “rests” of 3-4 weeks every few months. For me, milk thistle is indispensable for epileptic dogs on phenobarbitol as well. Most of the researchers I have looked at, including Susan Wynn DVM, Barbara Fougeres, co-author of the comprehensive Veterinary Herbal Medicine, Gregory Tilford and Mary Wulff-Tilford, authors of the classic Herbs for Pets and all related independent studies, suggest that milk thistle should not be used on a daily basis, despite it’s marvelous healing properties. The Tilfords write that “milk thistle is a medicine that is best reserved for situations where the liver is under abnormal stress”. I can’t say I agree 100% with this; I would say that dosage and duration depends on multiple factors and while I would use high doses for any acute case of poisoning or other acute liver distress, I have used it longer-term for a variety of conditions – with the qualifier I do give a “rest” every2-3 months for several weeks in these cases.
Toxicology: Relatively non-toxic and safe – if any reaction occurs it is most often allergic or gastrointestinal. For this reason I always recommend small initial doses and a build up to therapeutic levels. Susan Wynn has noted two cases in which supplemental milk thistle was associated with an elevation in ALT levels; given the very small number of cases in which this occurred it is believed to have been an allergic reaction. Since silymarin stimulates liver and gallbladder activity, increasing bile secretion, it may have a mild, transient (2-3 days) laxative effect in some individuals. Allergic reaction is rare; however, it should not be used by people with hypersensitivity to it or other plants in the Asteraceae family (e.g. ragweed). Other rare associated effects include GI upset, headache, rash, insomnia and malaise.
Drug Interactions: Milk thistle may reduce the insulin requirement for diabetic dogs due to it’s capacity to lower blood sugar levels: it has also been shown to protect organs when the patient is taking cisplatin, acetaminophen, butyrophenones, halothane, phenothiazines, tacrine and vincristine.People using antipsychotic medications, yohimbine, or male hormones such as testosterone should not take milk thistle. J.P. Haas, MD tells us this: Indinavir – There have been reports that milk thistle interferes with the disposition of the HIV protease inhibitor indinavir. However, Piscitelli et al. (2002) determined that 175 mg doses of milk thistle taken three times daily did not significantly interfere with indinavir levels. Cytochrome p450 – Some studies have suggested possible interaction with certain medications due to milk thistle’s utilization of cytochrome p450 pathways. Milk thistle was studied in relation to known cytochrome p450 inducers (rifampin) and inhibitors (clarithromycin) and was found not to have a significant effect of CYP3A (Gurley et al. 2006).
Preparation A variety of methods are useful for this herb, although this writer prefers dried standardized extract for the canine. Alcohol tincture may also be used; glycerite is usually easier to get the canine to accept but it is more difficult to extract the active constituents in glycerin or low alcohol.,as dogs dislike the taste of the alcohol tincture so much I generally use a standardized powder extract. It’s important to note in cases of acute liver disease with smaller dogs, adding alcohol might not be wise!
Dosage: Of the standardized extract (powder) I use 2- 5 mgs. per lb BW, 2 – 3 times daily. If using an alcohol tincture I like 1-2 drops per lb BW, twice daily with food. Jean Hofve uses up to 200 mg per 10 lbs BW for acute illness involving the liver.
Also Consider: Depending on the condition and individual (dog or human) consider licorice, dandelion, Oregon grape, burdock, yellow dock or turmeric.
Resources/Further Reading (veterinary):
Manual of Natural Veterinary Medicine, Susan Wynn DVM and Steve Marsden DVM
Veterinary Herbal Medicine, Susan Wynn DVM and Barbara Fougeres
Herbs for Pets, MaryL. Wulff-Tilford and Gregory L. Tilford
Botanical Medicines; the Desk Reference for Herbal Supplements; McKenna, Jones, Hughes, Humphrey
The Natural Health Bible for Dogs and Cats, Shawn Messonnier DVM
article Jean Hofve, DVM: http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm