Milk Thistle

بحث ال Milk Thistle التابع للبرنامج العلمى الأول للأبحاث,,,



الرابط

MILK THISTLE

Milk Thistle
Name of plant: Silybum marianum
family Asteraceae


Description Milk thistle is a long biennial herb which grows up to about 2 m high. Typical for milk thistle are the milk-white veins of the dark-green leaves. These leaves are toothed with sharp spines. The flowers are red-purple and bear brown shiny fruits


Part used
Mainly the ripe fruits or seeds of the milk thistle are used. Sometime the root or aerial parts are used


Habitat The plant is indigenous to Europe


Other Names Marian Thistle, Mediterranean Milk Thistle Mary Thistle



Active constituents Silymarin (flavonolignan mixture, 1.5-3%): chief components silybin A, silybin B (mixture known as silibinin), isosilybinA, isosilybin B, silychristin,

silydianin Flavonoids: apigenin, chrysoeriol, eriodictyol, naringenin,quercetin, taxifolin Fatty oil (20-30%)k




Method of extraction
It was found that water at 85-100°C was effective in extracting flavanolignans and the dihydroquercitin taxifolin from milk thistle without prior defatting with petroleum ether. It was also showed that the more polar taxifolin was preferentially extracted at lower temperatures, while the more nonpolar silybinin compounds were preferentially extracted at increased temperature.

Mechanism of action:


Milk thistle provides hepatocellular protection by stabilizing hepatic cell membranes. It alter the structure of the outer cell membrane of the hepatocytes in such a way as to prevent the penetration of the liver toxins into interior of the cell. It has a stimulation effect on nucleolar polymerase A, which results in an increase in ribosomal protein synthesis, and thus increases the regenerative ability of the liver and the formation of new hepatocytes. Other actions include interruption of enterohepatic recirculation of toxins and regeneration of damaged hepatocytes.
An animal study performed in rats demonstrated a reduction in kidney damage following administration of cisplatin without diminished anti-tumor activity. Other studies indicate the flavonoids in milk thistle have anticancer effects by inducing G1 and S phase arrest in cells. Anecdotal data suggests that milk thistle may prevent liver damage from hepatotoxic medications including butyrophenones, phenothiazines, and phenytoin.
Milk thistle prevents toxins from entering the liver by guarding the organ's numerous doorways-the membranes of liver cells. By slowing the rate at which the liver absorbs harmful substances, the toxins are excreted through the kidneys before they can cause liver damage. The most dramatic example of this is Milk Thistle's ability to block poisons from the death cap, mushroom (Amanita phalloides), one of the most notorious liver toxins known to humans. In a group of 49 patients with Amanita poisoning, physicians rated the results as amazing and spectacular after patients were given injections (20 mg/kg daily) of silybin, a major constituent in Milk Thistle. All of the patients survived, even though they were treated 24 to 36 hours after poisoning, when liver and kidney damage had already occurred. The death rate in emergency rooms from Amanita poisoning is usually 30 to 40 percent. Milk thistle acts in a similar fashion to detoxify other synthetic chemicals that find their way into our bodies, from acetaminophen and alcohol to heavy metals and radiation.
Much of Milk Thistle's protective effect is due to the flavonoid complex silymarin, which acts as a powerful antioxidant, combining with and thus neutralizing harmful free radicals that result from normal metabolic processes and from the breakdown of toxic substances. At least 10 times as potent as vitamin E, silymarin also helps increase levels of two additional antioxidants, glutathione and superoxide dismutase (SOD). A laboratory study showed that silymarin may increase glutathione ******* in the liver and intestines by up to 50 percent. Silymarin also increases the activity of SOD in erythrocytes (red blood cells) and lymphocytes (white blood cells) formed in the lymphatic tissue in patients with liver disease. Because silymarin is a potent antioxidant in the stomach and intestines, it may also have a role to play in treating inflammatory conditions such as colitis and ulcers.
When damage has already been done, Milk Thistle aids the liver in repairing injured cells and generating new ones. It does this by stimulating protein synthesis through the enzyme RNA polymerase I. Protein is a basic building block of cell walls, cell structures, and enzymes that are vital to all body processes. Recent evidence suggests that the constituent silybin may be responsible for stimulating protein synthesis, because it imitates a steroid hormone. Silybin increases protein synthesis by up to 25 to 30 percent, compared with controls. Milk thistle's regenerative ability is essential for treating serious conditions such as chronic hepatitis, cirrhosis, and toxic fatty deposits in the liver.
Recent evidence suggests that silymarin may be just as important for kidney health. Silymarin concentrates in kidney cells, where it aids in repair and regeneration by increasing protein and nucleic acid synthesis. One study showed that it increased cell replication by 25 to 30 percent.
Of the many compounds that make up the silymarin complex, silybin and silychristin are the two most potent ones, according to current pharmacological studies.
Unfortunately, these compounds are relatively poorly absorbed by the gastrointestinal tract. Some studies suggest an absorption rate of just 20 to 50 percent, which explains why it is so important to take standardized Milk Thistle extracts to ensure high concentrations of the active ingredients.


Clinical effects

Liver Cell Growth-Silymarin from milk thistle appears to promote the growth of some types of cells in the liver. Milk thistle is not used to prevent Hepatitis C Virus from causing liver disease. Rather, milk thistle is used with the hope that it would minimize the damage to the liver that HCV can cause.

Antihepatotoxic Activity-Studies suggest that silymarin from milk thistle can block various types of toxins from entering and injuring liver cells.

Antioxidation-Milk thistle's Silymarin may be an effective "antioxidant," which means milk thistle may help fight a destructive chemical process in the body known as "oxidation." In oxidation, harmful substances produced in the body (called free radicals) can damage cells. Some studies suggest that milk thistle (silymarin) can prevent these substances from damaging liver cells.

Inflammation Inhibition-Milk thistle's Silymarin is thought to prevent inflammation (swelling) of the liver; this may be described as displaying anti-inflammatory properties.

Blood lipids:silymarin may inhibit hepatic synthesis of cholesterol and reduce blood lipids, as shown in vitro, animal studies, and human trials.

Pancreas:As an antioxidant, silymarin can protect the pancreas against certain forms of damage. In a controlled trial of human diabetics, patients experienced decreases in blood glucose and insulin requirements.



Uses

Uses approved by commission E
Dyspeptic complaints Liver and gall bladder complaints Toxic liver damage, adjunctive treatment in chronic inflammatory liver disease and hepatic cirrhosis

Unproven Uses
The drug is also used as an antidote to death-cap mushroom poisoning

Uses in Silymarin's History
Liver Diseases: acute, chronic hepatitis
Protect liver from toxins, heavy metals, alcohol, poisons Cholagogue Fatty degeneration of the liver Jaundice Psoriasis Uterine tonic, menstrual difficulties Spleen, kidney, gall bladder tonic
Varicose veins

Side effects
No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Milk thistle is relatively nontoxic, and side effects from milk thistle happen only rarely, but may include stomach pain, nausea, vomiting, diarrhea, headache, rash or other skin reactions, joint pain, impotence, and anaphylaxis (a life-threatening allergic reaction that causes throat tightness, shortness of breath, and, possibly, loss of consciousness). The last two reactions listed are extremely rare

Note : People with allergies to plants in the aster family ( Compositea, Asteraceae ) or to daisies, artichokes, common thistle, kiwi, or to any of milk thistle's constituents (silibinin, silychistin, silydianin, silymonin, siliandrin) may have allergic reactions to milk thistle. Anaphylactic shock (a severe allergic reaction) from milk thistle tea or tablets has been reported in several patients.



Contraindication
*Avoid in pregnancy
*Allergy to chrysanthemums
*Hormone sensitive cancer


Interactions
Oral contraceptives
One report has noted that silybinin (a constituent of silymarin) can inhibit a bacterial enzyme called beta-glucuronidase, which plays a role in the activity of certain drugs, such as oral contraceptives. This could reduce their effectiveness.

Aspirin
One animal study found that milk thistle may enhance the effectiveness of aspirin in rats with liver cirrhosis.

Others
The concomitant use of silymarin and butyrphenones or phenothiazines results in a reduction of lipid peroxidation. Silymarin has an antagonistic effect with yohimbine and phentolamie when given simultaneously.


Precautions The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.


Dosage and regimen

200 – 400 mg/day divided into 3 doses using a standardized product that includes 70 – 80% silymarin.



Combinations
Most often used alone, but combines well with turmeric and artichoke.

Pharmaceutical forms
Capsules Tablets
Powders Suspensions

Trade names in Egypt

Silymarin in combinations ♦Normazan® tablets (Alfalfa leaf powder extract, Beet root powder, Black Radish, Choline, Dandelion, Inositol, Silymarin)

♦Levatech® Capsules
(Burdock root, Ginger, Parsley seed, Raphanus sativus niger, Silymarin, Traxacum officinale)


♦Levatone® Capsules
(Barberry extract, Cynara extract, Dandelion, Lecithin, Selenium, Silymarin, Zinc gluconate)



♦Liver albumin plus® Capsules
(Beet leaves, Betaine, Biotin, Black Radish, Brewer's yeast, Glutathione, Inositol, L-glutamine, Lecithin, Methionine, Egg albumin, Whey protein, Silymarin, Vitamin B12, Vitamin B1, Vitamin B2, Vitamin B6)



♦Simepar® Capsules
(Calcium pantothenate, Nicotinamide, Silymarin, Vitamin B12, Vitamin B1, Vitamin B2, Vitamin B6)


♦Levanox® Capsules
(Catechu tincture, Dandelion, Lecithin, Silymarin, Turmeric)


♦Cyncholine plus® Capsules
(Cynara extract, Magnesium oxide, Mentha dry extract, Silymarin)



♦Selectival® Capsules
(Dandelion, Folic acid, Selenium, Silymarin, Vitamin B12, Vitamin C, Vitamin E, Vitamin A) ♦Hepanox® Capsules (Glutathione, Selenium, Silymarin, Vitamin C, Vitamin E, Vitamin A, Zinc)


♦Liverin® Capsules
(Inositol, Methionine, Nicotinic acid, Pantothenic acid, Silymarin, Vitamin B12, Vitamin B1, Vitamin B2, Vitamin B6)


♦Seralon E® Capsules
(Silymarin, Vitamin E) وقريبا ان شاء الله:

♦Hepapro® Capsules
(Silymarin, Curcumin)



Silymarin alone

Hepamarin® Capsules Hepaticum® Suspension Hepaticum® Capsules Legalox® Tablets Legalon 35® Tablets Legalon 70® Tablets Mariagon® Capsules Mepasil® Tablets Silipex® Capsules Silymarin® Sachets Silymarin plus® Capsules Silymarin plus® Sachets

sReferences


*PDR for herbal medicines


*Comprehensive pharmacy review,6th edition, Chapter 35


*http://www.Silymarin.com


*Egypt Pharmaceutical drug directory, 3rd edition


*http://www.nrel.gov


*http://www.myoclinic.com