Carduus marianus

milk thistle (Silybum marianum)

Entire Monograph

Reported Uses

NOTE: see Herb & Supplement Effectiveness Rating Definitions table
acne [Insufficient Evidence]
acral erythema, chemo-induced [Insufficient Evidence]
acute kidney injury [Insufficient Evidence]
alcoholic liver disease [Insufficient Evidence]
allergic rhinitis [Insufficient Evidence]
Alzheimer disease [Insufficient Evidence]
atrial fibrillation prevention [Insufficient Evidence]
beta-thalassemia [Insufficient Evidence]
BPH [Insufficient Evidence]
COVID-19 [Insufficient Evidence]
critical illness (trauma) [Insufficient Evidence]
diabetes mellitus [Possibly Effective]
diabetic nephropathy [Insufficient Evidence]
dyslipidemia [Insufficient Evidence]
dyspepsia [Insufficient Evidence]
endometriosis [Insufficient Evidence]
gambling disorder [Insufficient Evidence]
hepatic cirrhosis [Insufficient Evidence]
hepatitis [Insufficient Evidence]
hepatitis B [Insufficient Evidence]
hepatitis C [Insufficient Evidence]
hepatotoxicity, chemo-induced [Insufficient Evidence]
hepatotoxicity, toxin-induced [Insufficient Evidence]
hyperlipoproteinemia [Insufficient Evidence]
hypoxic liver injury [Insufficient Evidence]
infertility in patients of childbearing potential [Insufficient Evidence]
lactation promotion [Insufficient Evidence]
melasma [Insufficient Evidence]
menopausal symptoms [Insufficient Evidence]
metabolic dysfunction-associated steatohepatitis [Insufficient Evidence]
metabolic dysfunction-associated steatotic liver disease [Insufficient Evidence]
metabolic syndrome [Insufficient Evidence]
multiple sclerosis [Insufficient Evidence]
mushroom toxicity (Amanita phalloides) [Insufficient Evidence]
nephropathy prophylaxis, contrast-induced [Insufficient Evidence]
nephrotoxicity, chemo-induced [Insufficient Evidence]
obesity [Insufficient Evidence]
obsessive-compulsive disorder [Insufficient Evidence]
Parkinson disease [Insufficient Evidence]
peripheral neuropathy, chemo-induced [Insufficient Evidence]
postpartum complications [Insufficient Evidence]
prostate CA [Insufficient Evidence]
radiation dermatitis [Insufficient Evidence]
radiation mucositis [Insufficient Evidence]
rheumatoid arthritis [Insufficient Evidence]
trichotillomania [Insufficient Evidence]
ulcerative colitis [Insufficient Evidence]
vitiligo [Insufficient Evidence]

Reported Doses

Safety/efficacy may not be established; reported doses may be derived from limited or potentially inadequate studies with variable regimens, multi-ingredient products, or where concentration of active ingredients may vary widely

Special Note

[formulation clarification]
Info: extracts generally standardized to silymarin content; active constituents may include silybin, other flavonolignans

Effectiveness Ratings

[see Herb & Supplement Effectiveness Rating Definitions table]

acne

[Insufficient Evidence]
Dose: 140 mg PO qd; Alt: apply 0.5% serum topically qd-bid; apply 25% extract cream topically bid; apply 1.4% cream topically bid

acral erythema, chemo-induced

[Insufficient Evidence]
Dose: apply 1% gel topically bid to palms and soles; Start: 1st day of chemo

acute kidney injury

[Insufficient Evidence]
Dose: 140 mg PO tid; Info: for prevention of vancomycin-induced nephrotoxicity

alcoholic liver disease

[Insufficient Evidence]
Dose: 420 mg PO qd

allergic rhinitis

[Insufficient Evidence]
Dose: 140 mg PO tid; Info: used with cetirizine

Alzheimer disease

[Insufficient Evidence]
Dose: 150 mg PO bid; Alt: 450 mg PO qd

atrial fibrillation prevention

[Insufficient Evidence]
Dose: 400 mg/day PO divided bid x3 days; Start: before surgery; Info: for patients undergoing CABG

beta-thalassemia

[Insufficient Evidence]
Dose: 140 mg PO tid; Info: used with conventional tx

BPH

[Insufficient Evidence]
Dose: 240 mg PO bid; Alt: 190 mg PO tid

critical illness (trauma)

[Insufficient Evidence]
Dose: 140 mg PO tid; Info: for patients with trauma-induced hepatotoxicity

diabetes mellitus

[Possibly Effective]
Dose: 140-200 mg PO tid; Alt: 105-2100 mg PO qd

diabetic nephropathy

[Insufficient Evidence]
Dose: 140 mg PO tid; Info: used with conventional tx

dyslipidemia

[Insufficient Evidence]
Dose: 105 mg PO qd-bid

dyspepsia

[Insufficient Evidence]
Dose: 33.3 mg/1 mL milk thistle fruit extract PO tid

endometriosis

[Insufficient Evidence]
Dose: 140 mg PO bid

hepatic cirrhosis

[Insufficient Evidence]
Dose: 140 mg PO tid; Alt: 150 mg PO bid-tid

hepatitis

[Insufficient Evidence]
Dose: 140 mg PO tid; Alt: 160-360 mg PO qd

hepatitis B

[Insufficient Evidence]
Dose: 140 mg PO tid; Alt: 240 mg PO bid

hepatitis C

[Insufficient Evidence]
Dose: 140 mg PO tid; Alt: 240-303 mg PO bid

hepatotoxicity, chemo-induced, adult patients

[Insufficient Evidence]
Dose: 150-900 mg PO qd; Alt: 140 mg PO tid; Info: doses >300 mg/day rarely more effective

hepatotoxicity, chemo-induced, peds patients

[Insufficient Evidence]
Dose: 70 mg PO bid; Alt: 50 mg syrup PO tid; Info: for patients 5-14 yo

hepatotoxicity, toxin-induced

[Insufficient Evidence]
Dose: 140-450 mg PO qd; Alt: 70 mg silibinin extract PO tid; 150 mg PO bid; Info: silibinin extract containing 1:1 silybin A:silybin B ratio

hypoxic liver injury

[Insufficient Evidence]
Dose: 280 mg PO tid

infertility in patients of childbearing potential

[Insufficient Evidence]
Dose: 70 mg PO tid

melasma

[Insufficient Evidence]
Dose: apply 1.4% cream topically bid

menopausal symptoms

[Insufficient Evidence]
Dose: 200 mg PO bid

metabolic dysfunction-associated steatohepatitis

[Insufficient Evidence]
Dose: 420-700 mg PO tid

metabolic dysfunction-associated steatotic liver disease

[Insufficient Evidence]
Dose: 103.2-2100 mg/day PO divided bid-tid; Alt: 140 mg PO qid

metabolic syndrome

[Insufficient Evidence]
Dose: 140-2100 mg PO qd

multiple sclerosis

[Insufficient Evidence]
Dose: 150 mg PO bid

obesity

[Insufficient Evidence]
Dose: 151.5 mg PO bid

obsessive-compulsive disorder

[Insufficient Evidence]
Dose: 200 mg PO tid

Parkinson disease

[Insufficient Evidence]
Dose: 150 mg PO bid

peripheral neuropathy, chemo-induced

[Insufficient Evidence]
Dose: 140 mg PO tid

postpartum complications

[Insufficient Evidence]
Dose: apply 3% ointment topically to suture site bid

prostate CA

[Insufficient Evidence]
Dose: 160 mg PO qd

radiation dermatitis

[Insufficient Evidence]
Dose: apply cream or gel topically; Info: used throughout XRT tx course

radiation mucositis

[Insufficient Evidence]
Dose: 140 mg PO tid; Start: 1st day of XRT; Info: continue x6wk after tx D/C

rheumatoid arthritis

[Insufficient Evidence]
Dose: 300 mg PO qd; Info: used with standard tx

ulcerative colitis

[Insufficient Evidence]
Dose: 140 mg PO qd; Info: for patients 16 yo and older; used with standard tx

vitiligo

[Insufficient Evidence]
Dose: 70 mg PO bid; Info: used with phototherapy and hair transplantation