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Considering Milk Thistle for Alcoholic Liver Disease – an Overview and Review of the Evidence

Milk thistle is a well known liver tonic and people have taken the herb for its medicinal properties for millennia – but does this supplementary medicine stand up to modern scientific scrutiny? Should you rely on this herbal medicine to treat a serious alcohol-related liver condition?

Read on to learn a bit more about:

  • The medicinal ingredients within the herb
  • How it works to promote liver health
  • The research results which argue both for and against its effectiveness as a liver medication
  • Expert recommendations on using this herbal treatment

What Is Milk Thistle?

Silybum marianum – better known as milk thistle - is a weed-like purple flowered plant that originated in the Mediterranean basin and which now grows well in temperate areas across the world.

The seeds and spinach-like leaves of the plant can be eaten as food or taken as an herbal supplement – in fact, people have used the plant for its medicinal properties for more than 2000 years.1

Milk thistle contains a substance called silymarin, which has potent antioxidant and anti-inflammatory properties. Silymarin is thought to be the herb’s primary medicinal substance.2

What’s It Used for?

People most often take milk thistle to protect or repair the liver, especially people with conditions such as:

  • Alcoholic hepatitis
  • Alcoholic cirrhosis
  • Viral hepatitis
  • Jaundice
  • Mushroom toxin poisoning
  • Liver damage caused by chemical toxins
  • People at risk of liver cancer

People also use the herb to:

  • Treat heartburn
  • Stimulate appetite
  • Treat hangovers
  • Treat diabetes
  • Treat prostate cancer
  • Treat depression
  • Treat malaria
  • Increase breast milk flow
  • Reverse certain allergy symptoms
  • And many other conditions3

How Does It Work?

Milk thistle influences liver health in a number of ways.

  • It is a potent antioxidant and has membrane stabilizing properties (alcohol causes significant oxidative stress damage)
  • It protects against lipid peroxidation
  • It helps with liver cell regeneration
  • It decreases liver inflammation and protects against fibrosis
  • It seems to reduce tumor cell proliferation (protecting against liver cancer)4

Research Supporting/Contraindicating Its Use


  • In one study, a group of patients with cirrhosis were divided into 2 groups. Half were given milk thistle and half were given a placebo. Neither group knew which they were taking. After 4 years, 58% of those taking milk thistle were still living, compared to only 38% of those taking a placebo still surviving.5
  • In a more recent study from the National Cancer Institute, among people with chronic serious hepatitis, the long-term use of silymarin slowed the fibrotic progression to cirrhosis, but had no effect on long-term outcomes. Based on these results, the researchers call for more research to investigate what’s causing the improvements but do not recommend a default use of the herbal medication.6

Alcoholic Hepatitis

  • A study from Finland performed on soldiers with alcoholic hepatitis showed that 4 weeks of treatment with milk thistle resulted in decreases in previously elevated liver enzymes and in improved liver histology.7
  • However, a more recent (2007) Cochrane Database Systems Review on milk thistle for alcoholic hepatitis was less favorable. According to this review, most studies reporting a protective effect from milk thistle were of poor quality, and in high quality studies, the herb did not reduce mortality.8

Side Effects and Safety

Most people can use milk thistle without experiencing side effects. In some cases, the herb may cause diarrhea and in fairly rare cases, nausea, bloating, gas and general gastrointestinal distress.

Long-duration studies indicate that it’s safe for chronic use.9

Where Can You Get It?

Since the FDA doesn’t regulate milk thistle as a medication you can buy it without a prescription as a dietary supplement.

The supplement is relatively inexpensive, retailing for approximately 10 cents per dose.

Do Experts Recommend It?

A number of smaller European studies show that it works and no studies indicate any significant side effects, but a couple of larger and better controlled studies haven’t found the same effectiveness.

  • Based on an overview of the current evidence, the Mayo Clinic gives milk thistle a B grade for the treatment of cirrhosis and chronic liver disease. This B grade is the second strongest recommendation, which indicates that there is ‘good scientific evidence’ supporting its use for this application.10
  • After weighing effectiveness evidence against the risks of use (few) experts from the Institute of Complementary Medicine in Zurich Switzerland advise that those with liver cirrhosis make use of the herb as a supportive medication (supporting other more conventional treatments).11

So Should You Use It?

It’s up to you. It’s not a magic-bullet solution to your problems and it certainly won’t protect you completely, but since there is evidence indicating its likely benefit and since it causes few/no serious side effects - it’s definitely something to consider.

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