From: Nurses' Drug Alert
Adverse Reaction : Milk Thistle-Associated Toxicity
Nurses' Drug Alert 23(7):51, 1999.

 
 

A 57-year-old woman presented with a 2-month history of intermittent episodes of nausea, abdominal pain, watery diarrhea, sweating, and weakness.[1] The attacks lasted up to 24 hours, and she felt well before and after the episodes. Physical examination and laboratory test results were unremarkable.

Questioning revealed that the episodes began after she had starting taking milk thistle (Silybum marianum) capsules for both headaches and liver cleansing, and that each episode had occurred shortly after taking a capsule. The attacks resolved after she stopped taking milk thistle.

Discussion: Milk thistle, a plant native to southern Europe and other areas, has been reported to be useful for the prophylaxis and treatment of some liver diseases. The active ingredients of the fruit, a group of flavonolignans known collectively as silymarin, alter the outer liver membrane cell structure to block toxins from entering the cell. Silymarin also stimulates RNA polymerase A, which promotes regeneration of the liver.[2] Although a recent review suggested that no serious adverse effects from herbal milk thistle medications had been reported,[3] the Adverse Drug Reactions Advisory Committee of Australia has received a report of a woman who experienced nausea, abdominal pain, listlessness, and insomnia after taking milk thistle.

References

Adverse Drug Reactions Advisory Committee: An adverse reaction to the herbal medication milk thistle (Silybum marianum). Medical Journal of Australia 1999;170 (March 1):218-219. From Woden, Australia.

Fetrow C, Avila J: Complementary & Alternative Medicines Springhouse 1999:430-432.

Flora K, et al: Milk thistle (Silybum marianum) for the therapy of liver disease. American Journal of Gastroenterology 1998;93:139-143.