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Silymarin (Milk Thistle)

Silymarin is a constituent (a polyphenolic flavonoid, possessing a white/yellow plant pigment) of the milk thistle plant Silybum marianum.

While native to the Mediterranean, milk thistle is now found throughout the world in dry, sunny areas. The plant derives its name from the white fluid which comes from all parts of the plant when cut. Milk thistle has been used medicinally for over 2,000 years, most commonly for the treatment of liver and gallbladder disorders. Other names for the plant include Marian Thistle, Mary Thistle, St Mary's Thistle, Mediterranean Milk Thistle and Variegated Thistle. Historically, the plant has also been consumed.

Within silymarin, there exists another constituent known as silybin (also known as silibinin) which is considered to be the most potent antioxidant found within the milk thistle plant.

Tests performed on human skin have shown that constituents of silymarin possess marked anti-inflammatory, photoprotective and anti-carcinogenic properties, if applied before and even after daylight exposure.

Photoprotective and anti-inflammatory antioxidants are of great interest in rosacea research because they have the potential to help prevent and treat rosacea symptoms while reducing reliance on sunscreens which are imperfectly protective. Studies routinely show that sunscreens only prevent approximately half the damage in rosacea patients skins' attributable to ultraviolet.

One highly attractive aspect of silymarin is that unlike sunscreens, once absorbed it can retain ability to protect skin from all forms of light for several days — it is more resistant to being worn away or washed off than sunscreens.

A high concentration of silymarin is found in Rosacea Oil-Free Antioxidant Daily Wear Sunscreen, Rosacea Treatment Fluid, Cream and Tri-Emollient Cream to help bolster the skin's defenses against photoaging and rosacea symptoms.

Greater effectiveness can be expected where silymarin is used both topically and systemically. A therapeutic quantity is found in the skin care supplements VitaMedica Broad Spectrum Antioxidant and Vitamedica Anti-Aging Formula Daily Packs together with other synergistic compounds. Blackmores Milk Thistle is an option containing silymarin alone.

Topical and systemic silymarin are welcome additions to the dermatologic armamentarium against rosacea.

• Anti-Inflammatory Creams for Rosacea
• Act on Early Rosacea Symptoms to Prevent/Stem Worsening
• Rosacea Oil-Free Antioxidant Daily Wear Sunscreen SPF 30 — All Skin Types
• Antioxidant Sunscreens
• Rosacea Treatment Fluid — All Skin Types
• Rosacea Treatment Cream — Normal/Dry Skin
• Silybin

Selected Silymarin References

Dermatology Online Journal, Volume 6, Number 1.

Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation. Berardesca E, Cameli N, Cavallotti C, Levy JL, Piérard GE, de Paoli Ambrosi G. San Gallicano Dermatological Institute, Rome, Italy. berardesca@berardesca.it

Silymarin and skin cancer prevention: anti-inflammatory, antioxidant and immunomodulatory effects (Review). Katiyar SK. Department of Dermatology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.

Chemopreventive Efficacy of Silymarin in Skin and Prostate Cancer, Gagan Deep, PhD, Department of Pharmaceutical Sciences, School of Pharmacy, School of Pharmacy, University of Colorado Cancer Center, University of Colorado Health Sciences Center, Denver, Colorado, Integrative Cancer Therapies, Vol. 6, No. 2, 130-145 (2007).

Svobodová A, Psotová J, Walterová D. Natural phenolics in the prevention of UV-induced skin damage [PDF]. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 147(2):137-45 (2003 Dec).

Dhanalakshmi S, Mallikarjuna GU, Singh RP, et al. Silibinin prevents ultraviolet radiation-caused skin damages in SKH-1 hairless mice via a decrease in thymine dimmer positive cells and an up-regulation of p53-p21/Cip 1 in epidermis. Carcinogenesis 25(8):1459-65 (2004 Aug).

Melbourne Dermatology Silymarin Monograph and Silymarin Improves Rosacea (accessed 15/5/10).

Additional Silymarin References

Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.

Tamayo C, Diamond S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative Cancer Therapies.6:146-157.

Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.

Gazák R, Walterová D, Kren V (2007). "Silybin and silymarin--new and emerging applications in medicine". Curr. Med. Chem. 14 (3): 315—38. doi:10.2174/092986707779941159. PMID 17305535.

Rainone F. (2005). Milk thistle. American Family Physician72:1285-1288.

Greenlee H, Abascal K, Yarnel E, Ladas E. (2007). Clinical applications of Silybum marianum in oncology. Integrative Cancer Therapies 6:158-165.

Kroll DJ, Shaw HS, Oberlies NH.(2007). Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integrative Cancer Therapies.6:110-119.

Hogan F, Krishnegowda N, Mikhailova M, Kahlenberg M. (2007). Flavonoid, silibinin inhibits proliferation and promotes cell-cycle arrest of human colon cancer. J Surg Res 143:58-65.

Rainone F. (2007). Milk thistle. American Family Physician. 72:1285-1288.

Huseini HF, Larijani B, Heshmat R et al. (2006). The efficacy of Silybum marianum (L.)Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res.20:1036-1039.

Gordon A, Hobbs DA, Bowden DS et al. (2006). Effects of Silybum marianum on serum hepatitis C virus RNA alanine aminotransferase levels and well-being in patients with chronic hepatitis C. J Gastroenterol Hepatol 21:275-280.

Greenlee H, Abascal K, Yarnel E, Ladas E. (2007). Clinical applications of Silybum marianum in oncology. Integrative Cancer Therapies 6:158-165.

Tamayo C, Diamond S. (2007). Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.). Integrative Cancer Therapies.6:146-157.

Rambaldi A, Jacobs BP, Iaquinto G, Gluud C (2005). "Milk thistle for alcoholic and/or hepatitis B or C liver diseases--a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials". Am. J. Gastroenterol. 100 (11): 2583—91. doi:10.1111/j.1572-0241.2005.00262.x. PMID 16279916.

Lawrence, Valerie MD, MSc et al. (2000). "Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects". AHRQ Publication No. 01-E025.

Angulo P, Patel T, Jorgensen RA, Therneau TM, Lindor KD (2001). "Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid". Hepatology. 2001 Feb;33(2):483-4. 32: 897. doi:10.1053/jhep.2000.18663. PMID 11050036.

Lieber CS, Leo MA, Cao Q, Ren C, DeCarli LM. (2003). "Silymarin retards the progression of alcohol-induced hepatic fibrosis in baboons". Journal of Clinical Gastroenterology. 2003 Oct;37(4):336-9.. PMID 14506392.

Szilard S, Szentgyorgyi G, Dhanalakshmi S et al. (1988). Protective effect of Legalon in workers exposed to organic solvents. Acta Med Hung. 45:249-256.

Palasciano G, Portincasa P, Palmieri V et al. (1994). The effect of silymarin on plasma levels of malon-dialdehyde in patients receiving long-term treatment with psychotropic drugs. Curr Ther Res Clin Exp. 55:537-545.

Floersheim GL, Weber O, Tschumi P et al. [Clinical death-cap (Amanita phalloides) poisoning: prognostic factors and therapeutic measures. Analysis of 205 cases]. Schweiz Med Wochenschr.112:1164-1177.

Hruby K, Fuhrmann M, Csomos G et al. [Pharmcotherapy of Amanita phalloides poisoning using silybin].Wein Klin Wochenschr.95:225-231.

American Botanical Council (2007). "Intravenous Milk Thistle Compound Used to Save Victims of Poisonous Mushrooms". HerbalGram (74): 16.

Agarwal R, Agarwal C, Ichikawa H, Singh RP, Aggarwal BB. Anticancer potential of silymarin: from bench to bed side. Anticancer Res. 2006 Nov-Dec;26(6B):4457-98. Review.

Agency for Healthcare Research and Quality. Milk thistle: effects on liver disease and cirrhosis and clinical adverse effects. Summary, evidence report/technology assessment: number 21, September 2000.

Asghar Z, Masood Z. Evaluation of antioxidant properties of silymarin and its potential to inhibit peroxyl radicals in vitro. Pak J Pharm Sci. 2008 Jul;21(3):249-54.

Barve A, Khan R, Marsano L, Ravindra KV, McClain C. Treatment of alcoholic liver disease. Ann Hepatol. 2008 Jan-Mar;7(1):5-15. Review.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:257-263.

Ferenci P, Scherzer TM, Kerschner H, Rutter K, Beinhardt S, Hofer H, et al. Silibinin is a potent antiviral agent in patients with chronic hepatitis C not responding to pegylated interferon/ribavirin therapy. Gastroenterology. 2008 Nov;135(5):1561-7.

Gazak R, Walterova D, Kren V. Silybin and silymarin -- new and emerging applications in medicine. Curr Med Chem. 2007;14(3):315-38. Review.

Giese LA. A study of alternative health care use for gastrointestinal disorders. Gastroenterol Nurs. 2000;23(1):19-27.

Gordon A, Hobbs DA, Bowden DS, Bailey MJ, Mitchell J, Francis AJ, Roberts SK. Effects of Silybum marianum on serum hepatitis C virus RNA, alanine aminotransferase levels and well-being in patients with chronic hepatitis C. J Gastroenterol Hepatol. 2006 Jan;21(1 Pt 2):275-80.

Hoh C, Boocock D, Marczylo T, Singh R, Berry DP, Dennison AR, et al. Pilot study of oral silibinin, a putative chemopreventive agent, in colorectal cancer patients: silibinin levels in plasma, colorectum, and liver and their pharmacodynamic consequences. Clin Cancer Res. 2006 May 1;12(9):2944-50.

Jiang C, Agarwal R, Lu J. Anti-angiogenic potential of a cancer chemopreventive flavonoid antioxidant, Silymairn: inhibition of key attributes of vascular endothelial cells and angiogenic cytokine secretion by cancer epithelial cells. Biochem Biophys Res Commun. 2000;276:371-378.

Köksal E, Gülçin I, Beyza S, Sarikaya O, Bursal E. In vitro antioxidant activity of silymarin. J Enzyme Inhib Med Chem. 2009 Apr;24(2):395-405.

Low Dog T. Traditional and alternative therapies for breast cancer. Altern Ther Health Med. 2001;7(3):36-47.

Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat. 2005 Nov;12(6):559-67. Review.

Najm W, Lie D. Dietary supplements commonly used for prevention. Prim Care. 2008 Dec;35(4):749-67.

Rainone F. Milk thistle. Am Fam Physician. 2005 Oct 1;72(7):1285-8. Review.

Ramasamy K, Agarwal R. Multitargeted therapy of cancer by silymarin. Cancer Lett. 2008 Oct 8;269(2):352-62. Review.

Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C liver diseases — a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials. Am J Gastroenterol. 2005 Nov;100(11):2583-91. Review.

Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, PA: Hanley & Belfus, Inc; 2002:266-271.

Saller R, Brignoli R, Melzer J, Meier R. An updated systematic review with meta-analysis for the clinical evidence of silymarin. Forsch Komplementmed. 2008 Feb;15(1):9-20. Review.

Zielinska-Przyjemska M, Wiktorowicz K. An in vitro study of the protective effect of the flavonoid silydianin against reactive oxygen species. Phytother Res. 2006 Feb;20(2):115-9

http://www.webmd.com/heart-disease/milk-thistle-benefits-and-side-effects

http://www.chiro.org/nutrition/ABSTRACTS/Silymarin_is_Effective_on_Hyperinsulinemia.shtml

National Center for Complementary and Alternative Medicine. "Milk Thistle". National Institutes of Health. - General information on milk thistle

http://www.femalefirst.co.uk/health/Avoid+hangover+hell+with+milk+thistle-1336.html

http://www.edible-plants.com

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