Silybi mariani fructus

Silybi mariani fructus is an officinal flavonoid drug extracted from the fruits of its parent plant Silybum marianum, the milk thistle. Positive monographs are available from Commission E, HMPC, WHO and ESCOP. The preparations are obtained from the ripe and dried fruits, freed from the pappus.

Quality is defined in the European Pharmacopoeia (Ph. Eur.).

HMPC monograph: Traditional-use: symptomatic treatment of digestive complaints, bloating, flatulence, supportive of liver function.
ESCOP monograph: for toxic liver damage, supportive in chronic inflammatory liver disease and cirrhosis.
Commission E monograph: dyspeptic complaints; toxic liver damage, supportive in chronic inflammatory liver disease and cirrhosis.

Experiential medicine: functional biliary complaints, hepatitis C, fatty liver.

In addition to protein, milk thistle fruits consist of 20 to 30 % fatty oil (glycerides of linoleic and oleic acid). In addition, they have a minimum content of silymarin (s.a.silibinin) of 1 %. The silymarin complex consists of silibinin (silybin A), silydianin and silychristin. These are flavonol lignans. Furthermore, other flavonoids such as quercetin and taxifolin are contained.

Silybimariani fructus are used in chronic, toxin-induced liver diseases. The drug Silybimariani fructus inhibits the effects of liver-toxic substances and also has a choleretic effect. It has been shown to competitively displace the toxins of the tuberous leaf fungus (phalloidin, amanitin). Furthermore, the drug has antiphlogistic and antifibrotic effects.

In a randomized, double-blind, placebo-controlled clinical study, a significant alleviation of skin reactions during radiation therapy by a 1 % silymarin gel could be demonstrated.

According to the guidelines of Commission E, the drug is indicated for dyspeptic complaints, adjuvant for chronic inflammatory liver diseases, adjuvant for liver cirrhosis. The effect on fatty liver is not proven.

The crushed fruits are used as tea preparations or as oral administration.

The common average daily dose is between 12-15 g of drug. Preparations correspond to 200-400mg silymarin, calculated as silibinin.

Tea extracts are often combined with fennel because of its unpleasant taste. However, tea infusions of milk thistle fruits are not recommended, the effective dose of silymarin cannot be achieved by tea infusions.

Mild gastrointestinal symptoms: dry mouth, nausea, upset stomach, stomach irritation, diarrhea; headache; allergic reactions up to and including anaphylaxis: dermatitis, urticaria, rash, pruritus, asthma.

Allergy to daisies, lactation and pregnancy: insufficient data. Also no sufficient data in children and adolescents under 18 years of age.

Milk thistle seeds contain a mixture of flavononol derivatives. These have been shown to have an antihepatotoxic effect and to stimulate cell regeneration in liver tissue.

For the treatment of tuberous mushroom poisoning, a chemically modified silybinin from milk thistle is given as a pure substance.

1. Karbasforooshan H et al (2019) Topical silymarin administration for prevention of acute radiodermatitis in breast cancer patients: A randomized, double-blind, placebo-controlled clinical trial, Phytother Res .33: 379-386
2. https://arzneipflanzenlexikon.info/mariendistel.php
3. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-silybum-marianum-l-gaertn-fructus_en.pdf
4. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 156-157
5. https://pflanzen.fnr.de/industrial-plants/medicinal-plants/pflanzen-datenbank.