Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Milk thistle (Silybum marianum) has been investigated for its potential to reduce certain side effects of chemotherapy, particularly liver toxicity. The key active component, silymarin, is known for its antioxidant and hepatoprotective properties. Several small clinical trials and observational studies, especially in pediatric oncology, have evaluated milk thistle's ability to protect the liver during chemotherapy regimens that are known to be hepatotoxic (such as methotrexate and certain antileukemic drugs). Some randomized controlled trials have demonstrated that milk thistle supplementation can help maintain lower liver enzyme levels (AST, ALT) in patients undergoing chemotherapy, suggesting a protective effect on liver function.

However, the evidence is still limited by small sample sizes, variability in milk thistle preparations, and inconsistent results. A 2015 Cochrane review concluded that while milk thistle appears to be safe and may offer some hepatoprotective effects in cancer patients, the quality of evidence is low and more rigorous, larger-scale studies are needed. Furthermore, milk thistle may interact with the metabolism of chemotherapeutic drugs, potentially altering their effectiveness, which necessitates caution. Thus, while there is some scientific support for milk thistle’s use in reducing chemotherapy-induced liver toxicity, its use should always be guided and monitored by a healthcare professional.

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