Milk Thistle & Amanita muscaria Poisoning
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The common wild mushroom, Amanita phalloides, is known as the "death cap" for a good reason. It takes
only a handful of this widely distributed fungus to kill an adult,
less to kill a child. Standard medical treatment - activated
charcoal - is not particularly effective. Amanita phalloides mushroom ingestion
proves fatal in about half of the cases. Twenty years ago, pilot
studies showed that silymarin [milk thistle extract] treatment
substantially reduced amanita-poisoning deaths in animals fed the
mushroom. Subsequently, several human studies were launched. In one
German hospital test, 60 consecutive people with amanita poisoning
were given intravenous silymarin [milk thistle extract]. None died.
Other studies have produced results that are similar, though not as
spectacular. (However, the success of silymarin [milk thistle
extract] in treating amanita poisoning should not encourage anyone
to go mushroom hunting without training in amanita avoidance. Unless
your an experienced hunter, the only place to pick mushrooms is at a
produce market.) If accidental ingestion of the
non-deadly Amanita muscaria occurs, it has been reported in several
places that Milk Thistle can be a dramatic help in such situations.
Studies in small animals have shown that silymarin exerts a liver
protective effect against a variety of toxins, including the
phallotoxins of the deadly amanita phalloides, and is considered the
only antidote to amanita poisoning. Human trials have also been
encouraging for conditions including hepatitis and cirrhosis of
various origins. The results of numerous studies suggest that
silymarin has considerable therapeutic potential, protecting intact
liver cells, or cells not yet irreversibly damaged, by acting on the
cell membranes to prevent the entry of toxic substances. Protein
synthesis is also stimulated, thereby accelerating the regeneration
process and the production of liver cells. As a result of this
information, German health authorities have endorsed the use of milk
thistle as a supportive treatment for inflammatory liver conditions
and cirrhosis.
Unfortunately, silymarin is very poorly soluble in water, so milk
thistle is not effective in the form of a tea. Studies show that
such a beverage contains less than 10 percent of the initial
activity in the plant material. This poor solubility, coupled with
the fact that silymarin is relatively poorly absorbed (20 to 50
percent) from the gastrointestinal tract, make it obvious that the
active principles are best administered parenterally, that is, by
injection. Oral use requires a concentrated product. Milk thistle is
marketed in this country as a dietary supplement in the form of
capsules containing 200 mg of a concentrated extract representing
140 mg of silymarin. Toxic effects resulting from the consumption of
milk thistle have apparently not been reported. Twenty-one cases out
of 2,169 (1 percent) in an observational study did report transient
gastrointestinal side effects. Otherwise, it is considered very
well-tolerated and quite effective.
Milk thistle was brought to the United States and has adapted to
life in the wild in California and along the East Coast. The sap is
white and milky, perhaps explaining at least one of its common
names. The white spots along the ribs of the leaves were said to
have been drops of the Virgin Mary's milk. The herb was used in
times past to help encourage milk production, but this may have been
due to the name and the association. The medicinal
use of milk thistle goes back two thousand years. Pliny the Elder
wrote of it, praising its value for "carrying off bile." Medieval
herbalists also made use of this property, and in the sixteenth
century English herbalists adopted it. It did not maintain its
popularity, however, and by the early twentieth century only
homeopaths were familiar with it. With a renewal of interest in
herbal medicines, researchers started to investigate milk thistle
scientifically in the 1950s. The part of the plant that is used is
the small hard fruit with the fuzz (technically called "pappus")
removed. Milk thistle is native to the Kashmir region of India and Pakistan,
but now grows throughout the temperate world. The plant grows from
five to ten feet tall, and has large prickly leaves and reddish
purple flowers with sharp spines that resemble artichokes. When de-spined,
milk thistle leaves are edible, and some vegetable gardeners
cultivate the plant as a substitute for spinach. When broken or
crushed, the stems and leaves exude a milky white juice, hence this
herbs's name. Milk thistle's specific name, marianum, comes from an
ancient legend that its leaf veins turned white after being touched
by a drop of the Virgin Mary's breast milk.
Milk thistle has been used in traditional herbal medicine since the
first century, when the Roman naturalist, Pliny the Elder (AD.
23-79), wrote that the plant's milky juice was good for "carrying
off bile." (Today "bile" denotes a product of the gall bladder, part
of the liver, which assists in the digestion of fats, but in ancient
times, bile was used more generally to describe any internal fluid.)
The noted 16th century British herbalist, John Gerard, was the first
to recommend milk thistle for liver problems, though his
prescription was oblique. He actually suggested the herb for
"expelling melancholy," which physicians at the time considered a
liver ailment. Half a century later, Britain's most famous
herbalist, Nicholas Culpepper, was the first to recommend milk
thistle specifically for liver disorders. By the 19th century,
German physicians were using a tincture prepared from milk thistle
seeds (actually the plants seed like fruits) to treat jaundice and
other liver diseases. America's 19th century eclectic physicians,
who specialized in botanical medicines, adopted the herb for liver
ailments and for intestinal cleansing.
With the rise of the modem pharmaceutical industry, U.S. research of
herbal medicines declined considerably. Fortunately, this did not
happen in Germany, where in 1949, scientists noticed that milk
thistle seemed to protect animal livers from poisoning with highly
toxic carbon tetrachloride. In 1968, scientists isolated the three
specific liver-protective molecules in milk thistle - silibinin,
silidianin, and silicristin - now known collectively as silymarin
[milk thistle extract]. How Much to Take
Many people with liver disease and impaired liver function take 420
mg of silymarin per day from an herbal extract of milk thistle
standardized to 70-80% silymarin content. According to research and
clinical experience, improvement should be noted in about eight to
twelve weeks. Once that occurs, intake is often reduced to 280 mg of
silymarin per day. This lower amount may also be used for preventive
purposes. For those who prefer, 12-15 grams of milk thistle seeds
can be ground and eaten or made into a tea. This should not be
considered therapeutic for conditions of the liver, however.
Side Effects & Cautions
Milk thistle extract is virtually devoid of any side effects and may
be used by a wide range of people, including pregnant and lactating
women. Since silymarin does stimulate liver and gallbladder
activity, it may have a mild, transient laxative effect in some
individuals. This will usually cease within two to three days.
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