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The Benefits of Milk Thistle in Combination with Oral Hormone Replacement Therapy (HRT)

Milk thistle is often used to support liver health. Today we look at the advantages and risks of supplementing your diet with this herbal remedy when taking oral hormone replacement treatments.

Milk thistle (Silybum marianum) is a flowering plant native to the Mediterranean region. Its distinctive, white-veined leaves and prickly appearance have made it a recognizable herbal remedy for centuries. One of it’s key components is silymarin, a group of flavonoids found in the seeds of the plant. Silymarin is believed to have potent antioxidant and anti-inflammatory properties, making milk thistle a popular choice for liver health and beyond.

Milk Thistle, a popular herbal supplement, is known by numerous names around the world. Whether you’re in a health store or researching online, you might encounter any of these alternative names:

  • Holy Thistle and Lady’s Thistle reflect its revered status in herbal lore.
  • Marian Thistle, Mary Thistle, and St. Mary’s Thistle highlight its historical connections to religious figures.
  • It also goes by several botanical names, like Silybum marianum, Carduus Marianum, and its derivatives, such as Cardui Mariae Herba or Fructus.
  • In different regions, it is called Chardon-Marie in French and Mariendistel in German.
  • Other names include Artichaut Sauvage, Épine Blanche, and Chardon de Marie, reflecting its physical characteristics.
  • It’s referred to in medical and herbal texts as Silibinin, Silybin, Silymarin, and Silymarine.

These names can vary slightly in spelling and terminology depending on cultural and regional differences, but they all refer to the same thistle-like plant known for its distinctive milky-white veins and reputed health benefits.

In recent years, individuals undergoing oral hormone replacement therapy (HRT) have shown interest in incorporating milk thistle into their wellness routines. Let’s explore the potential benefits of using milk thistle alongside HRT and the considerations to keep in mind.

Liver Support:

  • HRT and Liver Function: Hormone replacement therapy, especially oral forms, can impact liver function. The liver plays a crucial role in metabolizing hormones, including estrogen. It has a long-standing reputation for supporting liver health.
  • Silymarin’s Role: Silymarin, the active compound in milk thistle, is thought to protect liver cells from damage caused by toxins, oxidative stress, and inflammation. By promoting liver cell regeneration, it may help maintain optimal liver function during HRT.

Antioxidant Properties:

  • Neutralizing Free Radicals: Silymarin acts as a powerful antioxidant, scavenging free radicals that can harm cells and tissues. For individuals on HRT, this antioxidant defense may be particularly beneficial.
  • Reducing Oxidative Stress: HRT can sometimes lead to oxidative stress due to hormonal fluctuations. Milk thistle, which contains antioxidant properties, may counteract this stress, potentially reducing the risk of cellular damage.

Potential Blood Sugar Regulation:

  • Diabetes and HRT: Some individuals on HRT may have an increased risk of developing type 2 diabetes. Milk thistle has been studied for its potential to regulate blood sugar levels.
  • Caution: If you’re using diabetes medications alongside HRT, consult your healthcare provider. Milk thistle might enhance the effects of these medications, leading to low blood sugar levels.

Managing Indigestion (Dyspepsia):

  • Digestive Comfort: When combined with other supplements, it may alleviate symptoms of indigestion. Individuals on HRT sometimes experience gastrointestinal discomfort, and milk thistle could provide relief.

Milk Thistle & Estrogen Interaction:

  • Estrogen Levels: HRT often involves estrogen supplementation. Milk thistle may affect estrogen levels, so close monitoring is essential.
  • Consult Your Doctor: Discuss the use of this supplement with your healthcare provider, especially if you’re adjusting your HRT regimen.

Safety and Side Effects:

  • Generally Safe: When taken in appropriate doses, milk thistle appears safe for most people.
  • Possible Side Effects: These can include gastrointestinal issues (diarrhea, constipation, nausea), itchiness, headaches, and allergic reactions.
  • Allergies: Individuals allergic to plants in the Asteraceae family (such as ragweed) should exercise caution.

Medication Interactions:

  • CYP2C9 Enzyme: Milk thistle might influence the enzyme that processes drugs like diazepam and warfarin.
  • Raloxifene (Evista): If you’re taking this osteoporosis medication, discuss it’s use with your doctor.
  • Hepatitis C Medication: Avoid concurrent use with simeprevir.
  • Immunosuppressant: Consult your healthcare provider if you’re on sirolimus.

When considering the use of Milk Thistle, it’s important to acknowledge potential interactions with certain herbs and supplements, especially those known to affect blood sugar levels. Milk thistle has properties that may reduce blood sugar, which could be compounded when used concurrently with other supplements that have a similar effect. Notable examples include supplements such as aloe vera, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.

If you’re using Milk Thistle along with these or similar supplements, it’s crucial to monitor blood sugar levels closely to avoid hypoglycemia, a condition where blood sugar drops to dangerously low levels. Always consult with a healthcare provider to ensure safe usage and to manage dosage appropriately.

The Bottom Line

Milk thistle holds promise as a complementary supplement for individuals undergoing oral HRT. However, personalized guidance is crucial. Always consult your healthcare provider before adding any new supplement to your regimen. With proper care, it may enhance liver health, provide antioxidant support, and contribute to overall well-being during HRT.

Remember that individual responses can vary, and informed decisions are essential for a balanced approach to health and wellness.

Founder of TransVitae, her life and work celebrate diversity and promote self-love. She believes in the power of information and community to inspire positive change and perceptions of the transgender community.



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