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Will You Lower Your Cholesterol With Milk Thistle?

Milk thistle extract can lower total cholesterol, LDL cholesterol and triglycerides. It blocks the same enzyme as statins.

Is your cholesterol high? If you have a family history of high cholesterol, particularly if you had parents or siblings who died of heart disease, your doctor will do as much as possible to help you control this blood fat. Frequently, the physician’s first choice is to prescribe a statin, and that works well for many people. Others, however, notice unpleasant side effects from these drugs. As a result, they seek alternatives. Plant products such as milk thistle may offer unexpected help in this regard.

Lowering Cholesterol with Milk Thistle Plus Statin:

Q. I am wondering why you do not talk more about the benefits of milk thistle for high cholesterol. Lots of people have problems with statins and you should let them know there is an alternative.

I first read about milk thistle in your column and then I tried it. I was on statins and hated taking them, but my doctor insisted since high cholesterol runs in my family. The diet I was on for lowering cholesterol was not working.

Within three months of taking milk thistle plus a statin, my numbers were down to normal. The doctor has now lowered my statin dose. After my next blood work, I may be able to drop the statin completely if the readings are still lower. People struggling with statin side effects should know about this.

A. Milk thistle (Silybum marianum) has a reputation for protecting the liver from damage. In addition, research shows that it may also have the potential to benefit the cardiovascular and nervous systems (Journal of Agricultural and Food Chemistry, Oct. 12, 2020).

A six-week blinded trial of the milk thistle component silymarin for volunteers with type 2 diabetes showed that it significantly improved lipid profiles and blood sugar (Phytomedicine, May 15, 2018).  More recent trials have combined milk thistle with Berberis aristata (Indian barberry) extract. This combination lowers total and LDL cholesterol and improves blood glucose control (Planta Medica, Jan. 2020).

We are pleased to learn that you are working closely with your doctor.

Replacing a Statin with Milk Thistle:

Q. When I took a statin to control my cholesterol, I suffered from terrible muscle cramps. My husband had the same experience.
Then I read that milk thistle could be good for the liver and might also lower cholesterol levels. With a family history of high cholesterol, I decided to give this herb a try. My numbers shocked my doctor!

My cholesterol is now way below the level that would call for treatment. Without the statin, I have had no more cramping. I hope others will also benefit.

A. There is some evidence to suggest that silymarin can lower both LDL cholesterol and triglycerides (Pharmacological Research, Sept. 22, 2022). Studies show that bergamot and red yeast rice also lower cholesterol.

In rare cases, statins can damage the liver. One of the principal components of milk thistle, silymarin, has been shown to be helpful against drug-induced liver injury (Biomedicine, Dec. 21, 2022).  Whether people taking statins would benefit from milk thistle is unclear. We urge anyone undertaking this experiment to work with their physician.

Another Reader Offers a Success Story:

Q. My husband and I suffered from terrible muscle cramps while taking statins to lower cholesterol. I have a family history of high cholesterol, so when I read that milk thistle prevents the liver from making cholesterol, I tried it. It worked so well my doctor was shocked! My cholesterol is now well under control and I have not had any more muscle cramping.

A. Silymarin, the active ingredient in the botanical medicine milk thistle, has been studied as a lipid-lowering agent. One systematic review found that this natural product can contribute to lowering total cholesterol, LDL-C and triglycerides. It also raised the so-called good HDL cholesterol (Phytotherapy Research, April, 2019). Moreover, silymarin helps to protect the liver (Diabetes, Metabolic Syndrome and Obesity, Oct. 1, 2019).

Silymarin works in part by inhibiting the same enzyme that statin-type cholesterol-lowering drugs block. Side effects may include stomachache and diarrhea. Some people have reported headache or itching. Those who are allergic to ragweed may be more likely to have trouble with milk thistle.

Finding Quality Milk Thistle:

If you are seeking a high quality milk thistle product, we recommend that you consider Gaia Herbs. The company’s dedication to purity, potency and transparency means you can trust its products. Speaking of transparency, we also appreciate the fact that it used to underwrite our radio show and podcast.

Other Plant Products That Lower Cholesterol:

You might be surprised to learn that a common dietary supplement, psyllium, lowers cholesterol effectively (American Journal of Clinical Nutrition, Nov. 1, 2018). Although most people think of this plant product (the main ingredient in Metamucil) as preventing constipation, those who took it daily for at least three weeks had lower cholesterol. Some scientists have found that this soluble fiber can enhance low-dose statin therapy (American Journal of Cardiology, Oct. 1, 2018).

Beta-glucans from oats or barley also lower cholesterol (British Journal of Nutrition, Oct. 2016; European Journal of Clinical Nutrition, Nov. 2016). You can learn more about lowering cholesterol with medications and nondrug approaches in our eGuide to Cholesterol Control & Heart Health.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Wang X et al, "Health benefits of Silybum marianum: Phytochemistry, pharmacology, and applications." Journal of Agricultural and Food Chemistry, Oct. 12, 2020. https://doi.org/10.1021/acs.jafc.0c04791
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