Silibinin: a toxicologist's herbal medicine?

source extracted confidence: high 2026-04-09
#united-states #animals #humans #silybin #mushroom-poisoning

Silibinin: a toxicologist's herbal medicine?

Horowitz et al., 2022 | Clin Toxicol (Phila) | Systematic Review

Citation

Horowitz B Z. Silibinin: a toxicologist's herbal medicine?. Clin Toxicol (Phila). 2022-Nov;60(11):1194-1197. doi:10.1080/15563650.2022.2128815

Abstract

Silymarin is an herbal remedy, commonly called milk thistle, or St. Mary's Thistle, and has been used for over 2000 years. It has been available as a capsule of the plant extract in Europe since 1974 to treat hepatic disorders. To date toxicologists have relied on animal studies, human case series, or retrospective reviews to decide on its use. In the U.S. the ability to use IV silibinin, its pharmacologically active purified flavonolignan, is hindered by its lack of availability as a Food and Drug Administration approved pharmaceutical preparation. This commentary reviews the in vitro studies, animal studies, and human retrospective analyses which form the basis for its clinical use. Despite the numerous publications, summarized in this issue in a systematic review, the mortality rate from Amanita mushroom ingestion remains stubbornly the same over four decades of use, and hovers around 10%. Although in the retrospective systematic review the use of silibinin, or penicillin, compared to routine care is statistically significantly superior when the primary outcome is fatality. Despite this there is no quality randomized trial to definitively demonstrate its utility. While, intravenous silibinin has a low toxicity, unanswered is whether it is useful in protecting the liver in cases of amanitin-containing mushrooms toxicity, and whether earlier administration would likely improve outcomes.

Key Findings

While, intravenous silibinin has a low toxicity, unanswered is whether it is useful in protecting the liver in cases of amanitin-containing mushrooms toxicity, and whether earlier administration would likely improve outcomes.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • United States
  • Animals
  • Humans
  • Silybin
  • Mushroom Poisoning
  • Herbal Medicine
  • Retrospective Studies
  • Plant Extracts
  • Plants, Medicinal

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: milk-thistle

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09