Clinical applications of Silybum marianum in oncology.

Milk thistle (Silybum marianum) is an herb that is increasingly used in oncology research and treatment settings. Historically, it has been used to treat liver and biliary disorders and has been used in detoxification and cleansing protocols. However, milk thistle is increasingly being investigated for its use in adult and pediatric populations for oncology indications. Possible indications during cancer treatment include cleansing and detoxification after chemotherapy, preventing hepatotoxicity during chemotherapy, treating hepatotoxicity after chemotherapy, and potentiating chemotherapy and radiation therapy as an adjunctive treatment. Milk thistle may also have applications in ameliorating long-term hepatic and cardiovascular effects of cancer treatment. Preliminary studies are investigating its use as a chemopreventive agent and possibly to treat cancer directly. Much of milk thistle's current clinical use grows out of historical uses but is informed by an increasing number of clinical trials and animal studies. This article provides an overview of the current clinical applications of milk thistle in the oncology setting, including guidelines on commonly used forms and doses.

Credentialing of practitioners of botanical medicine.

This article discusses how practitioners, regardless of other professional licenses they may hold, could be credentialed in botanical medicine. The article reviews the field of clinical botanical medicine and the history and modern status of botanical medicine, as well as organizations currently involved in botanical medicine credentialing. Many different types of professionals prescribe botanical medicines, and the potential for collaboration among them is great. The current trend treats botanical medicine as a narrow subdivision of allopathic medicine and does not acknowledge the breadth, depth, and diversity of botanical medicine and ultimately will not provide maximum benefits for patients. An alternative approach that instead credentials practitioners skilled in the use of a wide variety of botanical medicines in a responsible, scientific fashion is presented.

The effect of freeze-drying and its implications for botanical medicine: a review.

Botanical samples are often freeze-dried (lyophilized) for use in research studies, and a variety of freeze-dried botanicals are marketed to the public. In both instances, there is an underlying assumption that freeze-drying properly preserves the medicinal qualities of plants, and is superior to other preservation methods. In fact, little systematic research has been done to verify this assumption. A review of the existing research, done primarily by the food and spice industry, indicates that freeze-drying has unanticipated and significant effects on the constituent profiles of medicinal plants that puts into question whether freeze-drying necessarily is the best method to preserve botanical medicines.This research review finds there is insufficient information to conclude that freeze-drying has negative effects on the medicinal qualities of plants. But, because existing research indicates that freeze-drying imperfectly preserves important classes of medicinal compounds (such as volatiles, phenolics and carotenoids), may increase the mutation rate in unicellular organisms and may diminish some medicinal plant actions, researchers and practitioners should carefully consider how the use of freeze-dried material may affect pharmacological and clinical study results.