Can You Take Milk Thistle With Metformin?

Answer

Thanks for reaching out! Milk thistle doesn't have a direct interaction with metformin, but I'll expand on what our 'drug-herbal interaction checker' reports between the two (it reports a 'moderate' interaction) based on both having blood-sugar-lowering effects.

Interaction Details

Milk thistle doesn't affect the absorption or metabolism of metformin, or how it works, but it is sometimes reported as having an interaction with all drugs used for diabetes as some studies show it has a mild antidiabetic effect in that it can lower blood sugar.

So, you'll actually see milk thistle having a theoretical interaction with really any drug used for diabetes, such as:

• Glipizide
• Glimepiride
• Acarbose
• Januvia
• Farxiga
• Ozempic
• Mounjaro
• Invokana
• Insulin

One of the larger studies evaluating the use of milk thistle for diabetes found positive effects on fasting blood sugar and A1c, among other metrics:

In conclusion, silymarin [milk thistle] treatment in type II diabetic patients for 4 months has a beneficial effect on improving the glycemic profile.

The primary concern with combining milk thistle and any diabetes drug is the risk of hypoglycemia or low blood sugar, which certainly can be dangerous.

However, the blood sugar-lowering effect of milk thistle could certainly be seen as a positive attribute, as long as blood sugar doesn't drop too low, to the point where you are experiencing symptomatic hypoglycemia.

Milk thistle, combined with drugs with a low hypoglycemia risk, is certainly safer than using it with drugs that are riskier in this regard (such as insulin and glipizide).

Ok To Use With Metformin?

One of the positive attributes of metformin is that it lowers blood sugar and generally has very little risk of causing symptomatic hypoglycemia. This is unlike other drugs that are more likely to cause hypoglycemia, like insulin.

Taking metformin along with milk thistle might have an overall positive effect on lowering your average blood glucose and, the good news is, the risk of symptomatic hypoglycemia occurring with taking both would be considered to be relatively low.

Nevertheless, it is important to be aware of the signs and symptoms of hypoglycemia, such as:

• Shaking
• Sweating
• Increased heart rate
• Nervousness
• Dizziness
• Irritability

As always, be sure to let your doctor know of all the medications you are taking so you can be appropriately monitored.

Final Words

Thanks for reaching out to us and I hope that you found this helpful.