Bleeding Milky Way!

Alireza Asgari; Morteza Daraei; Sahar Karimpour Reihan

doi:10.18502/crcp.v6i4.7857

Alireza Asgari Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Morteza Daraei Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Sahar Karimpour Reihan Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/crcp.v6i4.7857

Keywords: Milk thistle; Bleeding; Platelet aggregation inhibitors; Factor Xa inhibitors; Antithrombins

Abstract

Many people regard herbal plants as a safe natural product and routinely consume them for maintenance of healthy life or as home remedies without considering their potential health-threatening side effects. Here, we presented manifestations of milk thistle toxicity. The milk thistle’s flavonolignans, especially the silybin ingredient disturb the hemostatic process by dual anticoagulant and anti-platelet properties. This plant can inhibit serine proteases, including factors II and X as in the coagulation cascade as well as platelet activation by blocking adenosine diphosphate receptor and cyclooxygenase; hence, it causes bleeding diathesis.