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Silymarin

Silymarin is a group of plant compounds from milk thistle seeds that act as antioxidants and are studied for their role in protecting liver cells. People mostly look at it for nonalcoholic steatohepatitis, and combined trials found liver enzyme levels improved, with moderate evidence behind that. The studies were small, though, six trials with 437 people, and in fatty liver research body mass index and HDL cholesterol showed no clear difference, with very limited evidence.

Sources: PMID 28785154; PMID 33418491

Best evidence
Grade B
Conditions studied
5
Outcomes
13
Graded outcomes
0102

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

5 conditions

Nonalcoholic Steatohepatitis (NASH)

Nonalcoholic Steatohepatitis (NASH): outcomes studied for Silymarin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Liver Enzymes

Small Improvement

Improves (the measure goes down)Small effect6 studies437 people

Studies that measured liver enzymes

Total cholesterolImproves (the measure goes down)166 people
TriglyceridesImproves (the measure goes down)166 people

Nonalcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic Fatty Liver Disease (NAFLD): outcomes studied for Silymarin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Body Mass Index (BMI)

No effect

NoneNo effect1,908 people
High-density lipoprotein (HDL)

No effect

NoneNo effect1,908 people
Liver EnzymesChanges; see studies6 studies437 people

Studies that measured liver enzymes

Insulin ResistanceImproves (the measure goes down)1,908 people
Low-density lipoprotein (LDL)Improves (the measure goes down)1,908 people
Total cholesterolImproves (the measure goes down)166 people
TriglyceridesImproves (the measure goes down)166 people

Key findings

  • Liver EnzymesNonalcoholic Steatohepatitis (NASH)Improves (the measure goes down)
  • Body Mass Index (BMI)Nonalcoholic Fatty Liver Disease (NAFLD)
  • High-density lipoprotein (HDL)Nonalcoholic Fatty Liver Disease (NAFLD)

Shop the evidence-backed picks

Third-party tested Silymarin products, in the forms the graded studies used where we can match them.

  • Grade B

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Studies cited

7 studies from PubMed

  1. Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysisFront Immunol · PMID 36159792
  2. Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis.World J Gastroenterol · PMID 28785154
  3. Impact of Silymarin in individuals with nonalcoholic fatty liver disease: A systematic review and meta-analysisNutrition · PMID 33418491
  4. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trialsMedicine · PMID 29245314
  5. Effect of Medicinal Plants and Natural Products on Liver Enzymes in Non-alcoholic Fatty Liver Patients in Iran: A Systematic Review and Meta-Analysis.Int J Prev Med · PMID 35958359
  6. An updated systematic review with meta-analysis for the clinical evidence of silymarin.Forsch Komplementmed · PMID 18334810
  7. Effects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials.Biomed Res Int · PMID 25247194