Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

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#blood-glucose #diabetes-mellitus #hepatocytes #humans #liver-cirrhosis

Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

Gillessen et al., 2020 | Adv Ther | Systematic Review

Citation

Gillessen Anton, Schmidt Hartmut H-J. Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review. Adv Ther. 2020-Apr;37(4):1279-1301. doi:10.1007/s12325-020-01251-y

Abstract

Silymarin, an extract from milk thistle seeds, has been used for centuries to treat hepatic conditions. Preclinical data indicate that silymarin can reduce oxidative stress and consequent cytotoxicity, thereby protecting intact liver cells or cells not yet irreversibly damaged. Eurosil 85® is a proprietary formulation developed to maximize the oral bioavailability of silymarin. Most of the clinical research on silymarin has used this formulation. Silymarin acts as a free radical scavenger and modulates enzymes associated with the development of cellular damage, fibrosis and cirrhosis. These hepatoprotective effects were observed in clinical studies in patients with alcoholic or non-alcoholic fatty liver disease, including patients with cirrhosis. In a pooled analysis of trials in patients with cirrhosis, silymarin treatment was associated with a significant reduction in liver-related deaths. Moreover, in patients with diabetes and alcoholic cirrhosis, silymarin was also able to improve glycemic parameters. Patients with drug-induced liver injuries were also successfully treated with silymarin. Silymarin is generally very well tolerated, with a low incidence of adverse events and no treatment-related serious adverse events or deaths reported in clinical trials. For maximum benefit, treatment with silymarin should be initiated as early as possible in patients with fatty liver disease and other distinct liver disease manifestations such as acute liver failure, when the regenerative potential of the liver is still high and when removal of oxidative stress, the cause of cytotoxicity, can achieve the best results.

Key Findings

For maximum benefit, treatment with silymarin should be initiated as early as possible in patients with fatty liver disease and other distinct liver disease manifestations such as acute liver failure, when the regenerative potential of the liver is still high and when removal of oxidative stress, the cause of cytotoxicity, can achieve the best results.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population alcoholic or non
Sample Size See abstract
Age Range See abstract
Condition stress

MeSH Terms

  • Blood Glucose
  • Diabetes Mellitus
  • Hepatocytes
  • Humans
  • Liver Cirrhosis
  • Liver Diseases
  • Liver Diseases, Alcoholic
  • Non-alcoholic Fatty Liver Disease
  • Protective Agents
  • Silymarin

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: milk-thistle-liver

Provenance

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