Milk Thistle

69 research sources Also known as: silybum marianum silymarin silybin holy thistle
620 Products on Market
250.0 mg Median Dose
🟢 91/100 Market Safety Score
69 Research Sources
Browse 620 products →

Product Forms

Capsule 67% Liquid 14% Powder 6% Softgel Capsule 6% Tablet or Pill 5% Other (e.g. tea bag) 1% Gummy or Jelly 1%

Dose Distribution

1-5 mg 14 100-250 mg 185 25-50 mg 4 250-500 mg 185 50-100 mg 20 500-1000 mg 74 <1 mg 30 >1000 mg 50

Top Brands

TerraVita 33 TerraVita Premium Collection 27 The Vitamin Shoppe 13 NOW 12 GNC Herbal Plus 10 Nature's Way 10 Integrative Therapeutics 7 Life Extension 7 Nature's Answer 7 Pure Encapsulations 7 Bronson 7 Herbadiet 7

Claims on Labels

All Other 99% Structure/Function 83% Nutrient 4% No Claim 1% Approved Health 0%

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Milk Thistle 200 mg GNC Herbal Plus
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Evidence Summary

Milk thistle, primarily through its active component silymarin, is extensively researched for its hepatoprotective properties. Evidence suggests it is effective in managing various liver conditions, particularly NAFLD/MASLD, and improving metabolic markers.

Evidence by Condition

NAFLD/MASLD/NASH Strong

Multiple meta-analyses indicate silymarin is effective in treating nonalcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease, often as part of multi-intervention strategies.

Alcoholic and/or Hepatitis B or C liver diseases Moderate

Cochrane reviews suggest potential benefits for managing liver diseases related to alcohol and viral hepatitis.

Drug-induced liver injury Moderate

Evidence supports the use of silymarin in the prevention and management of idiosyncratic drug-induced liver injury.

Glucose/lipid metabolic dysfunction Moderate

Meta-analyses demonstrate therapeutic effects of silymarin on glucose and lipid metabolic dysfunction.

Radiodermatitis Moderate

Herbal agents including thistle are evaluated for managing radiodermatitis in breast cancer patients.

Effective Doses

Dose ranges are not specified in the provided research abstracts.

Key Findings

  • Silymarin is effective for adults with metabolic dysfunction-associated steatotic liver disease (PMID: 40552569)
  • The combination of berberine and silymarin has a measurable effect on liver enzymes (PMID: 35623810)
  • Silymarin provides therapeutic effects for patients with glucose and lipid metabolic dysfunction (PMID: 33019400)
  • Silymarin is useful in the prevention and management of idiosyncratic drug-induced liver injury (PMID: 33359912)

Limitations

Much of the current research focuses on silymarin in combination with other treatments (such as TCM or berberine) rather than monotherapy, and there is a call to re-evaluate standardized administration practices (PMID: 40221681).

Safety & Interactions

No specific contraindications or drug interactions were detailed in the provided text, though its use is studied in the context of managing drug-induced liver injury.

AI-generated summary from 69 peer-reviewed studies. Not medical advice. Always consult a healthcare provider.

Drug-Supplement Interactions

Antiarrhythmics 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of amiodarone (antiarrhythmics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of amiodarone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Anticonvulsants 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of carbamazepine (anticonvulsants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of carbamazepine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
GI Prokinetics 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of cisapride (gi-prokinetics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of cisapride. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Immunosuppressants 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of cyclosporine (immunosuppressants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of cyclosporine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Theophylline 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of theophylline (theophylline), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of theophylline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Warfarin 🔴 Critical
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of warfarin (warfarin), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of warfarin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
ADHD Medications 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of atomoxetine (adhd-medications), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of atomoxetine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
ARB 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of losartan (arb), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of losartan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antibiotics 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of clarithromycin (antibiotics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of clarithromycin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antidiabetic Drugs 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of repaglinide (antidiabetic-drugs), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of repaglinide. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antiemetics 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ondansetron (antiemetics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ondansetron. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antifungals 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of fluconazole (antifungals), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of fluconazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antiplatelet Drugs 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2C19, which decreases metabolism of CYP2C19 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of clopidogrel (antiplatelet-drugs), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of clopidogrel. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antipsychotics 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of haloperidol (antipsychotics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of haloperidol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antitussives 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of dextromethorphan (antitussives), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of dextromethorphan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Benzodiazepines 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of midazolam (benzodiazepines), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of midazolam. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Beta Blockers 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of metoprolol (beta-blockers), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of metoprolol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Beta-2 Agonists 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of salmeterol (beta2-agonists), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of salmeterol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
CFTR Modulators 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ivacaftor (cftr-modulators), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ivacaftor. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Calcium Channel Blockers 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of nifedipine (calcium-channel-blockers), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of nifedipine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Chemotherapy 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of doxorubicin (chemotherapy), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of doxorubicin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Corticosteroids 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of prednisone (corticosteroids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of prednisone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Iron Chelators 🟡 Moderate
Mechanism: Interaction identified from DDInter 2.0 database. Specific drugs: Deferiprone
Effect: See mechanism description
Management: Consult healthcare provider before combining.
Evidence: ddinter-verified
Leukotriene Antagonists 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of montelukast (leukotriene-antagonists), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of montelukast. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
NSAIDs 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ibuprofen (nsaids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ibuprofen. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Opioids 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of methadone (opioids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of methadone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Oral Contraceptives 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ethinylestradiol (oral-contraceptives), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ethinylestradiol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
PDE5 Inhibitors 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of sildenafil (pde5-inhibitors), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of sildenafil. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
PPIS 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of omeprazole (ppis), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of omeprazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
SNRI 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of venlafaxine (snri), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of venlafaxine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
SSRI 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of sertraline (ssri), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of sertraline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Sirolimus 🟡 Moderate
Mechanism: Milk thistle inhibits CYP3A4 and P-gp, potentially increasing sirolimus levels.
Effect: Increased sirolimus levels; potential toxicity
Management: Monitor sirolimus levels closely. May need dose reduction.
Evidence: probable
Statins 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of simvastatin (statins), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of simvastatin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Tricyclic Antidepressants 🟡 Moderate
Mechanism: Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of amitriptyline (tricyclic-antidepressants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of amitriptyline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Metronidazole 🟢 Minor
Mechanism: Milk thistle may inhibit CYP3A4 and CYP2C9, potentially increasing metronidazole levels.
Effect: Possible increased metronidazole levels
Management: Monitor for metronidazole side effects. Minor clinical concern.
Evidence: possible

⚠️ This information is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before combining supplements with medications.

Claims vs. Evidence

80% Evidence-Backed
20% Unsupported
83% Structure/Function
Claim Type% of ProductsEvidence RequiredStatus
All Other 99% Tier D (Unclassified) ✅ Supported
Structure/Function 83% Tier C (DSHEA Structure/Function (no pre-approval)) ✅ Supported
Nutrient 4% Tier D (Unknown) ✅ Supported
No Claim 1% Tier D (No claim on label) ✅ Supported
Approved Health 0% Tier A (FDA Approved Health Claim (21 CFR 101.9)) ⚠️ Unsupported

Research by Topic

Milk Thistle 53 studies
MET Evaluation of the effect of herbal agents as management of r...
MET Efficacy of different interventions for nonalcoholic fatty l...
MET Pharmacotherapy for trichotillomania
+50 more
Milk Thistle Liver 8 studies
MET Silymarin for adults with metabolic dysfunction-associated s...
MET Effects berberine-silymarin on liver enzymes: A systematic r...
MET Administration of silymarin in NAFLD/NASH: A systematic revi...
+5 more
Cochrane Milk Thistle 3 studies
MET Milk thistle for alcoholic and/or hepatitis B or C virus liv...
MET Milk thistle for alcoholic and/or hepatitis B or C virus liv...
RCT The activity of a herbal medicinal product of Phyllanthus ni...
Dietary Supplement General 3 studies
CLI Exercise, Milk Thistle, and Lactobacillus to Influence Plasm...
CLI An Intervention Study of Compound Silymarin in Patients With...
CLI N-Acetylcysteine and Milk Thistle for Treatment of Diabetic ...
Berberine 2 studies
MET Metabolic effect of berberine-silymarin association: A meta-...
SYS Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and B...

⚠️ FDA Safety Data

Adverse Event Profile: Milk Thistle

Research Evidence (69)

Meta Analysis: 34 Systematic Review: 26 Rct: 5 Clinical Trial: 3 Openfda Safety: 1
A Silymarin for adults with metabolic dysfunction-associated steatotic liver disease
Meta Analysis The Cochrane database of systematic reviews 2025 n=2069

RATIONALE: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major public health challenge, with approximately 32.4% of adults globally diagnosed with the condition and a steadily increasing prevalence. Currently, no specific medi...

PubMed DOI Cochrane
B Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis
Meta Analysis Japan journal of nursing science : JJNS 2024 n=1994

**Que et al., 2024** | Jpn J Nurs Sci | Meta Analysis Que Suyun, Ma Xuanlei, ... He Jiangtao. Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis. Jpn J Nurs Sci....

PubMed DOI
B Efficacy of different interventions for nonalcoholic fatty liver disease: A meta-analysis of lifestyle modifications, silymarin, and medications
Meta Analysis Asia Pacific journal of clinical nutrition 2025 n=2283

**Zhang et al., 2025** | Asia Pac J Clin Nutr | Meta Analysis Zhang Zhen, Li Shuai, Sun Jianjun. Efficacy of different interventions for nonalcoholic fatty liver disease: A meta-analysis of lifestyle modifications, silymarin, and medications. Asia Pa...

PubMed DOI
B Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases
Meta Analysis The Cochrane database of systematic reviews 2007 n=1088

**Rambaldi et al., 2007** | Cochrane Database Syst Rev | Meta Analysis Rambaldi A, Jacobs B P, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev. 2007-Oct-17;2007(4):CD003620 BACKGROUND: Alco...

PubMed
B Pharmacotherapy for trichotillomania
Meta Analysis The Cochrane database of systematic reviews 2021 n=286

**Hoffman et al., 2021** | Cochrane Database Syst Rev | Meta Analysis Hoffman Jacob, Williams Taryn, ... Stein Dan J. Pharmacotherapy for trichotillomania. Cochrane Database Syst Rev. 2021-Sep-28;9(9):CD007662. doi:10.1002/14651858.CD007662.pub3 BACK...

PubMed DOI
B Effects berberine-silymarin on liver enzymes: A systematic review and meta-analysis of randomized controlled trials
Meta Analysis Clinical nutrition ESPEN 2022 n=549

BACKGROUND & AIMS: Despite controversies, no study has systematically summarized findings from earlier studies on the effect of berberine (BBR)-silymarin on liver enzymes. Therefore, the current systematic review and meta-analysis aimed to investigat...

PubMed DOI
B Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review
Meta Analysis Medicine 2024 n=1335

**Zhang et al., 2024** | Medicine (Baltimore) | Meta Analysis Zhang Xiang, Jiang Zhenghao, ... Zhou Qiujun. Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review. M...

PubMed DOI
B Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury
Meta Analysis BMC complementary medicine and therapies 2025 n=3545

**Shahsavari et al., 2025** | BMC Complement Med Ther | Meta Analysis Shahsavari Kasra, Ardekani Shireen Shams, ... Hasanpour Maede. Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on...

PubMed DOI
B The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis
Meta Analysis Medicine 2020 n=1358

**Xiao et al., 2020** | Medicine (Baltimore) | Meta Analysis Xiao Fengyan, Gao Feng, ... Wang Lina. The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis. Medicine (Baltimore). 2020-Oct-02;99(40):...

PubMed DOI
B Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis
Meta Analysis Annals of hepatology 2024 n=2375

INTRODUCTION AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplem...

PubMed DOI
B The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials
Meta Analysis Medicine 2017 n=587

**Zhong et al., 2017** | Medicine (Baltimore) | Meta Analysis Zhong Sheng, Fan Yuxiang, ... Niu Junqi. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials. Medicine...

PubMed DOI
B Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials
Meta Analysis Pharmacological research 2021 n=2471

**Niu et al., 2021** | Pharmacol Res | Meta Analysis Niu Hao, Sanabria-Cabrera Judith, ... Lucena M Isabel. Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials. Pharm...

PubMed DOI
B Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases
Meta Analysis The Cochrane database of systematic reviews 2005 n=915

**Rambaldi et al., 2005** | Cochrane Database Syst Rev | Meta Analysis Rambaldi A, Jacobs B P, ... Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev. 2005-Apr-18(2):CD003620 BACKGROUND: Alcoh...

PubMed
B Efficacy of various plant-derived interventions in the prevention of radiation dermatitis in breast cancer patients: a systematic review and network meta-analysis of randomised controlled trials
Systematic Review Frontiers in oncology 2025 n=2177

**Li et al., 2025** | Front Oncol | Systematic Review Li Mingyu, Hao Jianping, ... Zhao Lijun. Efficacy of various plant-derived interventions in the prevention of radiation dermatitis in breast cancer patients: a systematic review and network meta-a...

PubMed DOI
B The effects of antioxidant supplementation on pain, oxidative stress markers, and clinical pregnancy rate in women with endometriosis: a systematic review and meta-analysis of randomized controlled trials
Systematic Review Frontiers in medicine 2025 n=1626

**Zhong et al., 2025** | Front Med (Lausanne) | Systematic Review Zhong Yuchan, Qiao Xinyu, ... Huang Wei. The effects of antioxidant supplementation on pain, oxidative stress markers, and clinical pregnancy rate in women with endometriosis: a system...

PubMed DOI
B Effects of silymarin on insulin resistance and sensitivity: A systematic review and meta-analysis of randomized controlled trials
Meta Analysis Diabetes research and clinical practice 2025 n=673

**Yin et al., 2025** | Diabetes Res Clin Pract | Meta Analysis Yin Shao, Zhu Fengya, ... Chen Qiu. Effects of silymarin on insulin resistance and sensitivity: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pr...

PubMed DOI
B Novel Therapies for Kidney Disease in People With Diabetes
Systematic Review The Journal of clinical endocrinology and metabolism 2022

**Khurana et al., 2022** | J Clin Endocrinol Metab | Systematic Review Khurana Nayana, James Steven, ... Ekinci Elif I. Novel Therapies for Kidney Disease in People With Diabetes. J Clin Endocrinol Metab. 2022-Jan-01;107(1):e1-e24. doi:10.1210/clinem...

PubMed DOI
B Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Meta Analysis Journal of diabetes research 2016 n=270

**Voroneanu et al., 2016** | J Diabetes Res | Meta Analysis Voroneanu Luminita, Nistor Ionut, ... Covic Adrian. Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Diabetes Res. 2016;2016:51...

PubMed DOI
B The effects of silymarin supplementation on metabolic status and oxidative stress in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials
Meta Analysis Complementary therapies in medicine 2018

**Hadi et al., 2018** | Complement Ther Med | Meta Analysis Hadi Amir, Pourmasoumi Makan, ... Miraghajani Maryam. The effects of silymarin supplementation on metabolic status and oxidative stress in patients with type 2 diabetes mellitus: A systemati...

PubMed DOI
B Metabolic effect of berberine-silymarin association: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials
Meta Analysis Phytotherapy research : PTR 2019 n=497

**Fogacci et al., 2019** | Phytother Res | Meta Analysis Fogacci Federica, Grassi Davide, ... Cicero Arrigo F G. Metabolic effect of berberine-silymarin association: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials. Phy...

PubMed DOI
B Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis
Meta Analysis Translational psychiatry 2022 n=629

**Kishi et al., 2022** | Transl Psychiatry | Meta Analysis Kishi Taro, Sakuma Kenji, Iwata Nakao. Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis. Transl Psychiatry. 2022-Jun-28;12(1):263...

PubMed DOI
B Effects of silymarin supplementation on liver and kidney functions: A systematic review and dose-response meta-analysis
Meta Analysis Phytotherapy research : PTR 2024 n=41

**Mohammadi et al., 2024** | Phytother Res | Meta Analysis Mohammadi Shooka, Ashtary-Larky Damoon, ... Afrisham Reza. Effects of silymarin supplementation on liver and kidney functions: A systematic review and dose-response meta-analysis. Phytother R...

PubMed DOI
B Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A Systemic Review and Bayesian Network Meta-Analysis
Systematic Review Phytotherapy research : PTR 2025 n=1337

**Miao et al., 2025** | Phytother Res | Systematic Review Miao Runyu, Zhang Boxun, ... Tong Xiaolin. Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A...

PubMed DOI
B Milk thistle for the treatment of liver disease: a systematic review and meta-analysis
Meta Analysis The American journal of medicine 2002 n=433

PURPOSE: Milk thistle, an herbal compound, is the dietary supplement taken most frequently by patients with chronic liver disease. We performed a systematic review of the literature to determine the efficacy and safety of this herb for the treatment ...

PubMed
B Meta-analysis of the effect of herbal supplement on glycemic control in type 2 diabetes
Meta Analysis Journal of ethnopharmacology 2011 n=487

**Suksomboon et al., 2011** | J Ethnopharmacol | Meta Analysis Suksomboon Naeti, Poolsup Nalinee, ... Suthisisang Chuthamanee C. Meta-analysis of the effect of herbal supplement on glycemic control in type 2 diabetes. J Ethnopharmacol. 2011-Oct-11;13...

PubMed DOI
B The role of ursodeoxycholic acid in non-alcoholic steatohepatitis: a systematic review
Systematic Review BMC gastroenterology 2013 n=1160

**Xiang et al., 2013** | BMC Gastroenterol | Systematic Review Xiang Zun, Chen Yi-peng, ... Jin Xi. The role of ursodeoxycholic acid in non-alcoholic steatohepatitis: a systematic review. BMC Gastroenterol. 2013-Sep-23;13:140. doi:10.1186/1471-230X-1...

PubMed DOI
B Effects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials
Meta Analysis BioMed research international 2014 n=167

OBJECTIVE: This study aimed to evaluate the efficacy and safety of silymarin on chronic hepatitis C virus- (HCV-) infected patients. METHODS: Randomized controlled trials (RCTs) of silymarin in chronic HCV-infected patients up to April 1, 2014 were s...

PubMed DOI
B Herbal galactagogues to improve breastmilk production and lactation in mothers of preterm babies: a systematic review of clinical trials
Systematic Review European journal of clinical nutrition 2026

**Cragg et al., 2026** | Eur J Clin Nutr | Systematic Review Cragg Aislinn, Levene Ilana, ... Willcox Merlin. Herbal galactagogues to improve breastmilk production and lactation in mothers of preterm babies: a systematic review of clinical trials. Eu...

PubMed DOI
C Coadministration of silymarin with iron chelators in transfusion-dependent β-thalassemia patients: a systematic review and meta-analysis for effect on iron overload
Meta Analysis Expert review of clinical pharmacology 2021 n=477

**Darvishi-Khezri et al., 2021** | Expert Rev Clin Pharmacol | Meta Analysis Darvishi-Khezri Hadi, Naderisorki Mohammad, ... Karami Hossein. Coadministration of silymarin with iron chelators in transfusion-dependent β-thalassemia patients: a systemat...

PubMed DOI
C The effect of pharmacological treatment and lifestyle modification in patients with nonalcoholic fatty liver disease: An umbrella review of meta-analyses of randomized controlled trials
Systematic Review Obesity reviews : an official journal of the International Association for the Study of Obesity 2022 n=518

**Cho et al., 2022** | Obes Rev | Systematic Review Cho Kyuyeon, Park Seoyeon, ... Smith Lee. The effect of pharmacological treatment and lifestyle modification in patients with nonalcoholic fatty liver disease: An umbrella review of meta-analyses of...

PubMed DOI
C Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review
Systematic Review Advances in therapy 2020

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 n...

PubMed DOI
C The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysis
Meta Analysis Inflammopharmacology 2024

**Bahari et al., 2024** | Inflammopharmacology | Meta Analysis Bahari Hossein, Shahraki Jazinaki Mostafa, ... Malekahmadi Mahsa. The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysi...

PubMed DOI
C Silymarin decreases liver stiffness associated with gut microbiota in patients with metabolic dysfunction-associated steatotic liver disease: a randomized, double-blind, placebo-controlled trial
Rct Lipids in health and disease 2024 n=41

BACKGROUND: Despite centuries of traditional use of silymarin for hepatoprotection, current randomized controlled trial (RCT) studies on the effectiveness of silymarin in managing metabolic dysfunction-associated steatotic liver disease (MASLD) are l...

PubMed DOI
C Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis
Meta Analysis World journal of gastroenterology 2017

**de et al., 2017** | World J Gastroenterol | Meta Analysis de Avelar Camila Ribeiro, Pereira Emile Miranda, ... de Oliveira Lucivalda Pereira Magalhães. Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review ...

PubMed DOI
C Impact of Silymarin in individuals with nonalcoholic fatty liver disease: A systematic review and meta-analysis
Meta Analysis Nutrition (Burbank, Los Angeles County, Calif.) 2021

**Kalopitas et al., 2021** | Nutrition | Meta Analysis Kalopitas Georgios, Antza Christina, ... Chourdakis Michail. Impact of Silymarin in individuals with nonalcoholic fatty liver disease: A systematic review and meta-analysis. Nutrition. 2021-Mar;8...

PubMed DOI
C Efficacy of elafibranor in patients with liver abnormalities especially non-alcoholic steatohepatitis: a systematic review and meta-analysis
Meta Analysis Clinical journal of gastroenterology 2021

**Malik et al., 2021** | Clin J Gastroenterol | Meta Analysis Malik Adnan, Nadeem Mahum, Malik Muhammad Imran. Efficacy of elafibranor in patients with liver abnormalities especially non-alcoholic steatohepatitis: a systematic review and meta-analysi...

PubMed DOI
C Milk thistle for alcoholic and/or hepatitis B or C liver diseases--a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials
Meta Analysis The American journal of gastroenterology 2005 n=915

OBJECTIVES: Our objectives were to assess the beneficial and harmful effects of milk thistle (MT) or MT constituents versus placebo or no intervention in patients with alcoholic liver disease and/or hepatitis B and/or C liver diseases. METHODS: Rando...

PubMed
C Novel Anti-inflammatory Treatments in Cirrhosis. A Literature-Based Study
Systematic Review Frontiers in medicine 2021

**Kronborg et al., 2021** | Front Med (Lausanne) | Systematic Review Kronborg Thit Mynster, Ytting Henriette, ... Kimer Nina. Novel Anti-inflammatory Treatments in Cirrhosis. A Literature-Based Study. Front Med (Lausanne). 2021;8:718896. doi:10.3389/...

PubMed DOI
C An updated systematic review with meta-analysis for the clinical evidence of silymarin
Meta Analysis Forschende Komplementarmedizin (2006) 2008

**Saller et al., 2008** | Forsch Komplementmed | Meta Analysis Saller Reinhard, Brignoli Reto, ... Meier Rémy. An updated systematic review with meta-analysis for the clinical evidence of silymarin. Forsch Komplementmed. 2008-Feb;15(1):9-20. doi:10.1...

PubMed DOI
C The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis
Meta Analysis Phytotherapy research : PTR 2022

**Soleymani et al., 2022** | Phytother Res | Meta Analysis Soleymani Samaneh, Ayati Mohammad Hossein, ... Zargaran Arman. The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis. Phytother...

PubMed DOI
C Silibinin as a major component of milk thistle seed provides promising influences against diabetes and its complications: a systematic review
Systematic Review Naunyn-Schmiedeberg's archives of pharmacology 2024

**Zare et al., 2024** | Naunyn Schmiedebergs Arch Pharmacol | Systematic Review Zare Mehrjerdi Parisa, Asadi Sara, ... Baradaran Rahimi Vafa. Silibinin as a major component of milk thistle seed provides promising influences against diabetes and its c...

PubMed DOI
C Nephroprotective Effects of Silymarin: A Systematic Review and Meta-Analysis
Meta Analysis Biochemistry. Biokhimiia 2025 n=7

**Frounchi et al., 2025** | Biochemistry (Mosc) | Meta Analysis Frounchi Negin, Mahmoodpoor Fariba, ... Roumiantsev Sergey. Nephroprotective Effects of Silymarin: A Systematic Review and Meta-Analysis. Biochemistry (Mosc). 2025-Aug;90(8):1140-1152. d...

PubMed DOI
C Meta-analysis: silymarin and its combination therapy for the treatment of chronic hepatitis B
Meta Analysis European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2013

**Wei et al., 2013** | Eur J Clin Microbiol Infect Dis | Meta Analysis Wei F, Liu S-K, ... Li Y-W. Meta-analysis: silymarin and its combination therapy for the treatment of chronic hepatitis B. Eur J Clin Microbiol Infect Dis. 2013-May;32(5):657-69. ...

PubMed DOI
C Effects of silymarin supplementation on blood lipids: A systematic review and meta-analysis of clinical trials
Meta Analysis Phytotherapy research : PTR 2019

**Mohammadi et al., 2019** | Phytother Res | Meta Analysis Mohammadi Hamed, Hadi Amir, ... Rouhani Mohammad Hossein. Effects of silymarin supplementation on blood lipids: A systematic review and meta-analysis of clinical trials. Phytother Res. 2019-A...

PubMed DOI
C Systematic review of pharmacokinetics and potential pharmacokinetic interactions of flavonolignans from silymarin
Systematic Review Medicinal research reviews 2021

**Tvrdý et al., 2021** | Med Res Rev | Systematic Review Tvrdý Václav, Pourová Jana, ... Mladěnka Přemysl. Systematic review of pharmacokinetics and potential pharmacokinetic interactions of flavonolignans from silymarin. Med Res Rev. 2021-Jul;41(4):...

PubMed DOI
C Efficacy of oral and topical antioxidants in the prevention and management of oral mucositis in head and neck cancer patients: a systematic review and meta-analyses
Meta Analysis Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2022 n=2

**Raza et al., 2022** | Support Care Cancer | Meta Analysis Raza Afsheen, Karimyan Nelli, ... Enciso Reyes. Efficacy of oral and topical antioxidants in the prevention and management of oral mucositis in head and neck cancer patients: a systematic re...

PubMed DOI
C The Radioprotective Potentials of Silymarin/Silibinin Against Radiotherapy- Induced Toxicities: A Systematic Review of Clinical and Experimental Studies
Systematic Review Current medicinal chemistry 2023

**Latacela et al., 2023** | Curr Med Chem | Systematic Review Latacela Gloria Alexandra, Ramaiah Pushpamala, ... Farhood Bagher. The Radioprotective Potentials of Silymarin/Silibinin Against Radiotherapy- Induced Toxicities: A Systematic Review of Cl...

PubMed DOI
C Current and future directions in the treatment and prevention of drug-induced liver injury: a systematic review
Systematic Review Expert review of gastroenterology & hepatology 2016

**Stine et al., 2016** | Expert Rev Gastroenterol Hepatol | Systematic Review Stine Jonathan G, Lewis James H. Current and future directions in the treatment and prevention of drug-induced liver injury: a systematic review. Expert Rev Gastroenterol H...

PubMed DOI
C The Effects and Safety of Silymarin on β-thalassemia in Children and Adolescents: A Systematic Review based on Clinical Trial Studies
Systematic Review Reviews on recent clinical trials 2024

**Rahimi-Dehkordi et al., 2024** | Rev Recent Clin Trials | Systematic Review Rahimi-Dehkordi Nasim, Heidari-Soureshjani Saeid, Sherwin Catherine M T. The Effects and Safety of Silymarin on β-thalassemia in Children and Adolescents: A Systematic Revi...

PubMed DOI
C The Role of Polyphenols in Rosacea Treatment: A Systematic Review
Systematic Review Journal of alternative and complementary medicine (New York, N.Y.) 2017 n=2

**Saric et al., 2017** | J Altern Complement Med | Systematic Review Saric Suzana, Clark Ashley K, ... Lev-Tov Hadar A. The Role of Polyphenols in Rosacea Treatment: A Systematic Review. J Altern Complement Med. 2017-Dec;23(12):920-929. doi:10.1089/a...

PubMed DOI

Showing top 50 of 69 sources, sorted by quality score.

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Frequently Asked Questions

What is Milk Thistle and what is it used for?

Milk thistle is a supplement containing silymarin, which is primarily used for its liver-protecting properties. There is strong evidence for its use in managing fatty liver disease and moderate evidence for supporting various other liver conditions.

Does Milk Thistle help with fatty liver disease?

Yes, there is strong evidence that silymarin is effective in treating nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD). It is often used as part of a multi-intervention strategy.

Can Milk Thistle help with blood sugar and cholesterol levels?

There is moderate evidence suggesting that silymarin can provide therapeutic effects for patients dealing with glucose and lipid metabolic dysfunction. This means it may help manage certain aspects of blood sugar and fat metabolism.

Is Milk Thistle effective for hepatitis or alcohol-related liver issues?

There is moderate evidence suggesting that silymarin may provide potential benefits for managing liver diseases related to alcohol consumption and viral hepatitis B or C.

What is the recommended dose of Milk Thistle?

The provided research does not specify an exact effective dose range for Milk Thistle. You should consult with a healthcare professional to determine the appropriate dosage for your specific needs.

Are there any known drug interactions or safety concerns with Milk Thistle?

No specific drug interactions or contraindications were documented in the available research. However, you should always consult your doctor before starting a new supplement, especially if you are managing liver injury.

Who should avoid taking Milk Thistle?

The current research does not identify specific groups of people who should avoid Milk Thistle. As with any supplement, it is best to discuss use with a medical provider to ensure it is safe for your individual health status.

Answers generated from research evidence. Not medical advice.