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evidence · mechanism · dose
Supplements/Herb

Milk Thistle

aka Silymarin · Silibinin

Hepatoprotective herb with antioxidant and anti-fibrotic effects.

Liver HealthHealthy Aging

Overview

Hepatoprotective herb with antioxidant and anti-fibrotic effects.

Natural sources
  • Silybum marianum seeds
Common forms
  • Silymarin (70–80% silymarin)
  • Silibinin (most active)
  • Siliphos (phytosome)

Forms & variants of Milk Thistle

Different chemical forms of Milk Thistle behave differently. Browse each form's mechanism, bioavailability, and best-use context.

High-dose silymarin
Silymarin (Liver Dose)

Standardized silybin-rich extract for liver disease.

Mechanism of action

Inhibits hepatic lipid peroxidation, stabilizes hepatocyte membranes, used IV for Amanita poisoning.

Pathways
  • · Antioxidant
  • · Anti-fibrotic
  • · Membrane stabilization

Effects on the body

Supports
Hepatocyte protection

Organ system effects

Liver

Modest LFT improvement in chronic liver disease.

Evidence-based benefits

Modest reduction in liver enzymes (NAFLD, alcoholic)

Moderate evidence

Antidote for Amanita mushroom poisoning (IV silibinin)

Strong evidence

Potential side effects

Common
  • · GI upset
Rare
  • · Allergic rash
Serious

    Drug interactions

    CYP3A4 substrates
    Weak inhibition in vitro.
    minor

    Safety & non-supplemental interactions

    Educational summary — always confirm with your clinician or pharmacist before starting, stopping, or combining with prescription therapy.

    Avoid if you are
    • ·Pregnant or breastfeeding (insufficient safety data)
    • ·Children under 18 (unless directed by a clinician)
    • ·Pregnant or breastfeeding (insufficient data)
    Avoid with these conditions
    • ·Ragweed/daisy family allergy
    • ·Hormone-sensitive cancers (weak estrogenic in vitro)
    Avoid / monitor with these medications
    • ·May alter CYP2C9 substrates (warfarin, phenytoin)
    • ·Sirolimus
    • ·Some chemotherapy agents

    Supplement interactions

    Pairs well with

    None listed.

    Avoid combining with

    No specific avoidances listed.

    Dosing & bioavailability

    Typical dose
    150–600 mg silymarin/d

    Where to buy

    Affiliate-style search links to reputable retailers. We don't endorse specific brands — verify third-party testing (USP, NSF, Informed Sport) before purchase.

    Herb
    Milk Thistle
    Amazon
    Wide selection · fast shipping
    Herb
    Milk Thistle
    iHerb
    Global delivery · curated brands
    Herb
    Milk Thistle
    Thorne
    Practitioner-grade · NSF tested

    Scientific evidence (9)

    Systematic reviewExamine.com Supplement Database · 2023

    Milk Thistle: pharmacology, clinical evidence, and safety — narrative review

    Examine.com Research Team

    Curated narrative review of human and preclinical evidence for Milk Thistle, including mechanism, typical dosing, and safety considerations.

    Key findings

    Best-supported outcome: Modest reduction in liver enzymes (NAFLD, alcoholic) (evidence: moderate). Additional outcomes and limitations summarized in the full profile.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — Modest reduction in liver enzymes

    Live PubMed search

    Live results for "Milk Thistle Modest reduction in liver enzymes" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "Modest reduction in liver enzymes". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — Antidote for Amanita mushroom poisoning

    Live PubMed search

    Live results for "Milk Thistle Antidote for Amanita mushroom poisoning" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "Antidote for Amanita mushroom poisoning". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — randomized controlled trial

    Live PubMed search

    Live results for "Milk Thistle randomized controlled trial" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "randomized controlled trial". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — meta-analysis

    Live PubMed search

    Live results for "Milk Thistle meta-analysis" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "meta-analysis". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — pharmacokinetics

    Live PubMed search

    Live results for "Milk Thistle pharmacokinetics" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "pharmacokinetics". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — safety adverse events

    Live PubMed search

    Live results for "Milk Thistle safety adverse events" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "safety adverse events". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewPubMed (NLM) · 1970

    PubMed: Milk Thistle — dose response

    Live PubMed search

    Live results for "Milk Thistle dose response" across the PubMed/MEDLINE peer-reviewed index.

    Key findings

    Opens current human and preclinical literature matching Milk Thistle and "dose response". Filter by RCT, meta-analysis, or year on the results page.

    Open study
    Systematic reviewGoogle Scholar · 1970

    Google Scholar: Milk Thistle — clinical evidence

    Live Scholar search

    Cross-database citation index for Milk Thistle as it relates to "clinical evidence".

    Key findings

    Includes preprints, theses, and journal articles. Useful for tracking citation counts and follow-on work.

    Open study
    Educational use only. This profile is not medical advice. Consult a qualified healthcare professional before starting any supplement, especially if you take prescription medication or have a chronic condition.