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Milk Thistle

Milk Thistle

Best for

Lower elevated liver enzymes

Faint early signal · 80–700 mg/day for 4–49 weeks · 1 meta-analysis , n=625

12 papers · 2 claims · 31 outcomes scored · 2 positive

Outcomes

What milk thistle actually does, by outcome

Each row is one outcome with effect size, evidence base, the dose that worked in trials, and time to first effect. Magnitude tiers come from native-unit MCID where available, Cohen's d otherwise.

Outcome Effect Evidence Dose Weeks Rank
Lower elevated liver enzymes Faint early signal
small 		7 meta-analyses n=625 Meta-analyzed 80–700 mg 4–49 wk #9/41
Reverse fatty liver buildup Not enough research
trivial 		2 RCTs n=108 140–700 mg 4–49 wk #9/17

Risk profile

Adverse events and known drug interactions

Safety events

Serious adverse event severe
collapse severe
anaphylactic reaction severe
serious adverse events (unspecified) including increased GI AEs severe
headache mild
nausea mild
heartburn mild
gastrointestinal_discomfort (nausea, diarrhea, abdominal pain) mild

Drug interactions

other major unknown
Simvastatin major increases concentration
Domperidone major increases concentration
Sirolimus major decreases concentration
Warfarin moderate increases concentration
Drug:Clopidogrel moderate increases concentration
Losartan moderate decreases effect
Drug:Raloxifene moderate increases concentration
Cyclosporine moderate increases concentration
Talinolol moderate increases concentration

Co-studied with

Supplements that share evidence with milk thistle

Sources

  1. 1. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL). (2010) ↑
  2. 2. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial. (2012) ↑
  3. 3. Effects of metformin, pioglitazone, and silymarin treatment on non-alcoholic Fatty liver disease: a randomized controlled pilot study. (2012) ↑
  4. 4. A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. (2015) ↑
  5. 5. Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: A randomized, double-blind, placebo controlled trial. (2019) ↑
  6. 6. Effect of silymarin on liver size and nonalcoholic fatty liver disease in morbidly obese patients: A randomized double-blind clinical trial. (2022) ↑
  7. 7. Silymarin for adults with metabolic dysfunction-associated steatotic liver disease. (2025) ↑
  8. 8. Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis. (2022) ↑
  9. 9. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. (2007) ↑
  10. 10. Milk Thistle Treatment for Children and Adults with Trichotillomania: A Double-Blind, Placebo-Controlled, Crossover Negative Study. (2019) ↑

Generated August 14, 2026

Related

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