Silymarin (Milk Thistle)
Also known as milk thistle · Silybum marianum · silybin · silibinin
Research profile
Clinically studied11 key studies reviewed
254 human trials & reviews
6,310 papers on PubMed
Clinical evidence
What the research shows
Milk thistle has the longest history of any liver herb, but the best-quality evidence is disappointing. A Cochrane review of alcohol and viral hepatitis liver disease found no effect on death, complications or liver tissue, and a large US trial in hepatitis C found no benefit even at high doses. A 2025 Cochrane review in fatty liver (MASLD) found a possible small drop in ALT but with very low certainty. Meta-analyses in type 2 diabetes suggest modest falls in fasting glucose and HbA1c, mainly from small Iranian and Asian trials using 140-600 mg/day.
The modest positive signals come from research in adults with type 2 diabetes (blood sugar) and fatty liver (ALT). There is no supported role for detox in healthy people.
The research is clear: ingredients deliver most when your body actually needs them. That’s why AXEL maps your terrain first, then builds a regimen around you.
Discover your terrainSafety & good-to-know
- Across RCTs, silymarin's adverse-event rate was similar to placebo (Cochrane 2007; JAMA 2012; NASH RCT). PubMed 17943794PubMed 22797645PubMed 28419855
- Cochrane 2025 found no clear increase in serious adverse events in fatty liver (low certainty). PubMed 40552569
Every AXEL regimen can be reviewed by a physician in a consultation.
The studies (11)
Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury.
Meta-analysis of RCTs · Patients with liver injury of various causes · n = 55 studies, 3,545 patients · Various · Varied
Reduced AST and ALT overall, mainly in NAFLD and viral hepatitis; no effect in drug-induced or alcohol-related liver injury.
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.
Network meta-analysis · Adults with type 2 diabetes · n = 17 studies, 1,337 participants · Silymarin vs curcumin, resveratrol, berberine · Varied
Silymarin significantly improved fasting glucose, insulin resistance and HbA1c versus placebo; authors call for larger trials.
The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis.
Meta-analysis · Adults with cardiometabolic risk · n = 11 trials · Various · Varied
Lowered fasting glucose (~18 mg/dL), HbA1c (~1.25%), total cholesterol, triglycerides and LDL; high heterogeneity; no change in BMI.
The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis.
Meta-analysis · Patients with glucose or lipid metabolic dysfunction · n = 16 studies, 1,358 patients · Various · Varied
Lower fasting glucose, HbA1c, insulin resistance, cholesterol, LDL and CRP versus control; no change in liver or kidney function tests.
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 · Adults with type 2 diabetes · n = 7 trials · Various · Varied
Lowered fasting glucose, HbA1c, insulin, LDL and MDA, and raised HDL. Authors note evidence is insufficient for firm conclusions.
Silymarin for adults with metabolic dysfunction-associated steatotic liver disease.
Cochrane review · Adults with MASLD (fatty liver) · n = 17 RCTs, 2,069 participants · Silymarin alone or complexed · 4-48 weeks
Silymarin alone vs placebo may lower ALT by about 7 U/L (very low certainty). Silymarin complexes showed no clear enzyme benefit. No trial reported mortality or quality of life; overall benefit and harm unclear.
The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysis.
Meta-analysis of RCTs · Adults (mostly diabetes, thalassaemia) · n = 15 RCTs · Various · Varied
Small falls in CRP, IL-6 and MDA; no effect on IL-10, total antioxidant capacity or glutathione.
A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis.
RCT · Malaysian adults with biopsy-proven NASH · n = 99 · 700 mg three times daily · 48 weeks
Primary endpoint (30% fall in NAFLD activity score) not met (33% vs 26%). Fibrosis scores improved more with silymarin as secondary endpoints. Adverse events similar.
Full research notesOverview, research in progress and study doses
Further research
- Supports liver function. In fatty liver, silymarin may lower ALT by about 7 U/L (very low certainty, Cochrane 2025). In alcoholic and viral liver disease, high-quality trials showed no effect on mortality, complications or liver tissue (Cochrane 2007; JAMA 2012). PubMed 40552569PubMed 17943794PubMed 22797645PubMed 28419855PubMed 28785154PubMed 40221681
- Blood sugar in type 2 diabetes. Several meta-analyses of small trials report lower fasting glucose and HbA1c in people with type 2 diabetes, usually at 140-600 mg/day; heterogeneity is high and trials are mostly small. PubMed 30477860PubMed 33019400PubMed 35016260PubMed 40439602
- Antioxidant / anti-inflammatory. A 15-RCT meta-analysis found small reductions in CRP, IL-6 and MDA, mostly in diabetes and thalassaemia; no change in glutathione or total antioxidant capacity. PubMed 38372848
Where the research is still limited
- Did not reduce death, liver complications or improve liver tissue in alcoholic or hepatitis B/C liver disease (Cochrane, 18 RCTs).
- Did not lower ALT more than placebo in people with hepatitis C, even at 2,100 mg/day (JAMA RCT).
- Did not meet its main liver-biopsy endpoint in biopsy-proven NASH at 2,100 mg/day for 48 weeks.
- There is no human evidence it enhances 'detoxification' in healthy people.
Study doses
Liver trials used 140–2,100 mg/day, and blood-sugar trials typically 140–600 mg/day. Per serving as labelled, AXEL provides 100 mg in C300 Hepa Factor, 50 mg in Metabolic Balance Factor and Women's Balance Factor, and 30 mg in Beauty Factor Skin Day. That is about 1.4–70 times below trial doses.