Silymarin, a flavonolignan complex extracted from milk thistle (Silybum marianum), has a long history of use in traditional medicine for liver ailments. In recent decades, there has been growing scientific interest in its potential benefits for liver diseases, including cirrhosis. The proposed mechanisms for silymarin’s hepatoprotective effects include antioxidant activity, inhibition of lipid peroxidation, stabilization of cellular membranes, stimulation of protein synthesis, and anti-inflammatory properties. These mechanisms have been demonstrated in vitro and in animal models.

Clinical studies in humans, however, present mixed results. Some randomized controlled trials and meta-analyses suggest that silymarin may improve liver function tests (such as ALT and AST) and possibly reduce mortality in patients with cirrhosis—particularly alcoholic cirrhosis. For example, a meta-analysis published in 2007 (Saller et al., Phytomedicine) showed a non-significant trend toward reduced mortality. Other studies have failed to demonstrate significant clinical benefits or improvements in histological liver status. Safety profiles are generally favorable, with few reported side effects.

In summary, the use of silymarin for cirrhosis is supported by plausible mechanisms and some clinical data, but the overall quality of evidence is low to moderate, and major clinical guidelines do not currently recommend silymarin as standard therapy for cirrhosis. Thus, its use is "scientific," but with limited evidence (rating: 2/5).