Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Milk thistle (Silybum marianum) is widely used as a complementary therapy for liver disorders, including non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease. The active component, silymarin, is a complex of flavonolignans thought to possess antioxidant, anti-inflammatory, and antifibrotic properties, which may protect liver cells from damage and support regeneration.

Several small-scale clinical trials and meta-analyses have examined milk thistle’s effects on fatty liver disease. Studies suggest that silymarin may reduce liver enzyme levels (ALT, AST), indicating improved liver function. However, most studies are limited by small sample sizes, short durations, and methodological weaknesses. A 2017 meta-analysis of randomized controlled trials found mild improvements in liver function tests, but did not show robust effects on liver histology or long-term clinical outcomes.

Guidelines from major liver societies do not currently recommend milk thistle as standard therapy for fatty liver disease, citing insufficient high-quality evidence. Nevertheless, the historical use of milk thistle for liver complaints, combined with encouraging but preliminary research, justifies its continued scientific investigation.

In summary, while there is some scientific rationale and limited clinical evidence suggesting possible benefits of milk thistle for fatty liver disease, the overall quality of the evidence is low, and further well-designed trials are needed to establish its efficacy and clinical relevance.

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