Milk Thistle (Silymarin)
The liver herb. 2,000 years of European folk use; modern evidence supports its role in protecting and regenerating liver cells.
Strong for amanita mushroom poisoning (IV form, hospital protocol). Moderate for NAFLD, alcoholic liver disease, and as adjunct in chronic hepatitis. Modest in healthy people without liver pathology. Effects on liver enzymes: 4–12 weeks.
Milk thistle (Silybum marianum) is a flowering plant whose seeds yield silymarin — a complex of flavonolignans including silybin, silydianin, and silychristin. It works on the liver in three ways: as an antioxidant in hepatocytes, by stabilising cell membranes against toxin entry, and by stimulating regeneration of damaged liver cells. Strong evidence in mushroom poisoning (IV silibinin is a hospital antidote for amanita poisoning), moderate evidence in alcoholic / fatty liver disease, and modest evidence in viral hepatitis. Often used as a hangover prevention / liver-supportive supplement for those drinking alcohol, taking acetaminophen, or on multiple medications.
- Form
- Standardised silymarin extract at 70–80% silymarin (the gold standard concentration). Silymarin phytosome (Siliphos / Silybin Phytosome) — better-absorbed phospholipid complex.
- Dose
- 150–300 mg silymarin 2–3x daily (450–900 mg total). Phytosome: 240–480 mg/day.
- Timing
- With food. Split AM/PM.
- Schedule
- Daily during periods of liver stress (medications, alcohol, exposure). Ongoing for chronic liver conditions.
- Side effects
- Very well-tolerated. Mild GI upset, loose stools, headache rarely.
- Interactions
- CYP3A4 / CYP2C9 substrates — silymarin is a mild inhibitor; can elevate levels of statins, calcium channel blockers, sirolimus, warfarin (modest). Generally clean otherwise.
- Contraindications
- Allergy to Asteraceae family (ragweed, daisy, chrysanthemum). Pregnancy (limited safety data).
- Lab markers
- ALT, AST, GGT (liver enzymes). Bilirubin if cholestasis is a concern.
- Food sources
- Milk thistle seeds can be ground and added to food, but practical doses for therapeutic effect require extract.
Pairs with
NAC, glutathione, alpha-lipoic acid (liver / antioxidant stack). TUDCA (additional bile / liver support). Dandelion, artichoke (traditional liver herbs).
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