Milk thistle (silymarin / silibinin)
Detox · Hepatoprotective flavonolignan
Tier C+
Bottom line
Read Off Label grades Milk thistle (silymarin / silibinin) as C+ (5.4/10) based on weak evidence, weak benefit magnitude, and a low-risk safety profile.
Oral silymarin has poor bioavailability; phytosome forms (Siliphos) or silibinin formulations improve absorption considerably.
Studied, labeled, or reported-use context: 200-400 mg/day silymarin standardized to 70-80% silymarin — OTC (oral); Rx/compassionate use; not individualized guidance.
What the evidence says
Oral silymarin has poor bioavailability; phytosome forms (Siliphos) or silibinin formulations improve absorption considerably. Most trials in chronic liver disease have been disappointing. Routine 'liver detox' marketing exceeds evidence. IV silibinin legitimately life-saving for Amanita poisoning.
Mechanism
Silymarin complex (silibinin A/B, silychristin, silydianin); scavenges free radicals, stabilizes hepatocyte membranes; silibinin blocks amatoxin uptake — specific antidote for Amanita phalloides poisoning
Studied, labeled, or reported dose & route
200-400 mg/day silymarin standardized to 70-80% silymarin
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Milk thistle (silymarin / silibinin)'s effects?
- Read Off Label rates the evidence for Milk thistle (silymarin / silibinin) as Weak and the benefit magnitude as weak, producing an overall grade of C+ (5.4/10). Oral silymarin has poor bioavailability; phytosome forms (Siliphos) or silibinin formulations improve absorption considerably.
- What safety findings are reported for Milk thistle (silymarin / silibinin)?
- Milk thistle (silymarin / silibinin) has a low risk profile in the database. Low (very well-tolerated; rare GI) Legal status: OTC (oral); Rx/compassionate use (IV Legalon-SIL).
- What doses or routes are reported for Milk thistle (silymarin / silibinin)?
- 200-400 mg/day silymarin standardized to 70-80% silymarin This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Milk thistle (silymarin / silibinin) work?
- Silymarin complex (silibinin A/B, silychristin, silydianin); scavenges free radicals, stabilizes hepatocyte membranes; silibinin blocks amatoxin uptake — specific antidote for Amanita phalloides poisoning
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.