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.
Typical use: 200-400 mg/day silymarin standardized to 70-80% silymarin — OTC (oral); Rx/compassionate use.
What this is
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
Dose & route
200-400 mg/day silymarin standardized to 70-80% silymarin
Citations
- https://pubmed.ncbi.nlm.nih.gov/29141497/
- https://pubmed.ncbi.nlm.nih.gov/23117294/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4712586/
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Common questions
- Does Milk thistle (silymarin / silibinin) work?
- 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.
- Is Milk thistle (silymarin / silibinin) safe?
- Milk thistle (silymarin / silibinin) has a low risk profile in published human data. Legal status: OTC (oral); Rx/compassionate use (IV Legalon-SIL). This is not medical advice — see the disclaimer.
- What is the typical dose for Milk thistle (silymarin / silibinin)?
- 200-400 mg/day silymarin standardized to 70-80% silymarin
- 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.