Milk Thistle (Silymarin)
Også kjent som: Milk Thistle, Silybum marianum, Silymarin, Silybin, Silibinin, Legalon
Milk thistle is sold almost entirely as a liver supplement, and the active fraction is silymarin, a complex of flavonolignans from the seed. It is worth knowing that the evidence has not landed where the marketing sits: the better-quality results are in metabolic markers, while the liver claims the category is built on rest on trials that are smaller and less consistent than the shelf presence suggests.
Hvordan Milk Thistle (Silymarin) fungerer
Silymarin is an antioxidant that stabilises hepatocyte membranes and appears to interfere with the uptake of certain toxins by liver cells, which is the basis of its established use in Amanita mushroom poisoning. It also inhibits several inflammatory and fibrotic signalling pathways in laboratory models.
Fordeler
- Fatty liver markers: a 2024 systematic review in Annals of Hepatology found silymarin improved liver enzymes and some imaging measures in NAFLD and NASH, though trials were mostly small and short.
- Blood glucose and lipids: this is where the evidence is strongest. A meta-analysis of randomised trials found meaningful reductions in fasting glucose and HbA1c in type 2 diabetes, which is not what most buyers are taking it for.
- Acute poisoning: intravenous silibinin is an established treatment for Amanita phalloides poisoning. That is a hospital use and says nothing about a daily capsule.
Forskningssammendrag
A 2024 meta-analysis in Annals of Hepatology covers NAFLD and NASH; a 2016 meta-analysis in the Journal of Diabetes Research covers glycaemic outcomes, and is the stronger body of the two.
Anbefalt dosering
Minimum effektiv dose
420 mg/day of silymarin, in divided doses
Maksimal sikker dose
700 mg/day of silymarin in trials
Trials typically use 140 mg of silymarin three times daily, so around 420 mg per day, and the diabetes work often used similar amounts. Read the label carefully: a product stating 250 mg of milk thistle standardised to 80% silymarin gives 200 mg of silymarin, while one stating 250 mg with no standardisation could give far less. Silymarin is poorly absorbed on its own, which is why phospholipid complexes exist.
Bivirkninger
Mild and uncommon. Loose stools and nausea are the usual complaints and tend to settle. People allergic to other Asteraceae plants such as ragweed, chrysanthemum or daisy can react to it.
Interaksjoner
Silymarin inhibits some CYP450 enzymes and UGT pathways in laboratory work, so it can in principle raise levels of drugs cleared that way. Clinically significant interactions have been hard to demonstrate, but anyone on narrow-therapeutic-index medication should check first.
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Medical Disclaimer
The content on this page is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before starting any new supplement regimen. Individual results may vary.
Sources & References
- Administration of silymarin in NAFLD/NASH: a systematic review and meta-analysis. Annals of Hepatology 2024.
- Voroneanu L et al. 2016. Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes Research.
- Zhong S et al. 2017. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty liver disease: a meta-analysis. Medicine (Baltimore).