TABLE 1.

Clinical trials are underway to evaluate the effectiveness of silymarin in treating liver diseases such as cirrhosis, alcoholic liver disease, and non‐alcoholic steatohepatitis or NAFLD.

Treatments	Outcome with silymarin	Duration	Number of subjects	Conditions	References
Silymarin 420 mg/day	An improvement in liver function markers, Alanine transaminase, Aspartate aminotransferase, and Histopathology	4 weeks	97	Liver disease	European Association for the Study of the Liver (EASL, 2018)
Silymarin 420 mg/day	No significant effect	3 months	116	Alcoholic liver disease (cirrhosis)	O'Shea et al. (2010)
Silymarin 420 mg/day	The 4‐year survival rate has improved, especially in ALD patients with cirrhosis and low‐severity diseases (Child class A).	41 months	170	Alcoholic liver disease or NAFLD (cirrhosis)	Mirhashemi et al. (2022)
Silymarin	Synthesis of bilirubin, procollagen, aspartate aminotransferase, and alanine transaminase has improved.	6 months	36	Alcoholic liver disease	Meng et al. (2022)
Silymarin 420 mg/day	Enhancing anti‐oxidative systems (↓ MDA, ↑ glutathione)	6 months	NA	Alcoholic liver disease	Zarif‐Yeganeh and Rastegarpanah (2019)
Silymarin 210 mg/day	Liver function, mortality, or clinical course are unaffected.	15 months	59	Alcoholic liver disease (cirrhosis)	Solhi et al. (2014)
Silymarin 600 mg/day + standard treatment	A reduction in the daily insulin demand, an improvement in blood sugar (including fasting), glycosylated hemoglobin, MDA, ↓ alanine transaminase, and aspartate aminotransferase	12 months	60	Insulin‐treated type II diabetes mellitus with alcoholic cirrhosis	Frank et al. (2021)
Silymarin 450 mg/day	No impact on the survival rate or development of liver disease	2 years	200	Alcoholic liver disease with cirrhosis	Gillessen and Schmidt (2020)
Silymarin 450 mg/day	↓ MDA and the procollagen type III aminoterminal propeptide	6 months	49	Alcoholic liver disease with cirrhosis	Amini et al. (2023)
Silymarin 420 mg/day	Transaminases and lipid markers are decreased, and subjective well‐being is improved	2 months	70	Non‐alcoholic steatohepatitis (50) or Non‐alcoholic fatty liver disease (20)	Thuy et al. (2015)
Silymarin 280–420 mg/day	Liver function indicators and overall quality of life are improving.	4 months	190	NAFLD	Perumpail et al. (2017)
Silymarin 420 mg/day + vitamin E	Improvements in liver size, indices, and biometric measurements including abdominal circumference and body mass index	90 days	78	Non‐alcoholic fatty liver disease and metabolic syndrome	Sonmez et al. (2021)
Silymarin 2100 mg/day	The parameters of noninvasive fibrosis indicators, liver function, and liver histology have all improved	48 weeks	99	Non‐alcoholic steatohepatitis	Lee et al. (2022)