It’s not news that silymarin, found in milk thistle, may benefit liver health. However, various recent studies have found that this extract specifically benefits individuals with non-alcoholic fatty liver disease (NAFLD, also known as metabolic dysfunction-associated steatotic liver disease). In fact, a meta-analysis of 26 clinical trials reported in the March-April 2024 issue of Annals of Hepatology¹ concluded that silymarin helps improve liver damage and liver fat in patients with this condition.

“Silymarin is a promising botanical treatment for NAFLD patients, and its efficacy has been investigated in several randomized-controlled trials (RCTs),” Shudi Li of Henan University of Chinese Medicine and colleagues wrote. Li added that the meta-analysis further demonstrated that “[s]ilymarin can regulate energy metabolism, attenuate liver damage and improve liver histology in NAFLD, and is thus a promising treatment for NAFLD.”

The meta-analysis included a total of 26 randomized trials involving 2,375 men and women with fatty liver disease. The trials compared the effects of various regimens with or without the addition of silymarin or compared silymarin to a placebo.  

The researchers grouped and analyzed the included trials according to the various outcomes the trials evaluated. Groups that received silymarin had reductions in total cholesterol, triglycerides, LDL cholesterol, fasting blood glucose, fasting insulin, insulin resistance, the liver enzymes ALT and AST, as well as an increase in HDL cholesterol in comparison with the control groups. Fatty liver index, fatty liver score, hepatic steatosis grade and body mass index were also lower among silymarin-treated groups.