SILYMARIN IN HEPATOLOGY

The use of milk thistle in hepatology is certainly the most established in clinical settings. An important systematic review (ref. 1) evaluated the activity of extracts containing silymarin on liver enzyme levels. A total of 29 RCTs (altogether 3846 subjects) were selected, in which dosages ranged from 140 mg to 420 mg for variable periods of time. The results showed that silymarin is able to significantly reduce liver enzymes in most studies.

Bibliographic sources: 1) Calderon Martinez E et al. Impact of Silymarin Supplements on Liver Enzyme Levels: A Systematic Review. Cureus. 2023 Oct 24;15(10):e47608. 2) Dhande D et al. Silymarin as an Antioxidant Therapy in Chronic Liver Diseases: A Comprehensive Review. Cureus. 2024 Aug 17;16(8):e67083. 3) Wu J et al. Silybin: A Review of Its Targeted and Novel Agents for Treating Liver Diseases Based on Pathogenesis. Phytother Res. 2024 Sep 23.

SILYMARIN FOR LIPID AND CARBOHYDRATE METABOLISM

Milk thistle, and its silymarin extract, can be used with beneficial effects in cases of impaired regulation of lipid metabolism, particularly carbohydrate metabolism. Clinically significant insulin-sensitizing activity has been highlighted, leading to an improvement in insulin resistance, a key factor in preventing disease progression.

Bibliographic sources: 1) MacDonald-Ramos K et al. Silymarin is an ally against insulin resistance: A review. Ann Hepatol. 2021 Jul-Aug;23:100255. 2) Mobasheri L et al. Pathophysiology of diabetic hepatopathy and molecular mechanisms underlying the hepatoprotective effects of phytochemicals. Biomed Pharmacother. 2023 Nov;167:115502.

MILK THISTLE, SILYMARIN AND MULTIFUNCTIONAL SILYBIN

In addition to the benefits for liver and metabolic levels, there is now extensive literature on the other phytotherapeutic potentials of milk thistle and its three primary flavonolignans (silybin, 70-80%, silichristin, and silidianin), which constitute the most active fraction, silymarin. These comprehensive reviews describe the main areas of action of the plant, as well as the mechanisms of action involved.

Bibliographic sources: 1) Wadhwa K et al. Mechanistic Insights into the Pharmacological Significance of Silymarin. Molecules. 2022 Aug 21;27(16):5327. 2) Zhang X et al. A review of the botany, phytochemistry, pharmacology, synthetic biology and comprehensive utilization of Silybum marianum. Front Pharmacol. 2024 Jul 11;15:1417655. 3) Zeng LH et al. Polycystic Ovary Syndrome: A Disorder of Reproductive Age, Its Pathogenesis, and a Discussion on the Emerging Role of Herbal Remedies. Front Pharmacol. 2022 Jul 18;13:874914.

SILYMARIN vs NEURODEGENERATIVE DISORDERS

Over the last 10-15 years, several studies have highlighted that silymarin also has substantial neuroprotective effects. Its action manifests in various neurological problems, including psychiatric, cognitive, and neurodegenerative issues. Milk thistle extracts, in this area, act through antioxidant, anti-inflammatory, anti-apoptotic, pro-neurotrophic, and pro-estrogenic mechanisms while preventing the accumulation of beta-amyloid protein.

Bibliographic sources: 1) Ranjan S and Gautam A. Pharmaceutical prospects of Silymarin for the treatment of neurological patients: an updated insight. Front Neurosci. 2023 May 18;17:1159806. 2) Ashique S et al. Unlocking the possibilities of therapeutic potential of silymarin and silibinin against neurodegenerative diseases - A mechanistic overview. Eur J Pharmacol. 2024 Oct 15;981:176906.