silymarin

Reported Uses

• NOTE: see Herb & Supplement Effectiveness Rating Definitions table
• acne [Insufficient Evidence]
• acral erythema, chemo-induced [Insufficient Evidence]
• alcoholic liver dz [Insufficient Evidence]
• allergic rhinitis [Insufficient Evidence]
• Alzheimer dz [Insufficient Evidence]
• beta-thalassemia [Insufficient Evidence]
• BPH [Insufficient Evidence]
• COVID-19 [Insufficient Evidence]
• critical illness (trauma) [Insufficient Evidence]
• diabetes mellitus [Possibly Effective]
• diabetic nephropathy [Insufficient Evidence]
• dyspepsia [Insufficient Evidence]
• endometriosis [Insufficient Evidence]
• gambling disorder [Insufficient Evidence]
• hepatic cirrhosis [Insufficient Evidence]
• hepatitis [Insufficient Evidence]
• hepatitis B [Insufficient Evidence]
• hepatitis C [Insufficient Evidence]
• hepatotoxicity, chemo-induced [Insufficient Evidence]
• hepatotoxicity, toxin-induced [Insufficient Evidence]
• hypercholesterolemia [Insufficient Evidence]
• hyperlipoproteinemia [Insufficient Evidence]
• hypoxic liver injury [Insufficient Evidence]
• infertility [Insufficient Evidence]
• lactation promotion [Insufficient Evidence]
• melasma [Insufficient Evidence]
• menopausal sx [Insufficient Evidence]
• metabolic dysfxn-assoc. steatotic liver dz [Insufficient Evidence]
• metabolic syndrome [Insufficient Evidence]
• multiple sclerosis [Insufficient Evidence]
• mushroom toxicity (Amanita phalloides) [Insufficient Evidence]
• nephropathy prophylaxis, contrast-induced [Insufficient Evidence]
• nephrotoxicity, chemo-induced [Insufficient Evidence]
• nonalcoholic fatty liver dz [Insufficient Evidence]
• nonalcoholic steatohepatitis [Insufficient Evidence]
• obesity [Insufficient Evidence]
• obsessive-compulsive disorder [Insufficient Evidence]
• Parkinson dz [Insufficient Evidence]
• peripheral neuropathy, chemo-induced [Insufficient Evidence]
• postpartum complications [Insufficient Evidence]
• prostate CA [Insufficient Evidence]
• radiation dermatitis [Insufficient Evidence]
• radiation mucositis [Insufficient Evidence]
• trichotillomania [Insufficient Evidence]
• ulcerative colitis [Insufficient Evidence]
• vitiligo [Insufficient Evidence]

Reported Doses

Safety/efficacy may not be established; reported doses may be derived from limited or potentially inadequate studies w/ variable regimens, multi-ingredient products, or where concentration of active ingredients may vary widely

Special Note

[formulation clarification]

Info: extracts generally stdzd to silymarin content; active constituents may incl. silybin, other flavonolignans

Effectiveness Ratings

[see Herb & Supplement Effectiveness Rating Definitions table]

acne

[Insufficient Evidence]

Dose: 140 mg PO qd; Alt: apply 0.5% serum topically qd-bid; apply 25% extract cream topically bid; apply 1.4% cream topically bid

acral erythema, chemo-induced

[Insufficient Evidence]

Dose: apply 1% gel topically bid to palms and soles; Start: 1st day of chemo

alcoholic liver dz

[Insufficient Evidence]

Dose: 420 mg PO qd

allergic rhinitis

[Insufficient Evidence]

Dose: 140 mg PO tid; Info: used w/ cetirizine

Alzheimer dz

[Insufficient Evidence]

Dose: 150 mg PO bid; Alt: 450 mg PO qd

beta-thalassemia

[Insufficient Evidence]

Dose: 140 mg PO tid; Info: used w/ conventional tx

BPH

[Insufficient Evidence]

Dose: 190 mg PO tid; Info: used w/ selenium

critical illness (trauma)

[Insufficient Evidence]

Dose: 140 mg PO tid; Info: for pts w/ trauma-induced hepatotoxicity

diabetes mellitus

[Possibly Effective]

Dose: 140-200 mg PO tid; Alt: 105-600 mg PO qd

diabetic nephropathy

[Insufficient Evidence]

Dose: 140 mg PO tid; Info: used w/ conventional tx

dyspepsia

[Insufficient Evidence]

Dose: 33.3 mg/1 mL milk thistle fruit extract PO tid

endometriosis

[Insufficient Evidence]

Dose: 140 mg PO bid

hepatic cirrhosis

[Insufficient Evidence]

Dose: 140 mg PO tid; Alt: 150 mg PO bid-tid

hepatitis

[Insufficient Evidence]

Dose: 140 mg PO tid; Alt: 160-360 mg PO qd

hepatitis B

[Insufficient Evidence]

Dose: 140 mg PO tid; Alt: 240 mg PO bid

hepatitis C

[Insufficient Evidence]

Dose: 140 mg PO tid; Alt: 240-303 mg PO bid

hepatotoxicity, chemo-induced, adult pts

[Insufficient Evidence]

Dose: 150-900 mg PO qd; Info: doses >300 mg/day rarely more effective

hepatotoxicity, chemo-induced, peds pts

[Insufficient Evidence]

Dose: 70 mg PO bid; Alt: 50 mg syrup PO tid; Info: for pts 5-14 yo

hepatotoxicity, toxin-induced

[Insufficient Evidence]

Dose: 140-450 mg PO qd; Alt: 70 mg silibinin extract PO tid; 150 mg PO bid; Info: silibinin extract containing 1:1 silybin A:silybin B ratio

hypercholesterolemia

[Insufficient Evidence]

Dose: 105 mg PO qd-bid

hypoxic liver injury

[Insufficient Evidence]

Dose: 280 mg PO tid

infertility

[Insufficient Evidence]

Dose: 70 mg PO tid

melasma

[Insufficient Evidence]

Dose: apply 1.4% cream topically bid

menopausal sx

[Insufficient Evidence]

Dose: 200 mg PO bid

metabolic syndrome

[Insufficient Evidence]

Dose: 140-2100 mg PO qd

multiple sclerosis

[Insufficient Evidence]

Dose: 150 mg PO bid

nonalcoholic fatty liver dz

[Insufficient Evidence]

Dose: 140-2100 mg/day PO divided bid-tid; Alt: 140 mg PO qid

nonalcoholic steatohepatitis

[Insufficient Evidence]

Dose: 420-700 mg PO tid

obesity

[Insufficient Evidence]

Dose: 151.5 mg PO bid

obsessive-compulsive disorder

[Insufficient Evidence]

Dose: 200 mg PO tid

Parkinson dz

[Insufficient Evidence]

Dose: 150 mg PO bid

peripheral neuropathy, chemo-induced

[Insufficient Evidence]

Dose: 140 mg PO tid

postpartum complications

[Insufficient Evidence]

Dose: apply 3% ointment topically to suture site bid

prostate CA

[Insufficient Evidence]

Dose: 160 mg PO qd

radiation dermatitis

[Insufficient Evidence]

Dose: apply cream or gel topically; Info: used throughout XRT tx course

radiation mucositis

[Insufficient Evidence]

Dose: 140 mg PO tid; Start: 1st day of XRT; Info: cont. x6wk after tx D/C

ulcerative colitis

[Insufficient Evidence]

Dose: 140 mg PO qd; Info: for pts 16 yo and older; used w/ standard tx