The liver — do milk thistle and herbs really cleanse it?

Aim of the study: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplements or nutrients may slow NAFLD progression. Silymarin is a hepatoprotective extract of milk thistle, but its efficacy in NAFLD remains unclear.

Results: A total of 26 randomized controlled trials involving 2,375 patients were included in this study. Administration of silymarin significantly reduced the levels of TC (SMD[95%CI]=-0.85[-1.23, -0.47]), TG (SMD[95%CI]=-0.62[-1.14, -0.10]), LDL-C (SMD[95%CI]=-0.81[-1.31, -0.31]), FI (SMD[95%CI]=-0.59[-0.91, -0.28]) and HOMA-IR (SMD[95%CI]=-0.37[-0.77, 0.04]), and increased the level of HDL-C (SMD[95%CI]=0.46[0.03, 0.89]). In addition, silymarin attenuated liver injury as indicated by the decreased levels of ALT (SMD[95%CI]=-12.39[-19.69, -5.08]) and AST (SMD[95% CI]=-10.97[-15.51, -6.43]). The levels of fatty liver index (SMD[95%CI]=-6.64[-10.59, -2.69]) and fatty liver score (SMD[95%CI]=-0.51[-0.69, -0.33]) were also decreased. Liver histology of the intervention group revealed significantly improved hepatic steatosis (OR[95%CI]=3.25[1.80, 5.87]). Silymarin can regulate energy metabolism, attenuate liver damage, and improve liver histology in NAFLD patients.

Aim of the study: Silymarin, extracted from milk thistle (Silybum marianum), is esteemed for its antioxidative, anti-inflammatory, and antifibrotic properties, notably within liver-related contexts. Nevertheless, a comprehensive grasp of its effects on liver enzymes remains elusive.

Results: Nevertheless, outcome disparities may stem from comorbidities, suboptimal doses, and underlying diseases. Notably, silymarin's impact on liver enzymes could be context-dependent, with varying responses among different conditions, with the decrease of liver enzyme levels in patients with non-alcoholic fatty liver disease. Silymarin supplements exhibit potential for hepatoprotection by ameliorating liver enzyme levels across diverse conditions. Further research should ascertain optimal dosages and contexts, accounting for individual patient characteristics and underlying diseases.

Aim of the study: Metabolic dysfunction-associated steatotic liver disease (MASLD) lacks treatment options, with few evidence-based choices beyond lifestyle modification. This is the first clinical study to assess the efficacy of an organic liquid oral nutraceutical composed of turmeric extract, dandelion powder, milk thistle extract, and ginger powder in MASLD.

Results: Fifteen patients each were enrolled in the test product and placebo groups. The mean [standard deviation (SD)] age was 40.6 (10.8) years and 83.3% were male. A significantly higher proportion of patients in the nutraceutical product group had fatty liver grade improvement at Day 60 vs. placebo [60.0% (9/15) vs. 13.3% (2/15); p = 0.008]. Mean (SD) change in fatty liver grading was -0.60 (0.51) and -0.13 (0.35) for test product vs. placebo (p = 0.007). Adverse events were mild with similar incidence in both groups. The results are limited by the small sample size, single-center design, and short study duration.

Aim of the study: Liver function is foundational to human health. While numerous herbal extracts have individually been shown to improve liver function, there are relatively few studies on combinations of herbal ingredients that may have synergistic effects. In addition, capsule fatigue is a common problem when aiming to incorporate multiple ingredients to support liver health.

Results: In total, 130 participants enrolled in the trial; 65 were randomized to each group. Mean improvements in ALT, AST, ALP, and GGT were significantly greater with the nutraceutical product than placebo (p ≤ 0.001). No adverse events were reported.

Aim of the study: Fatty liver disease is a build-up of fats in the liver that can damage the organ and lead to serious complications. This study aimed to investigate the effects of exercise training and supplementation (milk thistle, chicory and cumin) on liver metabolites related to its function and health in rats with non-alcoholic fatty liver disease (NAFLD).

Results: The 4 NAFLD groups were subdivided and treated with (a) plain HFD, (b) high-intensity interval training (HIIT), (c) supplement (milk thistle, chicory, and cumin), and (d) combined HIIT and supplementation for 4 weeks. The induction of NAFLD through HFD yielded dyslipidemia, liver tissue damage, increased malondialdehyde, uncoupling protein 2 (UCP2), and phosphatidylinositol-3 kinase (PI3K), as well as decreased superoxide dismutase (SOD) and peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1α) in liver tissue (p < 0.05). The 4 weeks intervention with either HIIT, supplement or especially the combined application of both, reversed these factors (p < 0.05) through changes in their concentrations in a direction indicative of enhanced liver health and function.