๐ Common Names (6 Languages)
โ Evidence-Based Benefits
Premier hepatoprotective herb with robust clinical evidence. Cochrane systematic review of 13 RCTs shows significant improvement in liver enzyme levels (AST, ALT) in alcoholic and non-alcoholic liver disease (PMID: 16235356). Meta-analysis demonstrates efficacy in chronic hepatitis C improving quality of life and reducing inflammation (PMID: 15635074). Silymarin protects against hepatotoxins including acetaminophen, alcohol, and chemotherapy agents. May benefit diabetic nephropathy and metabolic syndrome (PMID: 16447229).
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๐ฌ Clinical Trials & Evidence
โ๏ธ Evidence-Based Research: Clinical trials provide the highest level of evidence for herbal efficacy and safety. The trials listed below represent peer-reviewed research registered on ClinicalTrials.gov. Each trial includes detailed protocols, patient populations, interventions tested, and measurable outcomes. Click links to access full trial details and published results.
Cochrane review: 13 RCTs, liver disease improvement
Meta-analysis: Hepatitis C benefits demonstrated
๐ Find More Clinical Trials
Search for additional ongoing and completed trials investigating this herb's therapeutic effects:
๐ก Research Tip: Use both common name and scientific name when searching for comprehensive results. Filter by "Completed" trials to find published outcomes.
๐ Drug Interactions
โ ๏ธ CRITICAL SAFETY INFORMATION
Herb-drug interactions can be serious and potentially life-threatening. Always inform your healthcare provider about all herbs, supplements, and medications you are taking. The interactions listed below are supported by clinical evidence and case reports. Citations link to peer-reviewed research on PubMed.
๐ Evidence-Based Interactions: Each interaction below includes research citations (PMID links) documenting the mechanism, clinical significance, and management recommendations. Click citations to access full studies.
Antidiabetic Medications
Effect: May lower blood glucose
Mechanism: Improves insulin sensitivity
Action: Monitor blood glucose levels. May allow medication dose reduction
CYP450 Substrates (Statins, Warfarin)
Effect: Silymarin may inhibit CYP2C9, CYP3A4
Mechanism: Competitive enzyme inhibition
Action: Monitor drug levels with narrow therapeutic index medications
Chemotherapy (Irinotecan, Doxorubicin)
Effect: May alter drug metabolism
Action: Inform oncologist before use. Requires medical supervision
Hepatotoxic Medications
Effect: Hepatoprotective - may reduce liver damage
Action: Generally beneficial but not a substitute for proper dosing
๐ Key Interaction Databases & Resources
- Natural Medicines Database: Professional herb-drug interaction checker
- PubMed: Search for latest interaction research
- Drugs.com: Drug interaction checker
- Micromedex: Hospital-grade interaction database (subscription required)
๐ก Clinical Tip: Show your healthcare provider this page and the linked research citations when discussing potential interactions.
โ ๏ธ Safety Information
Adverse Events
Excellent safety profile with minimal adverse effects (<3% users). Mild gastrointestinal upset (loose stools, nausea) occasionally. Rare allergic reactions in those allergic to Asteraceae family (ragweed, chrysanthemums). No serious adverse events in systematic reviews. Safe for long-term use (up to 41 months studied).
โ Contraindications
Caution in estrogen-sensitive conditions (theoretical estrogenic effects - weak). May interact with diabetes medications. Avoid in Asteraceae allergy. Generally safe but monitor with CYP450-metabolized drugs. Safe in pregnancy at therapeutic doses but avoid high doses.
๐งฌ Mechanism of Action
Silymarin (mixture of flavonolignans: silybin A/B, silydianin, silychristin) provides hepatoprotection via: (1) Antioxidant effects - scavenges free radicals, (2) Anti-inflammatory - inhibits NF-ฮบB and leukotrienes, (3) Membrane stabilization - prevents toxin entry into hepatocytes, (4) Protein synthesis stimulation - promotes liver regeneration, (5) Anti-fibrotic effects.
๐ Dosage & Administration
140mg silymarin 3 times daily (standardized to 70-80% silymarin) with meals for optimal absorption. Total daily: 420mg. For liver disease: 280-420mg daily in divided doses. Effects on liver enzymes seen after 4-12 weeks. Bioavailability enhanced with phosphatidylcholine complex.
โ๏ธ Note: Consult healthcare provider for appropriate dosing, especially if taking medications.
๐ Additional Resources
๐ WHO Monograph
Available in WHO Monographs on Selected Medicinal Plants
๐ฌ PubMed Search
๐งช ClinicalTrials.gov
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Data Retrieval Date: November 29, 2025
Compiled by: Sheraz Ahmed
License: CC BY-SA 4.0
Citation: Ahmed, S. (2025). Medicinal Herbs Database. Clinical Corner. https://welovelmc.com/medical-tools.htm