Silymarin

Silymarin is a group of flavonolignan compounds extracted from the seeds of Silybum marianum, commonly known as milk thistle. The most active component is silybin (silibinin), which occurs as two diastereomeric forms, and it is present together with other flavonolignans such as silychristin, silydianin, and isosilybin. Commercial preparations vary in content and are frequently standardized to a percentage of silibin.

Silymarin is thought to exert hepatoprotective effects by stabilizing hepatocyte membranes, inhibiting lipid peroxidation, and enhancing intracellular glutathione. It may modulate cellular signaling pathways including NF-kB and TGF-β, and it exhibits anti-inflammatory and, in some models, antifibrotic properties. It also acts as an antioxidant, scavenging reactive oxygen species.

In clinical use, silymarin is marketed as a dietary supplement for liver conditions and is used as an adjunct in some regions for alcoholic liver disease and chronic liver disease. It is also used in combination with other therapies as an antidote for amatoxin mushroom poisoning in specific regimens that include intravenous silibinin.

The quality and strength of preparations vary, and robust clinical evidence for clear therapeutic benefit in liver disease remains limited.

Safety and regulatory status: silymarin is generally well tolerated, with mild gastrointestinal symptoms and rare allergic reactions reported. Potential drug interactions exist, particularly with medications processed by cytochrome P450 enzymes; caution is advised for people taking anticoagulants, antidiabetic drugs, or those with liver or kidney impairment. It is not approved as a cure for liver disease by major regulatory agencies in many jurisdictions.