Silymarin in biopsy-proven non-alcoholic steatohepatitis
The question: What does silymarin do in fatty liver disease?
- Study type
- Randomised controlled trial
- Participants
- 99
- Population
- Adults with biopsy-proven NASH, tertiary hospital in Kuala Lumpur
- Intervention
- Silymarin 700 mg three times daily
- Compared with
- Placebo
- Duration
- 48 weeks
- Published
- Clinical Gastroenterology and Hepatology, 2017
What was measured
Primary: at least a 30 per cent reduction in the NAFLD activity score. Secondary: fibrosis on biopsy and liver stiffness.
What was found
The primary outcome was not met (32.7 per cent with silymarin versus 26.0 per cent with placebo). More patients on silymarin showed a reduction in fibrosis on biopsy (22.4 versus 6.0 per cent) and on liver stiffness measurement.
Limitations
The fibrosis findings were secondary outcomes and so are hypothesis-generating. A later US trial did not reproduce a benefit. The dose was much higher than in most commercial products.
What it means
Silymarin did not improve overall disease activity, but the fibrosis signal deserves further study. It is honest to call the evidence promising but unconfirmed.
Source
Wah Kheong C, Nik Mustapha NR, Mahadeva S. A randomized trial of silymarin for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2017;15(12):1940-1949.
Read the original (DOI 10.1016/j.cgh.2017.04.016) · Source verified 8 October 2026
Study summaries describe published research for education. They are not claims about any product and are not medical advice.