Supplement · Grade A/B

Silymarin and medications.

Not yet catalogued in the Distil interactions database. We surface that distinction explicitly.

Silymarin is in the Distil supplement database, evidence Grade A/B. The page below lists every medication we have explicitly assessed it against.

Silymarin, the active fraction of milk thistle, is one of the better-studied liver compounds, rated Grade A/B for liver health. It works as an antioxidant and membrane stabiliser in liver cells, and the evidence supports lower liver enzymes (ALT and AST) in fatty liver disease and a mortality benefit in cirrhosis across pooled trials. The honest limit is that benefit is clearest in established liver conditions; it is not a general detox supplement. Typical dosing is 420 to 600mg daily of standardised extract, split into two or three doses. It pairs well with NAC and phosphatidylcholine, which share complementary liver-support mechanisms. The interaction to watch is with medications cleared by the CYP2C9 or CYP3A4 enzymes, where a mild interaction is possible, so flag it if you take several drugs. It is among the safest herbal compounds and is even used in pregnancy for cholestasis, though those in the ragweed family should check for allergy. If a liver condition is the target, this is a primary candidate.

We have not yet completed an explicit assessment of medications for Silymarin in the Distil interactions database. We surface this distinction deliberately: the Distil checker tells you when we have explicitly assessed a pair and when we have not, because both are useful information. If you take Silymarin alongside a medication, the checker below will surface anything already in our database, and the missing-item form at the bottom of the page routes uncatalogued pairs into our next curation pass.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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Your supplements

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Your medications

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.

Thanks, that's logged. We go through flagged items every week.

Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.