Tackling the NAFLD Epidemic: Milk Thistle & Many Other Natural Substances Offer Hope

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Imagine a simple herb, used for centuries, that could hold the key to reversing one of the fastest-growing health epidemics of our time. This humble plant is milk thistle, and its remarkable ability to protect and heal the liver is now backed by a wealth of scientific evidence; along with many other natural remedies researched to have potential benefits for NAFL.

A recent meta-analysis found that milk thistle (silymarin) supplementation is effective in reducing liver enzymes and improving other markers in non-alcoholic fatty liver disease (NAFLD). With NAFLD rates rising dramatically and no approved pharmaceutical treatments, milk thistle represents a promising natural therapy for this condition largely driven by poor dietary habits. Extensive research shows milk thistle has therapeutic potential for many diseases.

Non-alcoholic fatty liver disease (NAFLD) has reached epidemic proportions, now affecting an estimated 25% of the global population.1 Characterized by excess fat accumulation in the liver, NAFLD can progress to more severe conditions like non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. Despite the grave health consequences, there are currently no approved pharmaceutical treatments for NAFLD. However, a natural remedy is showing immense promise: milk thistle.

A recent meta-analysis published in Advances in Therapy found that milk thistle supplementation significantly reduced liver enzyme levels and improved other disease markers in NAFLD patients.2 The researchers pooled data from randomized controlled trials involving 2,375 participants. Compared to control groups, milk thistle treatment led to significant reductions in ALT, AST, total cholesterol, LDL cholesterol, triglycerides, fasting insulin, and fatty liver index scores, while increasing beneficial HDL cholesterol. Improvements were also seen in histological markers of liver health.

Milk thistle (Silybum marianum) has been used medicinally for over 2000 years, particularly for liver disorders. Its main active compound is silymarin, a potent antioxidant flavonoid complex.3 By scavenging harmful free radicals, boosting antioxidant defenses, and modulating inflammatory pathways, silymarin helps protect liver cells from damage. It may also inhibit fat accumulation by regulating lipid metabolism.4

The development of NAFLD is strongly linked to unhealthy dietary patterns, especially high intake of fructose and fructose-containing sweeteners like high-fructose corn syrup (HFCS). Excess fructose consumption promotes de novo lipogenesis (the liver's creation of new fat), hepatic insulin resistance, oxidative stress, and inflammation - all key drivers of NAFLD.5 Therefore, addressing the root causes through dietary change and supporting the body's innate healing processes with natural agents like milk thistle offers immense potential.

GreenMedInfo.com, the world's largest open-access natural health database, has indexed over 350 scientific articles on milk thistle's therapeutic properties.6 Some of the most well-supported uses include:

1. Liver Disorders: Hepatitis, cirrhosis, liver damage
2. Diabetes and Metabolic Syndrome
3. Obsessive-Compulsive Disorder
4. Alcohol-Related Liver Disease
5. Chemotherapy-Induced Toxicity
6. Prostate Disorders: Enlarged prostate, prostate cancer
7. Skin Disorders: Psoriasis, eczema, rosacea
8. Osteoarthritis
9. Gallstones and Kidney Stones
10. Hemochromatosis (Iron overload)

Milk thistle appears to work primarily through antioxidant, anti-inflammatory, hepatoprotective, and detoxification pathways. However, its benefits extend far beyond the liver. Researchers are discovering milk thistle may help protect the brain, heart, bones, and other vital organs and tissues. Its active compounds modulate numerous cell signaling pathways involved in metabolic health, the inflammatory response, cell survival, and gene expression.7

For NAFLD in particular, GreenMedInfo has identified a number of other promising natural interventions.8 The top 10 most evidenced-based remedies include:

1. Vitamin E
2. Curcumin (Turmeric)
3. Berberine
4. Omega-3 Fatty Acids
5. Probiotics
6. Anthocyanins (from berries)
7. Resveratrol
8. Coffee
9. Silibinin (from Milk Thistle)
10. Astaxanthin

In conclusion, the simple addition of milk thistle to the diet, whether through supplementation or culinary use, could make a profound difference in liver health and NAFLD progression for millions of people. When combined with an overall healthy lifestyle and other liver-supportive nutrients and botanicals, milk thistle's healing potential is even greater. With the staggering rise in fatty liver disease and lack of effective treatments, both patients and practitioners should be aware of the remarkable science supporting natural approaches. Nature's wisdom is right under our nose - or sprouting at our feet - if we simply open our eyes to see it.


1. Younossi ZM. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol. 2019;70(3):531-544. doi:10.1016/j.jhep.2018.10.033 https://doi.org/10.1016/j.jhep.2018.10.033

2. Gillessen A, Schmidt HH. Silymarin for the Treatment of Nonalcoholic Steatohepatitis. Adv Ther. 2020;37(4):1279-1301. doi:10.1007/s12325-020-01271-https://doi.org/10.1007/s12325-020-01271-8

3. Abenavoli L, Izzo AA, Milić N, Cicala C, Santini A, Capasso R. Milk thistle (Silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases. Phytother Res. 2018;32(11):2202-2213. doi:10.1002/ptr.6171 https://doi.org/10.1002/ptr.6171

4. Xiao Y, Liu Y, Yu K, Zhou L, Bi J, Cheng J, Li F, Hu W, Zhang Q, Xu T. The effect of Chinese herbal medicine on non-alcoholic fatty liver disease: a systematic review and meta-analysis. Complement Ther Med. 2019;42:187-195. doi:10.1016/j.ctim.2018.11.016 https://doi.org/10.1016/j.ctim.2018.11.016  

5. Jensen T, Abdelmalek MF, Sullivan S, et al. Fructose and sugar: A major mediator of non-alcoholic fatty liver disease. J Hepatol. 2018;68(5):1063-1075. doi:10.1016/j.jhep.2018.01.019 https://doi.org/10.1016/j.jhep.2018.01.019

6. GreenMedInfo. Milk Thistle. Greenmedinfo.com. https://greenmedinfo.com/substance/milk-thistle. Accessed April 15, 2024.

7. Abenavoli L, Capasso R, Milic N, Capasso F. Milk thistle in liver diseases: past, present, future. Phytother Res. 2010;24(10):1423-1432. doi:10.1002/ptr.3207 https://doi.org/10.1002/ptr.3207

8. GreenMedInfo. Nonalcoholic Fatty Liver Disease. Greenmedinfo.com. https://greenmedinfo.com/disease/nonalcoholic-fatty-liver-disease-nafld. Accessed April 15, 2024.

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