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The trial enrolled 99 biopsy-confirmed NASH patients randomized to 700 mg silymarin daily versus placebo and found significant fibrosis reduction in the silymarin arm.[4]Silymarin Nonalcoholic Steatohepatitis RCT — PubMed View source For morbidly obese patients with NAFLD specifically, a randomized double-blind trial of silymarin found measurable improvements in liver size and steatosis markers over 12 weeks, supporting its use as an adjunct to weight management.[5]Silymarin Liver Size NAFLD Obese RCT — PubMed View source NAFLD enzyme reduction: Consistent across 5+ RCTs and meta-analyses

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doi: 10.3389/fphys.2020.00694 Received 16 April 2020 Accepted 27 May 2020 Published 02 July 2020 Volume 11 - 2020 Edited by Chengxing Shen, Shanghai Sixth People’s Hospital, China Reviewed by Kai Hu, University Hospital Würzburg, Germany