Milk thistle extract with a long safety record. Human evidence is modest and mixed: small improvements in liver health, blood sugar, blood fats, and inflammation, mainly in people who already have raised values. Low-risk and inexpensive, but poorly absorbed and often underdosed in commercial products. Least certain benefit for the already-healthy. (Full Review)
| Marker | Target | Why |
|---|---|---|
| ALT | < 25 U/L (men), < 20 U/L (women) | Primary marker of liver-cell stress and silymarin's best-documented target |
| AST | < 25 U/L | Complements ALT for liver-cell injury |
| GGT | < 25 U/L | Sensitive marker of oxidative liver stress and bile flow |
| Fasting glucose | 70–85 mg/dL | Tracks the glycemic benefit seen in diabetic trials |
| HbA1c | < 5.4% | Average blood sugar over ~3 months; key metabolic outcome |
| Fasting insulin | 2–6 µIU/mL | Captures insulin-resistance changes underlying metabolic benefit |
| LDL cholesterol | < 100 mg/dL | Tracks the modest lipid effects reported in trials |
| HDL cholesterol | > 50 mg/dL | Tracks the modest lipid effects reported in trials |
| Triglycerides | < 80 mg/dL | Tracks the modest lipid effects reported in trials |
| hs-CRP | < 1.0 mg/L | General inflammation marker silymarin may lower |
Cadence: Baseline, recheck at ~8–12 weeks, then every 3–6 months; more frequent glucose checks early on for anyone on diabetes medication