Does milk thistle help with cholesterol? What the research does and doesn't show

The evidence doesn't support milk thistle as a cholesterol treatment, and no trial has tested it that way in a healthy general population. What exists is a 2024 pooled analysis of 33 controlled trials that found total cholesterol, triglycerides and LDL fell more with silymarin, milk thistle's standardized active complex, than with placebo — but found no significant change in HDL, and the authors say the result needs confirming in larger, longer trials.

What the evidence doesn't support

It doesn't support milk thistle or silymarin as a treatment for high cholesterol or any diagnosed lipid disorder, and it doesn't support taking it in place of a prescribed cholesterol medication or a doctor-directed diet change. No trial has tested milk thistle for cholesterol in people without an existing metabolic risk factor — every trial pooled below was run in adults research describes as having a cardiometabolic condition, not a healthy population trying to nudge normal numbers. None of it describes a specific brand's dose or product, and nothing here is a claim about any product.

What the trials found

A 2024 systematic review and dose-response meta-analysis in Antioxidants pooled 33 controlled trials, 1,943 participants total, published through January 2023, looking at silymarin's effect on a range of cardiovascular risk factors. Across the pooled trials, total cholesterol fell by about 14 mg/dL on average with silymarin compared with placebo, triglycerides fell by about 26 mg/dL, and LDL ("bad" cholesterol) fell by about 17 mg/dL, alongside declines in fasting blood glucose, fasting insulin, HbA1c and a modest drop in diastolic blood pressure. HDL ("good" cholesterol), body weight, BMI, systolic blood pressure and C-reactive protein didn't differ significantly between the two groups. The doses and durations varied across the 33 trials rather than following one protocol, and the authors themselves note the findings should be confirmed by larger trials run for longer. The abstract doesn't break out results by each trial's specific diagnosis, but the wider silymarin literature — including the diabetic kidney disease trials covered in milk thistle benefits: what the research does and doesn't show — is concentrated in people already living with diabetes, fatty liver disease or another metabolic condition, not a general population managing ordinary cholesterol.

A separate 2024 pooled analysis of 26 trials specifically in people with nonalcoholic fatty liver disease found a similar pattern on lipids — total cholesterol, triglycerides and LDL fell, and HDL rose — alongside improvements in liver enzymes and, in a subset with biopsy data, liver histology. That trial population is more specific (diagnosed fatty liver disease) than the 33-trial analysis above, and it's covered in more depth on the benefits page linked above.

Trial	Population	Result
Mohammadi 2024 (33 pooled trials, n=1,943)	Adults with cardiometabolic risk factors (diagnosis not broken out in abstract)	Total cholesterol, triglycerides and LDL fell; no change in HDL, weight or BMI
Li 2024 (26 pooled trials, n=2,375)	Adults with diagnosed NAFLD/NASH	Total cholesterol, triglycerides and LDL fell; HDL rose; liver enzymes improved

Questions people ask

Can milk thistle lower cholesterol?

A 2024 pooled analysis of 33 trials found total cholesterol, triglycerides and LDL fell significantly more with silymarin than with placebo, with no significant change in HDL. That's a real, repeated finding across the pooled trials, but the authors call for confirmation in larger, longer studies, and it wasn't tested in a general healthy population.

Will milk thistle lower cholesterol as well as a statin or other medication?

No trial has compared milk thistle head-to-head against a cholesterol medication, and none of the research reviewed here makes that comparison. Anyone on a prescribed cholesterol medication should not stop or substitute it based on the findings above without talking to a doctor.

Is milk thistle good for cholesterol at any dose?

The pooled trials used a range of doses rather than one standardized amount, which is part of why the authors call the result preliminary. See how much milk thistle should you take a day for what individual trials in other outcomes have used.

When to talk to a doctor

Anyone with diagnosed high cholesterol, diabetes or a metabolic condition should manage it with a doctor's guidance; milk thistle is not a treatment for a lipid disorder, and the trials above were run alongside standard care, not instead of it. If you take a cholesterol medication or any other prescription drug, ask a doctor before adding milk thistle — see milk thistle and medications: what to check.

Related reading: milk thistle benefits: what the research does and doesn't show, does milk thistle help with weight, and what is milk thistle.