Milk Thistle
Silybum marianum
Milk thistle is the botanical AlphaCleanse is built around. Its seeds carry silymarin, a mixture of flavonolignans from a daisy-family plant that behaves as an antioxidant inside liver cells.
AlphaCleanse, 2-capsule serving
- Milk Thistle165 mg
- Spirulina110 mg
- Ginger110 mg
- Turmeric110 mg
- Dandelion Root55 mg
- Reishi MushroomReishi55 mg
- Beetroot55 mg
- Burdock Root27.5 mg
- Rhubarb Root27.5 mg
- Schisandra BerrySchisandra27.5 mg
- Nettle Leaf27.5 mg
- BioPerine2.75 mg
Every amount is printed on the label. No proprietary blend.
Silybum marianum has been used for liver complaints since Roman agricultural writing, and it is the single most studied herb in the liver-supplement category. That cuts both ways.
Because it has been trialled properly, including by the National Institutes of Health, we know more about where milk thistle fails than we know about most botanicals.
This page gives the dose in our formula, what the human trials measured, where our 165 mg sits against theirs, and who should not take it. It is also the ingredient we can say the most about.
How much is in AlphaCleanse
In short: AlphaCleanse contains 165 mg of milk thistle per 2-capsule serving, the largest single amount on its 12-ingredient panel.
165 mg of milk thistle per 2-capsule serving. Of the 12 ingredients on the Supplement Facts panel, milk thistle is first by weight; BioPerine at 2.75 mg is last.
The panel states 165 mg of milk thistle and carries no silymarin standardisation figure, so we do not claim one.
Competitor labels that read "80% silymarin" are describing a concentrated seed extract, which is a different raw material from whole milk thistle.
Comparing the 2 by milligrams alone will mislead you in either direction. If you are comparing labels, that is the question to ask of every brand, including this one.
There is no proprietary blend on the AlphaCleanse panel. All 12 ingredients carry their own amount, and AlphaCleanse is made with organic ingredients.
What the evidence shows
In short: the strongest silymarin trial missed its primary outcome, pooled analyses show small enzyme drops, and our 165 mg sits far below trial doses.
The strongest human evidence for silymarin missed its primary outcome.
In 99 adults with biopsy-confirmed nonalcoholic steatohepatitis, 32.7% of the silymarin group reached a drop of 30% or more in the NAFLD activity score, against 26.0% on placebo, P = .467.
Fibrosis improved in 22.4% of the silymarin group against 6.0% on placebo, P = .023.
The design: randomised and placebo-controlled, silymarin 700 mg or placebo 3 times daily, 2,100 mg a day, for 48 weeks, with biopsies at both ends (Wah Kheong, Nik Mustapha, Mahadeva, Clinical Gastroenterology and Hepatology 2017;15(12):1940-1949, PMID 28419855).
The NIH-funded SyNCH trial went the other way.
In 154 adults with chronic hepatitis C and ALT of 65 U/L or higher, silymarin at 420 mg or 700 mg 3 times daily for 24 weeks did not lower ALT more than placebo (Fried et al., JAMA 2012;308(3):274-282, PMID 22797645).
Pooled analyses are gentler, and each carries its own caveat:
- Across 8 randomised trials in 587 adults with fatty liver, silymarin lowered ALT by 9.16 U/L and AST by 6.57 U/L against controls (Zhong et al., Medicine 2017;96(49):e9061, PMID 29245314).
- In 5 trials covering 270 people with type 2 diabetes, fasting glucose fell 26.86 mg/dL, though those authors call the trials low quality and decline to recommend it (Voroneanu et al., Journal of Diabetes Research 2016:5147468, PMID 27340676).
Where our dose sits: lower, and made of different material. Those trials used concentrated silymarin extract at 1,260 mg to 2,100 mg a day, against 165 mg of milk thistle here inside a 12-ingredient formula.
What we claim:
- 165 mg of milk thistle per 2-capsule serving, the amount printed on the panel.
- The largest single amount in a 12-ingredient formula, with no proprietary blend.
What we do not claim:
- A silymarin standardisation percentage. The panel carries none, so neither do we.
- Equivalence to the 1,260 mg to 2,100 mg trial doses above.
- That any of those trials was run on this formula.
The NIH's own summary is that the evidence is not strong enough for definite conclusions (NCCIH).
What we can tell you without qualification is what is in the bottle: 165 mg of milk thistle, printed on the panel, the largest amount in the formula, and the one number you can hold us to.
Why this dose
In short: 165 mg is the anchor of a 12-ingredient formula, not an attempt to match the dose of a standalone silymarin product.
AlphaCleanse is an anchor-and-support formula, and milk thistle is the anchor.
At 165 mg it is the largest amount on the panel, it is the most studied botanical in this category, and it is the ingredient the rest of the formula is built around.
The other 11 are in for breadth, each at an amount printed where anyone can read it.
Judging one of those 11 against its own solo trial dose is the wrong yardstick, because none of them was ever sold as a solo botanical. Milk thistle is the one carrying the weight.
165 mg is also the largest share one botanical can take inside a 2-capsule serving that people will actually swallow twice a day.
A standalone silymarin product at 2,100 mg a day is a different product answering a different question, and the trials above are the ones it answers.
The comparison that decides something here is not our 165 mg against a trial's 2,100 mg.
It is our panel, 12 amounts printed in full, against the products that put the same botanicals into a proprietary blend and print no amounts at all.
The one piece of evidence about this specific combination is our own 12-week study in 40 adults, registered at ClinicalTrials.gov as NCT07738744. What it was:
- Single-arm and open-label, with no placebo group.
- 40 adults, 12 weeks.
- Measured a hepatic function panel plus 5 self-reported symptoms.
- Alkaline phosphatase fell 10.6%.
The ALT and AST results from that study are not yet published, and we will not quote them until they are.
On standardisation, take this with you. We print what the panel prints, the panel carries no silymarin percentage, and so we claim none.
When a label does print one, that figure is a specification for a raw material.
The question that separates a real one from a number on a box is whether it came off the incoming supplier's spec sheet or off an assay run on the finished lot.
Ask that of any brand you are weighing up, and ask us the same at help@liverated.co.
What comes back will tell you more about how a liver supplement is made than the percentage itself ever does.
Safety and interactions
In short: skip AlphaCleanse if you are pregnant, breastfeeding, or allergic to ragweed, and talk to your prescriber first if you take warfarin.
Who should not take AlphaCleanse, or should ask before starting:
- Anyone pregnant, breastfeeding or trying to conceive.
- Anyone who reacts to ragweed, chrysanthemum, daisies or marigold.
- Anyone on warfarin or another blood thinner, until they have told their prescriber and asked for an INR check.
- Anyone on simvastatin, atorvastatin or lovastatin, until a pharmacist has read the panel.
The NIH's LiverTox database gives milk thistle a likelihood score of E, unlikely cause of clinically apparent liver injury, and notes it has not been linked to serum enzyme elevations or acute liver injury despite very wide use (LiverTox, NBK548817).
Reported side effects in trials are mild and digestive: nausea, loose stools, bloating.
Allergy. Milk thistle sits in the Asteraceae family with ragweed, chrysanthemum, daisies and marigold.
If you react to those, this is a reason to skip AlphaCleanse rather than to try it carefully. Dandelion and burdock root, also on our panel, are in the same family.
Drug interactions. Silymarin inhibits CYP2C9 and CYP3A4 in laboratory conditions, which is why milk thistle appears on interaction lists next to warfarin, simvastatin, atorvastatin and lovastatin.
The best human test found less than the lab work predicted.
9 healthy volunteers took a standardised milk thistle extract 3 times daily for 14 days, and probe-drug testing showed no significant change in CYP1A2, CYP2C9, CYP2D6 or CYP3A4/5 activity (Kawaguchi-Suzuki et al., Drug Metabolism and Disposition 2014;42(10):1611-1616, PMID 25028567).
9 people and 1 product is a thin basis for reassurance, so the honest position is that the theoretical risk is real, the measured risk looks small, and nobody has tested this formula.
If you take warfarin, tell your prescriber before you start and ask for an INR check.
Pregnancy and breastfeeding. Do not take AlphaCleanse if you are pregnant, breastfeeding or trying to conceive.
Safety data for milk thistle in pregnancy is absent rather than reassuring, and other ingredients on our panel carry their own cautions.
Corroboration, not evidence of harm. Our registered study (NCT07738744) excluded people on warfarin or antiplatelet therapy, pregnant and breastfeeding women, and people with a history of kidney stones.
That was a design choice made before anyone was dosed, and it tells you which groups were not studied. It is not a finding about harm.
Stop taking it and see a doctor if you develop dark urine, pale stools, yellowing of the eyes or skin, or new persistent itching.
Common questions
In short: 165 mg does not match trial doses; statins need a pharmacist, warfarin needs a prescriber, and ragweed allergy is a reason to skip.
Is 165 mg of milk thistle enough, when other brands use 200 to 300 mg of an 80% silymarin extract?
For matching the published silymarin trials, no, and we will not pretend otherwise.
The trials that people cite for milk thistle used 1,260 mg to 2,100 mg of concentrated silymarin extract a day.
That is roughly 10 times what a 200 to 300 mg extract capsule delivers, and far more than the 165 mg of milk thistle in an AlphaCleanse serving.
A second point matters more than the first. Milligrams of whole milk thistle and milligrams of an 80% extract are different materials, so the label comparison people run in the shop is not comparing like with like.
Our panel does not carry a silymarin standardisation figure, so we claim none. Here is the question that makes any percentage on any label mean something.
Ask the brand whether the figure came off the incoming supplier's spec sheet or off an assay run on the finished lot, and ask to see the certificate of analysis. Ask us the same at help@liverated.co.
Then weigh what comes back against the rest of the shelf. AlphaCleanse prints all 12 amounts including the 165 mg anchor, and most of the formulas beside it hide the same botanicals inside a proprietary blend.
Can I take AlphaCleanse with a statin?
Probably, after a pharmacist check, and the reason to check is milk thistle. Silymarin inhibits CYP3A4 and CYP2C9 in the laboratory, and those are the enzymes that clear simvastatin, atorvastatin and lovastatin.
In theory, blood levels of those drugs could rise.
In practice, the one controlled human test we can point to found no significant change in CYP3A4 or CYP2C9 activity: 9 volunteers took a standardised milk thistle extract 3 times daily for 14 days (PMID 25028567).
Rosuvastatin and pravastatin are cleared by different routes anyway.
No interaction study exists on this specific 12-ingredient formula, so take the Supplement Facts panel to your pharmacist and ask directly. That takes 5 minutes and settles it better than we can.
Can I take it with warfarin or another blood thinner?
Ask your prescriber before you start, and do not begin without telling them.
Milk thistle flavonolignans can slow warfarin clearance through CYP2C9, and 2 other ingredients on our panel, ginger and turmeric at 110 mg each, appear on antiplatelet caution lists.
Individually the evidence for each is weaker than the warnings suggest, but warfarin has a narrow therapeutic window, and the sensible move is an INR check about 2 weeks after starting anything new.
Our own 12-week study excluded anyone on warfarin, clopidogrel or aspirin therapy. That is a design choice rather than a finding, but it does mean we have no data on that group.
This is the one interaction question where our answer is "tell your doctor first" rather than "generally fine".
I'm allergic to ragweed. Is milk thistle a problem?
Possibly, and it is the reason to skip AlphaCleanse rather than to trial it cautiously.
Milk thistle belongs to the Asteraceae family alongside ragweed, chamomile, chrysanthemum, marigold and daisies, and cross-reactivity within that family is well described.
2 other ingredients in the formula, dandelion root at 55 mg and burdock root at 27.5 mg, are in the same family, so avoiding milk thistle alone does not solve it.
NCCIH lists allergic reaction as a known risk of milk thistle in people sensitive to ragweed and related plants.
If your reaction to ragweed is hay fever rather than anything systemic, that is a conversation for an allergist, not for us. A 60-day money-back guarantee covers you either way, no questions asked, no restocking fee.
The other 11 ingredients
AlphaCleanse contains milk thistle at 165 mg per serving.
See AlphaCleanse60-day money-back guarantee, no questions asked, no restocking fee.
Verified citations on this page: PMID 28419855, PMID 22797645, PMID 29245314, PMID 27340676, PMID 25028567, NIH LiverTox NBK548817, NCCIH milk thistle. Every PMID was confirmed to resolve to the paper named on 2026-09-09, and none was re-attributed in this pass.
Last reviewed: 2026-09-16