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Head-to-head evidence comparison — which supplement is right for you?
Red Yeast Rice wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Likely helps
11 of 15 studies with measurable effects showed benefit.
Top outcomes
Verdict
Likely helps
15 of 16 studies with measurable effects showed benefit.
Top outcomes
200-400mg silymarin (standardized extract)
With meals, Split into 2-3 doses
Standardized extract (70-80% silymarin)
1200-2400mg providing 10mg monacolin K
Evening (cholesterol synthesis peaks at night)
Standardized extract with verified monacolin K content
4-8 weeks
8-12 weeks
4 weeks
8-12 weeks
8-12 weeks
Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A Systemic Review and Bayesian Network Meta-Analysis
Phytotherapy research : PTR (2025) · Meta analysis · n=1337
For HbA1c, silymarin was more effective than resveratrol (MD -2.08, 95%Cl -3.50 to -0.72) (P < 0.05).
Effects of different natural products in patients with non-alcoholic fatty liver disease-A network meta-analysis of randomized controlled trials
Phytotherapy research : PTR (2024) · Meta analysis · n=2509
The results of the network meta-analysis showed that artichoke leaf extract confers a relative advantage in reducing the aspartate aminotransferase (AST) levels (SUCRA: 99.1%), alanine aminotransferase (ALT) levels (SUCRA: 88.2%) and low-density lipoprotein cholesterol (LDL-C) levels (SUCRA: 88.9%).
Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury
BMC complementary medicine and therapies (2025) · Meta analysis · n=3545
According to the findings of this meta-analysis silymarin administration showed a significant reduction in AST (SMD [95% CI]: - 0.670 [- 0.931, - 0.408], p-value = 0.000), and ALT (SMD [95% CI]: - 0.912 [- 1.177, - 0.646], p-value = 0.000) levels.
Efficacy and Safety of Armolipid Plus(®): An Updated PRISMA Compliant Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials
Nutrients (2021) · Meta analysis · n=1050
Armolipid Plus® was well tolerated.
Safety and Efficacy of the Consumption of the Nutraceutical "Red Yeast Rice Extract" for the Reduction of Hypercholesterolemia in Humans: A Systematic Review and Meta-Analysis
Nutrients (2024) · Meta analysis
The consumption of RYR extract by people with hypercholesterolemia was associated with statistically significant reduction in total cholesterol and LDL-C, whereas it was not associated with an increase in life-threatening side effects.
Impact of Berberine or Berberine Combination Products on Lipoprotein, Triglyceride and Biological Safety Marker Concentrations in Patients with Hyperlipidemia: A Systematic Review and Meta-Analysis
Journal of dietary supplements (2024) · Meta analysis · n=4838
Products with berberine alone had less robust effects on TC (MD -12.08 mg/dL [95%CI: -21.79 to -2.37]), LDL (MD -9.26 mg/dL [95%CI: -20.31 to 1.78]), and HDL (MD 1.38 mg/dL [95%CI: -1.27 to 4.03]) but TG effects were similar (MD -17.40 mg/dL [95%CI: -32.57 to -2.23]).
Based on multiple meta-analyses showing significant ALT/AST reduction. Effect size modest (SMD -0.67 to -0.9). Effectiveness assumes standardized 80% silymarin extract. Lower bioavailability forms may require higher doses.
Based on RCT showing 16.77% reduction with 3mg and 26.46% reduction with 10mg monacolin K. Conservative effectiveness scaling due to limited dose-response data and variable study quality noted in meta-analyses.
AI-estimated from published studies. Interpret as directional guidance.
Red Yeast Rice has a higher evidence score (7.8/10 vs 6.5/10) and wins in 2 of 3 categories.
For reduce inflammation, Milk Thistle has a higher relevance score (95 vs 90).
No known interactions between Milk Thistle and Red Yeast Rice have been documented in our database. However, always consult a healthcare provider before combining supplements.