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Head-to-head evidence comparison — which supplement is right for you?
Milk Thistle wins 1 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Probably helps
9 of 13 studies with measurable effects showed benefit.
Top outcomes
Verdict
Likely helps
18 of 23 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)
100-200mcg
With food
Selenomethionine (best absorbed)
4-8 weeks
8-12 weeks
4 weeks
4-8 weeks
4-8 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.
Selenium, antioxidants, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials
The American journal of clinical nutrition (2020) · Meta analysis · n=9423
However, a decreased risk with antioxidant mixtures was seen for CVD mortality when selenium was part of the mix (RR: 0.77; 95% CI: 0.62, 0.97; P = 0.02), with no association when selenium was absent.
Selenium for preventing cancer
The Cochrane database of systematic reviews (2018) · Meta analysis · n=27232
For analyses of RCTs with low risk of bias, the summary risk ratio (RR) for any cancer incidence was 1.01 (95% confidence interval (CI) 0.93 to 1.10; 3 studies, 19,475 participants; high-certainty evidence).
Selenium and prostate cancer: systematic review and meta-analysis
The American journal of clinical nutrition (2012) · Meta analysis · n=13254
Three high-quality studies included in the meta-analysis of toenail selenium and cancer risk indicated a reduction in prostate cancer risk (estimated RR: 0.29; 95% CI: 0.14, 0.61) with a toenail selenium concentration between 0.85 and 0.94 μg/g.
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 Cochrane systematic review showing moderate-certainty evidence for TPO antibody reduction. Effects on thyroid hormone levels (TSH, T4, T3) were inconsistent across studies.
AI-estimated from published studies. Interpret as directional guidance.
Milk Thistle has a higher evidence score (9/10 vs 9/10) and wins in 1 of 3 categories.
For reduce inflammation, Milk Thistle has a higher relevance score (95 vs 52).
No known interactions between Milk Thistle and Selenium have been documented in our database. However, always consult a healthcare provider before combining supplements.