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Head-to-head evidence comparison — which supplement is right for you?
Vitamin B6 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
9 of 11 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)
25-100mg daily
Morning with food, Can take with other B vitamins
P-5-P (Pyridoxal-5-Phosphate)
4-8 weeks
8-12 weeks
4 weeks
2-4 weeks
1-2 cycles
Months of high doses
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.
Dosage exploration of combined B-vitamin supplementation in stroke prevention: a meta-analysis and systematic review
The American journal of clinical nutrition (2024) · Meta analysis · n=76664
In areas without and with partial folic acid fortification, combined B-vitamin supplementation significantly reduced the risk of stroke by 34% [RR: 0.66; 95% confidence interval (CI): 0.50, 0.86] and 11% (RR: 0.89; 95% CI: 0.79, 1.00), respectively.
Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life
The Cochrane database of systematic reviews (2018) · Meta analysis · n=83000
We found that giving B vitamin supplements to cognitively healthy adults, mainly in their 60s and 70s, probably has little or no effect on global cognitive function at any time point up to 5 years (SMD values from -0.03 to 0.06) and may also have no effect at 5-10 years (SMD -0.01).
Drug Efficacy in the Treatment of Antipsychotic-Induced Akathisia: A Systematic Review and Network Meta-Analysis
JAMA network open (2024) · Meta analysis · n=492
No association between effect sizes and psychotic severity was found.
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 systematic review of nutritional interventions for PMS psychological symptoms. Evidence quality limited by study heterogeneity and need for more consistent protocols.
AI-estimated from published studies. Interpret as directional guidance.
Vitamin B6 has a higher evidence score (9/10 vs 9/10) and wins in 1 of 3 categories.
No known interactions between Milk Thistle and Vitamin B6 have been documented in our database. However, always consult a healthcare provider before combining supplements.