Optimum Nutrition
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Evergreen Apothecary Milk Thistle Capsules is single-ingredient Silybum marianum seed, positioned for liver support and hepatocellular protection. Milk thistle is one of the better-studied herbal supplements: silymarin (a complex of flavonolignans including silybin, silydianin, silychristin) at 140 mg standardized extract three times daily (420 mg/day, Legalon standardization at 70-80% silymarin) is the reference clinical dose. Evidence base: Ferenci 1989 in alcoholic cirrhosis showed reduced mortality vs placebo; multiple hepatitis C trials mixed (Rambaldi 2007 Cochrane review found no significant clinical outcome improvement but noted some biomarker improvements); Mengs 2012 review for hepatoprotection. The clinical picture is: real biochemical hepatoprotective mechanism, mixed clinical outcome data, best-studied at the Legalon 140 mg three times daily dose. Evergreen Apothecary's product does not specify silymarin standardization or the Legalon-equivalent dose. Standard tier for reasonable evidence base at appropriate execution; held there by absence of silymarin standardization discussion.
The Vyvata score's Evidence dimension measures the quality of published RCT support for a product's active ingredients at the label dose. Our source hierarchy: double-blind RCTs in MEDLINE-indexed journals > single-blind RCTs > open-label trials > observational studies > mechanism papers > N=1 case studies (anecdotes). Predatory journals and manufacturer-authored studies without independent replication are weighted down.
Product-specific evidence citations for this item are embedded in the analysis text on the "Analysis" tab. For the full framework and evidence hierarchy, see the methodology page.
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