Effects berberine-silymarin on liver enzymes: A systematic review and meta-analysis of randomized controlled trials

Despite controversies, no study has systematically summarized findings from earlier studies on the effect of berberine (BBR)-silymarin on liver enzymes. Therefore, the current systematic review and meta-analysis aimed to investigate the effect of berberis aristate and Silybum marianum on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in adults.

Relevant studies, published up to June 2021, were searched through PubMed/Medline, Scopus, ISI Web of Science, EMBASE and Google Scholar. The mean differences and standard deviations were pooled using a random-effects model. The studies' quality was evaluated using the Cochrane Risk of Bias Tool.

Out of 80 citations, 5 trials that enrolled 549 participants were included. Berberis aristate and Silybum marianum resulted in no statistically significant change in ALT (weighted mean differences (WMD): -0.39 mg/dl; 95% CI: -1.67 to 0.89, P = 0.55), and AST (WMD: -0.44 mg/dl; 95% CI: -2.02 to 1.14, P = 0.58).

We did not find any significant reduction in liver enzymes following BBR-silymarin consumption in adults. Further clinical trials with high quality according to the challenges mentioned seem to be helpful to use BBR-silymarin as a supplement for improving liver function.