Clinical indicators of improvement in the health of the liver include:

• assessment of general condition, appetite, epigastric discomfort, enlargement and consistency of the liver,
• blood plasma tests.
• changes in membrane permeability are deduced from measurements of glutamic-pyruvic transaminase (GPT), glutamic-oxaloacetic transaminase (GOT), lactic acid dehydrogenase (LDH), sorbitol dehydrogenase, and gamma glutamyl transpeptidase (GGT)
• membranotropic properties and the excretory functions of the liver are assessed through measurements of bilirubin, LAP, gamma-GT, alkaline phosphatase, and bromethalein
• synthesizing ability is assessed through prothrombin, triglycerides, and cholesterin
• measurements of mesenchymic activity include clotting factors, alpha, beta and gamma globulin, immunoglobulins IgA, and IgG.

• One study involved 129 patients and a control group of 56 for a period of about one month. Their conditions included toxic-metabolic liver damage, fatty degeneration of the liver for various reasons, and chronic hepatitis. Milk Thistle markedly changed both subjective and objective symptoms, brought a return to normal enzymatic activities, and improved digestive disorders. Enlarged livers diminished substantially in volume. A 50% regression in pathological symptoms, versus 25% in controls, occurred. No cases of intolerance, side effects, or allergic reactions were observed.
• in a double-blind study, serum bilirubin, GOT, and GPT in 28 patients treated with silymarin were compared with those in 29 patients treated with a placebo. The silymarin treated group were more improved than those in the control group after the 5th day of treatment. The number of patients having attained normal values after 3 weeks' treatment was higher in the silymarin-treated group than in the control group.
• Toxic damage was tested in 33 patients treated with silymarin. The parameters GOT, GPT, and g-glutamyltranspeptidase (g-GTP) were improved significantly by silymarin, sometimes returning to normal in a much shorter time than in the control group.
• 106 patients with liver disease, mostly induced by alcohol, were selected on the basis of elevated serum transaminase levels and randomly allocated into the silymarin-treated and control groups. Decreases of serum GPT and GOT in the treated group were statistically significant over those of the controls.
• in chronic liver disease, silymarin prevented the decrease of seralbumin from 3 months of therapy to the end of the study. The histopathological findings of focal necrosis and fibrosis were also much improved. Silymarin proved to be beneficial in the parameters of parenchymal disorders, intralobular mesenchymal reaction, and fibrosis.
• Long-term treatment with silymarin on chronic hepatopathies caused by psycho-pharmaceuticals resulted in significant improvements in the liver function parameters such as GOT, GPT, and BSP during treatment.
• two cases of food poisoning caused by flagellates responded very rapidly to Milk Thistle, showing subjective, biochemical and histological improvements.

• toxic/metabolic liver disease (including both alcohol & drug induced forms),
• acute viral hepatitis,
• chronic-persistent hepatitis,
• chronic-aggressive hepatitis,
• cirrhosis of the liver,
• fatty degeneration of the liver