Milk Thistle: Antioxidant Powerhouse

Antioxidant, Liver Protector and NAD+ Regenerator

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common liver disease in the US. It’s caused by metabolic conditions such as insulin resistance, diabetes type 2, and being overweight. Cirrhosis, or permanent and irreversible damage, occurs in about 10-15% of these cases, which is why it’s important to assess liver health on a regular basis, and implement preventive treatment strategies promptly. In my practice, I believe optimal range for liver enzymes is within the middle of the reference range, which is about 20 IU/L. Towards the upper end of the reference range (above 30 IU/L), although this may be “inside the reference range,” is not ideal, and can be suggestive of the early stages of NAFLD.


What is metabolic condition?

This is when the normal processes in your body (your metabolism) that turn food into energy for your body to maintain optimal health don’t work correctly. For example, in a condition like diabetes type 2, an individual has difficulty using glucose to make energy. It’s as if the body’s energy-making machine is broken, which results in things like abnormal storage of energy into extra fat which then gets stored in the liver. (Side Note – this is also why having muscle is so important, as the muscles are where extra calories get stored first, as glycogen. Once the muscles are full, the liver is next in the chain of storage).

Silibinin, a natural compound in milk thistle with antioxidant and liver-protective properties, has been researched for its potential benefits in various liver-related conditions, and has been proposed as a potential treatment for NAFLD. Some research has found that silibinin restores NAD+ levels, reduces oxidative stress, and induces the SIRT1/AMPK pathway, which plays a role in metabolic regulation.


What is NAD+?

NAD+ is like a special helper in your body. It helps with lots of important jobs that keep us healthy and full of energy. Imagine NAD+ as a tiny superhero that goes around and fixes everything. It helps your body turn food into energy, repair damaged parts, and even helps your cells communicate with each other. So, NAD+ is like a little power booster that keeps everything running smoothly.

Many diseases, and even the aging process, are associated with a decline in NAD+ levels. NAD+ homeostasis is a crucial factor in the development of NAFLD. NAD+ plays a protective role against metabolic diseases (including insulin resistance, diabetes type 2, metabolic syndrome and cardiovascular disease).

If you’d like to learn more about NAD+ click here.


What is the SIRT1/AMPK Pathway?

Imagine SIRT1 and AMPK are your 2 very important bodyguards. SIRT1 is like a guard that helps your body stay in good shape, fixing problems and repairing broken things. AMPK manages your energy and makes sure you have enough of it for every task you complete. Your 2 bodyguards use teamwork to communicate with each other to make sure everything runs smoothly.

As you can see, when it comes to metabolism, silibinin accomplishes a lot! Due to its ability to positively influence NAD+ homeostasis and the SIRT1/AMPK pathway, research has found silibinin to be a promising molecule for the treatment of NAFLD.


Salomone, Federico; Silibinin Restores NAD+ Levels and Induces the SIRT1/AMPK Pathway in Non-Alcoholic Fatty Liver; Journal of Nutrients; 2017.

What is NAD+

Short for Nicotiamide Adenide Dinucleotide, NAD+ is a coenzyme that is found in every cell in your body. In simple biochemistry terms, a coenzyme is something that is necessary in order to make stuff happen. NAD+ shares and shuttles electrons to create gradients that help make ATP, our cellular form of energy, which is then used to make lots of stuff happen. NAD+ also works with other enzymes systems (most notably, Sirtuins), which are involved in cellular function and biological processes that affect longevity and the aging process.

Here’s an analogy that might be helpful: Think of NAD+ as a really good wedding planner. In charge of a very large wedding. If you’ve ever been married or planned a wedding, you likely understand the very long and daunting list of tasks that goes into planning such an event: Coordinating the guest list, organizing all the vendors, knowing exactly where and when to place things and people (and maybe dogs!), knowing what fits (and what doesn’t!), understanding the importance of decor and ambience, ensuring the comfort and happiness of all guests (for the entire evening!), making sure Uncle Hal doesn’t end up falling into the cake, and being able to avoid any and all unwanted circumstances. There’s an extremely large number of tasks to accomplish, a very large number of people to keep in mind and coordinate with, and it’s all done seamlessly with a perfect vision in mind. 


What is NAD+ responsible for?

Much like our world-class wedding planner, NAD+ is central to over 500 reactions (that we know of so far!), making it a primary driver in cellular function and metabolism. It impacts almost all processes of cellular function, helping to convert food into energy, protecting our DNA from damage, and protecting us from disease and premature aging. NAD+ is essential for life – if we can’t make it, we can’t survive. 


In a nutshell, here are some of the many
things NAD+ can do:

      • Supports mitochondrial function
      • Repairs damaged DNA
      • Reduces inflammation
      • Boosts energy
      • Improves metabolism
      • Regulates circadian rhythm
      • Reverses insulin resistance
      • Combats the aging process
      • Supports brain health
      • Supports neuroregeneration
      • Increases memory and concentration
      • Diminishes brain fog and improves mental clarity and alertness
      • Improves athletic performance
      • Supports a healthy immune system
      • Prevents risk of disease

What causes NAD+ levels to decrease?

NAD+ levels naturally decline with age. Levels can also decrease prematurely with high stress levels, illness, environmental toxin exposures and excessive alcohol consumption. 


How can I increase or naturally support
healthy levels of NAD+?

It should be no surprise that, when it comes to enhancing longevity and healthspan, certain lifestyle habits can serve as a way to obtain higher amounts of the anti-aging benefits of NAD+. Most notably, exercise and caloric restriction are amongst the most effective. IV administration or injections of NAD+ are also supplemental options to improving metabolic health.