NAFLD and its pathogenesis is a great mystery until now.Even if there is just one pathway for all patients or whether there are two distinct pattern for simple steatosis and steato-hepatitis from beginning is in doubt. But whatever the pathogenesis, medical treatment as you know is a major problem and depends mainly on weight reduction and exercise.

Most drugs used in the setting of NAFLD/ NASH have limited effect and are not effective universal. Silymarin has been shown in some studies - including our study () - that can reduce AST / ALT levels. As I know there is no evidence on the histological effect of Silymarin in man. However there are some animal studies in this field; if this can be applied to man or not needs further studies and time of course!

Thanks. but we should differentiate the affect of drug on staeatosis from inflammation in NASH. Decrease in steatosis is predicted, but about NASH we do not have enough evidence to support using it yet.