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The most common side effects of oral silymarin ingestion include:2 Abdominal pain/fullness Bloating Bowel changes Diarrhea Dyspepsia (indigestion) Flatulence Headache Nausea Pruritus (itching) Of note, there's at least one case report of more severe instances of the above, along with sweating, colicky pain, weakness, and collapse, in a 57-year-old woman after taking a milk thistle capsule

Chronic inflammation is problematic

Some users experience a plateau around weeks 10-12

van Vlimmeren MA, et al

[110] Animals can convert cyanocobalamin and hydroxocobalamin to the bioactive forms adenosylcobalamin and methylcobalamin by enzymatically replacing the cyano or hydroxyl groups

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