By attempting to improve their general health, nearly 15 million Americans might be jeopardizing their liver health. The degree of harm caused by taking well-known botanical supplements, such as green tea, ashwagandha, turmeric, and Garcinia cambogia, which helps people lose weight, has been made clear by a recent study.
Researchers studying health at the University of Michigan, Ann Arbor, examined data spanning nine,685 individuals from 2017 to 2021, and discovered that about 4.7% of US adults had used one of the six possibly harmful supplements in the preceding 30 days. Turmeric, green tea, ashwagandha, Garcinia cambogia, black cohosh, and red yeast rice were among those supplements.
The majority of supplement users were taking these botanicals for a variety of purposes, not because their doctors had prescribed them: red yeast rice for heart health, turmeric for joint health and arthritis, green tea extract to increase energy, garcinia cambogia for weight loss, and black cohosh to control hot flashes. It is important to note that the study only discusses green tea extract and not actual tea consumption (although a daily maximum of eight cups is advised; tea has no known link to liver damage).
Furthermore, although reports of liver toxicity linked to these supplements have been around for a while—including this 2022 study—medical researchers are worried that people may not be aware of the significant risk of overdosing and presenting to the emergency room as a result of these supplements. Over the ten years from 2004 to 2014, hospitalization rates rose from 7% to 20%.
A growing percentage of medication hepatotoxicity cases can be attributed to the use of herbal and dietary supplements (HDSs), according to the researchers, who were led by assistant professor of gastroenterology Alisa Likhitsup. Acute or chronic liver damage caused by drugs, commonly referred to as toxic liver disease, can cause yellowing of the skin, weariness, nausea, rash, itching, and upper-right abdomen pain, among other symptoms. Although it is treatable by eliminating the toxic trigger, if left untreated or overlooked, it can have fatal implications, necessitating a liver transplant for the patient.
The researchers are not advocating for abstinence, but rather caution among users about contents and quantities, particularly if they are taking a combination of herbal supplements and other medications to address chronic disorders, even though hospitalizations resulting from mishandling these supplements are increasing.
When evaluating patients with unexplained symptoms or abnormal liver test results, doctors are advised to collect a complete pharmaceutical and HDS use history due to the absence of regulatory monitoring on the manufacturing and testing of botanical products, the authors of the study stated.
"Considering the widespread and growing popularity of botanical products, we urge government authorities to consider increasing the regulatory oversight on how botanicals are produced, marketed, tested, and monitored in the general population." They further highlight the fact that there are discrepancies between the dose listed in a tablet and what is advertised on the bottle and that the regulations governing these supplements are less onerous than those governing prescription drugs. Furthermore, when these supplements are used at greater levels, there isn't strong evidence to support their benefits above their hazards, according to clinical investigations investigating their efficacy.
Naturally, safe dosages for each supplement depend on a person's medical history, current liver health, prescription medication regimen, and other ailments. Because of this, safe dose recommendations ought to be tailored to the individual.
The US Food and Drug Administration does not require human pharmacokinetic studies or prospective clinical trials before marketing, which means that the safety and effectiveness of HDSs are not well established, the researchers continued. The Therapeutic Goods Association (TGA), the Australian FDA's equivalent, released a warning in 2023 highlighting the possibility of liver damage from eating turmeric and/or curcumin. Although they issued a warning that severe harm is uncommon, the risk differed based on a person's liver function and capacity for absorption. For those who cook with the beloved orange spice, there is some good news: "The risk of liver injury does not appear to relate to Curcuma longa (turmeric) when consumed in typical dietary amounts as a food," the TGA continued.
