The Silent Threat in Your Medicine Cabinet

We all strive for a healthy lifestyle, frequently enough incorporating exercise, a balanced diet, and, for many, vitamins and supplements. Though, the pursuit of wellness through supplements may carry unforeseen risks. While intended too bolster health, some supplements can inadvertently jeopardize it, primarily by impacting the liver.

The liver, responsible for filtering harmful substances, can become overwhelmed by certain drugs or supplements, leading to drug-induced liver injury (DILI), also known as toxic hepatitis. Acetaminophen, commonly known as Tylenol, is a well-known culprit, being one of the most common causes of toxic hepatitis. However, the increasing use of supplements is contributing to a rise in DILI cases.

Supplement Use on the Rise

The popularity of supplements is undeniable. A 2024 survey by the Council for Responsible Nutrition revealed that as many as three out of four – or 75% of U.S. adults take some form of supplement, whether it be herbal or dietary. The survey also indicated that nearly 4 in 5 adults prefer supplements over prescription or over-the-counter medications.

This contrasts with data from the Centers for Disease Control and Prevention (CDC), whose most recent study on the subject shows that between 2017 and 2018, just a little over half of adults 20 and older had used a supplement in the last 30 days. This discrepancy highlights a potential increase in supplement usage in recent years.

The Alarming Rise in Liver Failure

The consequences of supplement-related liver damage are becoming increasingly apparent. A 2022 study published in the medical journal “Liver Transplantation” revealed a concerning trend: the number of patients added to the waitlist for a liver transplant as of supplement-related liver failure increased dramatically.

From 2.9% in 1995 to 24.1% in 2020.
Liver Transplantation, 2022

This eightfold increase underscores the growing impact of supplements on liver health.

Identifying the Culprits

Pinpointing the exact cause of supplement-related liver damage is a complex challenge. A 2017 study by the American Association for the Study of Liver Diseases found that 20% of liver toxicity cases in the U.S. could be linked to dietary or herbal supplements. The difficulty lies in the fact that supplements frequently enough contain multiple ingredients, making it hard to determine wich one, or combination thereof, is responsible.

However, recent research has shed light on some specific ingredients of concern. A study published last year by the University of Michigan identified six common ingredients that can definitively be tied to toxic hepatitis:

• turmeric
• Green Tea Extract
• Ashwagandha
• Garcinia Cambogia
• Red Yeast rice
• black Cohosh

The study’s authors estimate that approximately 15 million Americans take at least one of these supplements.

The Regulation Gap

A significant factor contributing to the risk associated with supplements is the lack of stringent regulation. Unlike medications, supplements are not subject to the same rigorous testing and approval processes. This means that you can’t always be sure what you’re getting or if the dosage is correct. This lack of oversight can lead to inconsistencies in product quality and inaccurate labeling,further increasing the risk of adverse effects.

FAQ: Supplements and Liver Health

Can supplements really damage my liver?

Yes, certain supplements can cause drug-induced liver injury (DILI), also known as toxic hepatitis.

Which supplements are most likely to cause liver damage?

Turmeric, green tea extract, ashwagandha, garcinia cambogia, red yeast rice, and black cohosh have been linked to liver toxicity.

Are supplements regulated?

supplements are not regulated as strictly as medications, leading to potential inconsistencies in quality and dosage.

What should I do before taking a new supplement?

Consult with a healthcare professional to discuss potential risks and benefits.