STATEN ISLAND, N.Y. — Popular supplements used by more than 15 million Americans may be putting their liver health at risk, according to health researchers.
Research has revealed the extent of the damage being caused by taking popular botanical supplements including turmeric, green tea, the stress-relieving ashwagandha and weight-loss aid Garcinia cambogia.
For this most recent study, University of Michigan health researchers in Ann Arbor looked at data from 2017 to 2021, covering 9,685 people, and found that nearly 4.7% of U.S. adults had used one of the six potentially toxic supplements within the previous 30 days. The resulting paper, “Estimated Exposure to 6 Potentially Hepatoxic Botanicals in U.S. Adults,” appeared in JAMA Network Open this month.
Supplement users were mostly taking these botanicals on their own, not under medical advice, for a range of issues: Turmeric is taken for joint health and arthritis, green tea extract is thought to boost energy levels, G. cambogia is taken for weight loss, black cohosh is taken to manage hot flushes and red yeast rice is taken for heart health.
The study was specifically concerned with green tea extract, not drinking tea, which has no link to liver toxicity – though a limit of eight cups a day is recommended, according to a report in New Atlas, a science and technology publication.
And while news of liver toxicity connected to these supplements is not new, having been reported to be on the rise for some time now, including in this 2022 study, medical researchers are concerned that people are unaware that they come with a serious risk of overdose.
Hospitalizations increased from 7% to 20% over the decade between 2004 and 2014, the new study found.
“Use of herbal and dietary supplements (HDSs) accounts for an increasing proportion of drug hepatotoxicity cases,” researchers, led by Alisa Likhitsup, an assistant professor of gastroenterology, told New Atlas
Drug-induced hepatotoxicity is an acute or chronic liver injury also known as toxic liver disease, with a host of symptoms including yellowing of the skin, fatigue, nausea, rash, itching and upper-right abdominal pain, according to the National Library of Medicine. And, while it can be treated by removing the toxic trigger, it can lead to serious consequences — including the patient needing a liver transplant or even death if it is left untreated.
The researchers are not campaigning for abstinence, but urge users to be vigilant with ingredients and dosages, especially if they’re taking a combination of them or other medications, according to the report.
“In light of the lack of regulatory oversight on the manufacturing and testing of botanical products, it is recommended that clinicians obtain a full medication and HDS use history when evaluating patients with unexplained symptoms or liver test abnormalities,” they wrote in the study. “Considering 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.”
‘A coin flip’
Regulatory processes surrounding these supplements are not as stringent as for prescription medicines, and chemical testing of products has revealed inconsistencies between what’s advertised on the bottle and what dose is in a tablet, researchers reported.
“In a previous study, we found that there was a great deal of mislabeling of some of these products,” said Dr. Robert Fontana, a Michigan Medicine a hepatologist, professor of medicine and the study’s senior author.
“We performed analytical chemistry and found about a 50% mismatch between stated ingredients on the label and what they actually contained, which is quite alarming,’' Fontana said. “If you buy a supplement and it says it has a certain ingredient, it’s basically a coin flip if that’s true or not.”
In the studied population, the highest proportion of people consumed turmeric (3.46%), followed by green tea (1.01%), ashwagandha and black cohosh (0.38%), garcinia cambogia (0.27%), and red yeast rice products (0.19%), researchers reported.
And clinical trials into the efficacy of these supplements have not provided robust evidence of their benefits compared to their risks when they’re taken at higher doses, the researchers reported.
Safe amounts of each supplement depends on any prescription medicines an individual may be taking, as well as their baseline liver health and other medical conditions.
If you purchase a product or register for an account through a link on our site, we may receive compensation. By using this site, you consent to our User Agreement and agree that your clicks, interactions, and personal information may be collected, recorded, and/or stored by us and social media and other third-party partners in accordance with our Privacy Policy.
