More than 15 million Americans may be putting their liver health at risk by trying to improve their overall health. A new study has revealed the extent of the damage caused by taking popular herbal supplements, such as turmeric, green tea, stress reliever ashwagandha and weight loss aid. Garcinia cambogia.
Health researchers from the University of Michigan, Ann Arbor, examined data covering 9,685 people from 2017 to 2021 and found that about 4.7% of U.S. adults used one of six potentially toxic supplements in the past 30 days. These supplements included turmeric, green tea, ashwagandha, G. cambogia, black gentian and red yeast rice.
Those who took supplements were often taking these herbs on their own initiative, rather than under medical instructions: turmeric for joint health and arthritis, green tea to boost energy levels, G. cambogia Black cohosh for weight loss, black cohosh for managing hot flashes, and red yeast rice for heart health.
And while reports of liver toxicity linked to these supplements aren’t new—they’ve been on the rise for some time, including in this 2022 study—medical researchers are concerned that people aren’t aware that they carry a serious overdose risk, leading to emergency room visits, with hospitalizations increasing from 7% to 20% in the decade between 2004 and 2014.
“The use of herbal and dietary supplements (HDSs) accounts for an increasing proportion of cases of drug hepatotoxicity,” wrote the researchers, led by Alisa Likhitsup, assistant professor of gastroenterology.
Drug-induced hepatotoxicity, also known as toxic liver disease, is an acute or chronic liver injury that presents with a range of symptoms including yellowing of the skin, fatigue, nausea, rash, itching, and upper right abdominal pain. Although it can be treated by removing the toxic trigger, if left untreated or missed, it can lead to serious consequences, including the patient needing a liver transplant or even dying from it.
As hospitalizations from herbal supplement misuse rise, researchers are not calling for abstinence from herbs; they are urging users to be mindful of ingredients and dosages, especially if they are taking a combination of these supplements or other medications to treat chronic conditions.
“Given the lack of regulatory oversight of the manufacture and testing of botanical products, it is recommended that clinicians obtain a complete medication and HDS use history when evaluating patients with unexplained symptoms or liver test abnormalities,” they wrote in the study. “Given the widespread and increasing popularity of botanical products, we urge government officials to consider increasing regulatory oversight of how botanicals are manufactured, marketed, tested, and monitored in the general population.”
They also note that the regulatory processes surrounding these supplements are not as stringent as those for prescription drugs, and chemical tests on the products have revealed discrepancies between the advertised content on the bottle and the dose in the tablet.
Furthermore, clinical trials on the effectiveness of these supplements have not provided solid evidence of their benefits outweighing their risks when taken in high doses.
“The safety and efficacy of HDSs are not well established due to the lack of regulatory requirements from the U.S. Food and Drug Administration for human pharmacokinetics or prospective clinical trials prior to marketing,” the researchers added.
In 2023, the Therapeutic Goods Association (TGA), the Australian equivalent of the FDA, issued a warning highlighting the risk of liver damage from consuming turmeric and/or curcumin. While they warned that serious injuries were rare, the risk varied depending on an individual’s bioabsorption and liver health.
“Risk of liver damage, Turmeric long “(Turmeric) is safe to eat when consumed as a food in typical dietary amounts,” the TGA added, providing some good news for those cooking with the popular orange spice.
The study was published in the journal JAMA Network Open.
Source: University of Michigan via Medical Xpress