Study Finds Potential Liver Risks from Popular Herbal Supplements

A study published in JAMA Network Open reveals that about 5% of adults are exposed to six potentially hepatotoxic botanicals, which are largely unregulated products typically used to improve health or treat minor health complications.

The use of herbal and dietary supplements (HDSs) is rapidly increasing worldwide due to their perceived health benefits. With over 80,000 products available at various unregulated retail outlets, these supplements can be purchased without a prescription. The most common categories include multivitamins, minerals, vitamin D, omega-3 fatty acids, and calcium. However, these products do not require approval from the Food and Drug Administration (FDA) before being marketed. As a result, there is often a lack of thorough safety and efficacy assessments.

In the current study, scientists have determined population-level estimates of exposure to six potentially hepatotoxic botanicals, including turmeric or curcumin, green tea, Garcinia cambogia, black cohosh, red yeast rice, and ashwagandha.

The study analysed data from over 9,500 adults, focusing on their exposure to prescription drugs and herbal and dietary supplements in the past 30 days.

Among 9,685 adult participants, about 58% reported consuming herbal and dietary supplements at least once within the past 30 days. The majority of participants reported consuming hepatotoxic botanicals without any recommendations from their healthcare providers. The most commonly reported reasons for the use were health improvement, disease prevention, and immunity boosting.

Given the lack of regulatory oversight on botanicals, scientists advise clinicians to obtain a complete medication and botanicals use history when evaluating patients with unexplained symptoms or liver test abnormalities.

References: Likhitsup A. 2024. Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in U.S. Adults. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821951