Herbal supplements cause an increase in liver injuries.

supplemensA study published in the journal of the American Association for the Study of Liver Diseases has shown that herbal and dietary supplements have caused an increase in liver injury, from 7%-20% over a ten year period.

The most severe form of liver injury is causes by non-bodybuilding supplements in middle aged women, frequently resulting in death or the need for a liver transplant. The statistics from the National Health and Nutrition Examination Survey reveal that supplements are most often used by women, non-hispanic whites, those over 40 years of age and those with more advanced education.

The study examined the extent of liver toxicity as a result of supplements in 893 patients with liver injury between 2003-2004. Liver injury cases included 45 caused by bodybuilding supplements, 85 attributed to non-bodybuilding supplements, and 709 due to medications. The research team determined that among cases enrolled, liver injuries from herbal and dietary supplements rose to 20% during the study period. While bodybuilding supplements caused prolonged jaundice (median 91 days) in young men, no fatalities or liver transplantations occurred. Death or liver transplantation occurred more frequently among cases of injury from non-bodybuilding supplements, 13%, than from conventional medications, 3%. Liver injury from non-bodybuilding supplements was more common in middle aged women.

“While many Americans believe supplements to be safe, government regulations (Dietary Supplement Health and Education Act of 1994) require less safety evidence to market products than what is required for conventional pharmaceuticals” said lead author Dr. Victor Navarro, from Einstein Medical Center Philadelphia. “With less stringent oversight for herbals and dietary supplements, there is greater potential for harmful consequences including life-threatening conditions.”

Although the researchers of this study specifically avoid concluding that liver injury is on the rise due to herbals and dietary supplements they do recommend that the public be informed of the potential dangers of using dietary supplements and advise that supplemental producers, governmental agencies, health care providers and consumers work together to improve safety.


Victor J. Navarro, Huiman Barnhart, Herbert L. Bonkovsky, Timothy Davern, Robert J. Fontana, Lafaine Grant, K. Rajender Reddy, Leonard B. Seeff, Jose Serrano, Averell H. Sherker, Andrew Stolz, Jayant Talwalkar, Maricruz Vega, Raj Vuppalanchi. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology, 2014; DOI: 10.1002/hep.27317

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