Nearly 5% of Americans take a botanical product that could be damaging to their liver, a new study has found

Turmeric, Ashwagandha, and 4 Other Herbal Supplements That Could Be Damaging Your Liver

Nearly 5% of Americans take a botanical product that could be damaging to their liver, a new study has found

• A new report estimates almost 5% of Americans take botanical supplements that could potentially cause liver damage.
• These herbal products may have some health benefits, but case reports show that, in some cases, they can cause jaundice and even liver injury or failure.
• Experts said it’s crucial for people to speak with their doctor before taking botanical supplements to make sure they’re informed on the benefits and risks.

Millions of Americans take botanical supplements that could be damaging to their health, according to new research.

The study, published last month in JAMA Network Open, found that the U.S. is seeing an uptick in drug-induced liver injury that may be tied to products such as green tea extract, turmeric or curcumin, black cohosh, ashwagandha, red yeast rice, and Garcinia cambogia.

Nearly 5% of American adults may take one or more of these products, per the new report.

The study highlights the dangers of the supplement market—which isn't as stringently regulated—and the importance of speaking with a healthcare provider before taking any new over-the-counter pills, said study author Robert John Fontana, MD, professor of medicine and director of the transplant hepatology fellowship program at University of Michigan Health.

“The [Food and Drug Administration] have really weak laws to regulate the dietary supplement industry as a whole,” Fontana told Health. “Manufacturers can market things without doing any human testing.”

Because of this, many Americans take botanical supplements that promise health benefits—such as increased energy or better immunity—without really knowing what’s in the products or whether they’re safe.

What’s especially concerning is that many people take these supplements in excess or take multiple at the same time, Fontana said.

“People don’t oftentimes trust Western medicine, so they want to take a plant-based thing because they have this mindset that, because it’s natural or botanical, it’s ‘safe,’” he explained. “[They think] if some is good for you, more is better.”

Here’s what experts had to say about botanical supplements and what you need to know if you’re currently taking one.

Many Americans Are Taking Potentially-Harmful Supplements

Fontana and his team decided to investigate how these botanical products were affecting Americans’ health after noticing these supplements seemed to be causing more drug-induced liver injuries. Research showed that between 2004 and 2005, about 7% of drug-induced liver injury cases were linked to herbal and dietary supplements—by 2013 to 2014, that rate had jumped to 20%.

In this study, Fontana and his team explored how many people were taking green tea extract, turmeric, black cohosh, ashwagandha, red yeast rice, and Garcinia cambogia. Each of these supplements has a number of alleged benefits—however, these six are also the most frequently reported hepatoxic botanicals, meaning they could lead to liver toxicity or injury.

“Because these things are over-the-counter and they’re not medications, it’s hard to get exposure data in the U.S. population,” Fontana said. “You can’t just go to one company and say, ‘How many units did you sell?’ because there are several hundred companies.”

So, in order to determine how common use of these supplements really is, Fontana said his team used data from the National Health and Nutrition Examination Survey (NHANES), a program that interviews participants on their medication and dietary supplement history.

His team reviewed data from 9,685 people enrolled in NHANES from January 2017 to March 2020; the average age was 47.5, and about 52% of the participants were female.

More than 57% of participants reported having taken an herbal or dietary supplement within the past 30 days, while nearly 5% reported having taken one of the six botanicals Fontana and his team were studying. Turmeric was the most common, followed by green tea extract, ashwagandha, Garcinia cambogia, red yeast rice, and black cohosh.

Use of these botanicals was more common among people who had chronic conditions and people who were female, white, more educated, and wealthier. People who seek out these botanicals likely mean well, Fontana said, but often aren’t aware that these products come with risks.

“People perceive that if you can get them without a prescription, without seeing anyone, it must be safe,” he said.

However, there have been a number of case reports linking botanical supplements to acute liver injury, liver failure, jaundice, and other issues. “Some people are getting hospitalized from acute hepatitis, and very rarely some are super sick and need a liver transplant,” Fontana said.

But it’s challenging to know at what point—or what dose—the products may become unsafe.

“The problem that we have with over-the-counter preparations is they are not developed or regulated as drugs,” William Carey, MD, senior hepatologist in the department of gastroenterology at Cleveland Clinic, told Health. “They’re managed as food supplements, which is a lot less stringent. Nobody really knows what’s in them.”

Sometimes, there are even differences in what’s on the label versus what’s in the supplement itself, Carey added.

Because of this, the risk varies really from product to product, experts said. This also explains why Fontana and his team dubbed these six botanicals as “potentially hepatotoxic.”

“This is going to keep happening unless something changes at a federal level,” Fontana said.

What to Know If You Take Botanical Supplements

Though herbal supplements are increasingly being linked to drug-induced liver injury, they’re certainly not always dangerous. Most research isn’t conclusive, but there have been some studies that have found links between botanicals and certain health benefits, including ashwagandha for sleep and turmeric for anti-inflammatory effects.

However, the research is a reminder that it’s always best to check with your doctor before adding any new supplements or medications—whether over-the-counter or prescription—to your routine, experts said.

People should also make sure they’re forthcoming with their doctors about any botanical supplements they take, since that’s important information if they were to ever experience liver issues.

“If [a doctor] doesn’t record it when they come to an outpatient visit, then they show up in the [emergency room, and] we will never know” whether their liver injury was caused by a supplement, Fontana said.

Again, the risk of liver injury from these supplements is low. “The majority of people taking them are going to be fine,” he said.

However “some people are going to get into trouble,” which is why doctors always need to know which medications or supplements their patient is taking, Fontana explained.

If you are currently taking one of these botanical products, it may be best to pause your use until you’ve spoken with your healthcare provider about the benefits and risks, experts said.

This story originally appeared on: Health News - Author:Maggie O'Neill