Doctors warn of liver damage risks from natural supplements

Natural supplements, particularly those containing concentrated plant extracts or a combination of multiple ingredients, may pose serious risks to liver health, warn doctors. A rise in cases of liver damage and acute liver failure has been observed, according to recent studies. This concern stems from the fact that turning natural substances into concentrated extracts can lead to higher levels of active compounds than found in food.

The case of 72-year-old Tilda Bateman from Nottingham illustrates these dangers. In January 2022, she started taking a mix of supplements including green tea, turmeric, black seed, ginseng, melatonin, and ashwagandha to alleviate post-COVID-19 symptoms. Three weeks later, she experienced severe fatigue, pain, constipation, and yellowing of her eyes and palms.

Tests confirmed she had acute liver failure, leading to a liver transplant in a Cambridge specialist hospital. Tests indicated that most of her liver cells had perished, and doctors concluded that her supplements were likely the cause of the failure.

Some supplement ingredients can generate toxic compounds that harm liver cells, while others may incite the immune system to attack the liver. Genetic factors, such as the HLA-B*35:01 mutation, are also linked to certain cases. Turmeric and green tea extract are identified as particularly risky. Adding piperine to curcumin enhances its absorption, and high doses of EGCG, a component in green tea extract, can be liver-toxic.

Dietary supplements for weight loss, bodybuilding, and detoxification are especially worrisome due to their often undisclosed or illegal ingredients.

Research reveals a growing trend of liver damage cases traced back to dietary supplements. A global study indicated that herbal and dietary supplements are responsible for approximately 7% of confirmed cases of drug- and supplement-induced liver injury. A US study showed that supplement-related acute liver failure among patients on liver transplant waiting lists surged more than eightfold between 2003 and 2020.

Doctors caution against the assumption that natural products are inherently safe, emphasizing that supplements are classified as foods and are not subject to the same regulations as medications. In Tilda's case, she required kidney dialysis and a ventilator following her liver transplant. However, she gradually recovered and returned to her daily life.