Summary: A new study found that more people are using natural supplements. Yet many of them are known to be hepatotoxic (harmful to the liver) in the long run. So reports of liver damage from natural supplements are also rising. People now use some of these supplements more often than drugs like painkillers or medicines that lower bad cholesterol.
A new study by researchers at the University of Michigan suggests that some of the most popular herbal supplements might also cause liver toxicity. And the risk is real. The findings were published in the JAMA Network Open.
Many people believe that “natural is safe,” but scientific studies show that natural supplements may also cause many side effects. Natural supplements may also damage organs. This matters a great deal, because many people use them to “detox” or as antioxidants. In other words, they are not just used to manage health conditions. Many people take them to prevent disease.
It is true that natural supplements are fairly safe compared with the synthetic chemicals used as medicines. That is why natural supplements do not need US FDA approval to be sold. But that does not mean the market has no rules. The US FDA still controls the market and tracks how toxic these products are. It also makes sure that sellers of food supplements do not make wild health claims.
So many people now use natural supplements. That is why it matters to know how toxic they can be. Of course, humans have used natural remedies for ages. But humans have never processed and packed natural remedies on an industrial scale. In the old days, traditional healers or people with experience often prescribed these remedies, and people used them sparingly.
Today, though, the market for natural remedies is booming. Also, people now live much longer than before. So many people who use these remedies are older adults. Older adults are even more prone to side effects. Chronic pain specialists often advise caution with supplements, above all in older adults managing chronic pain.
This new study estimates that more than 15 million US adults have used herbal supplements in the last 30 days. Many of them might damage their liver. The study also found an almost four-fold rise in the use of herbal remedies in the last two decades, which is significant. And people who use these supplements already live with health conditions like inflammatory disorders, joint pain and more.
Many past studies have shown that many herbals might be hepatotoxic. In this study, researchers focused on ashwagandha, black cohosh, turmeric or curcumin, green tea extract, garcinia cambogia, and red yeast rice.
They found that these six botanicals (plant products) are now used more than some common drugs. These include non-steroidal anti-inflammatory drugs and drugs that lower bad cholesterol, like simvastatin. So the number of people using these herbals is massive. Some use them to fight inflammation and treat arthritis. But many use them to improve and maintain health.
So the researchers warn that doctors must know these numbers. Studies show that liver injuries from botanicals have been rising steadily in the last few decades. In some cases, the injury is even fatal or requires a liver transplant. So both doctors and patients need to be more aware. Interventional pain management in St. Louis centers also need to know the possible risks of herbal supplements. Many patients who seek pain relief use them.
Researchers are not asking people to stop using these supplements. But they warn against overuse or abuse. Many people might take them at higher doses for months and years, for no clear reason. They believe the supplements are safe and improve health.
Researchers also say people should use a “food-first approach.” This means eating these things as food first, not taking store-bought supplements. For example, it may be safer to add turmeric to foods and curries. Or drink more green tea. That may be safer than taking them as supplements.
Source:
Likhitsup, A., Chen, V. L., & Fontana, R. J. (2024). Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults. JAMA Network Open, 7(8), e2425822. https://doi.org/10.1001/jamanetworkopen.2024.25822
Dr. Gurpreet Singh Padda, MD, MBA, MHP
