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Six supplements claiming to boost immune health and energy could lead to irreversible liver damage, a study suggests.
Researchers in Michigan analyzed data from nearly 10,000 US adults surveyed over a three-year period.
Participants were asked how often they used six popular but unproven supplements, including turmeric, green tea extract, and ashwagandha.
The team found that the supplements, used by one in 20 Americans, were most popular with older, white women trying to treat conditions like arthritis, low energy, and hot flashes.
As many as one in 20 Americans take these supplements, the researchers found. Users were mainly older white women
They warned that these common supplements could contain ingredients leading to permanent liver injuries and organ failure, though they did not specify how many contain them or which specific ingredients these include. The mechanism is also unclear.
Dr Alisa Likhitsup, lead study author and gastroenterologist at the University of Michigan Health, said: 'Herbal and dietary supplements (HDSs) include a multitude of products consumed by millions of people every day to improve their general health and to treat minor ailments.'
'Chemical analyses of HDS products associated with confirmed liver toxic effects show frequent discrepancies between product labels and detected ingredients.'
The study, published Monday in JAMA Network Open, collected data from the National Health and Nutrition Examination Survey (NHANES), a survey of the general US population.
The 9,685 participants were surveyed about how often they had used one of six supplements in the last 30 days. These were turmeric, green tea extract, garcinia cambogia, black cohosh, red yeast rice, and ashwagandha.
About 58 percent said they had used at least one of the supplements in the last month, and those who used them tended to be eight years older - 52 years old - on average than those who didn't.
White women were the most likely group to take at least one of these supplements. They were also more likely to have health conditions like arthritis, thyroid disorders, and cancer.
Maintaining overall health, preventing health issues, and boosting immunity were the most common reasons participants took the supplements. One in four of those taking turmeric did so for joint health or arthritis and used green tea for energy.
Additionally, 70 percent of garcinia cambogia users did so to lose weight, and 84 percent of those taking black cohosh were trying to treat hot flashes. And nine in 10 of those taking red yeast rice wanted to improve their heart health.
Turmeric was the most popular supplement in the survey. It has been touted for joint benefits, though it could be linked to liver injuries
The above graph shows why users chose to take the six studied supplements
The researchers did not specify which ingredients in these supplements could lead to liver issues, though they warned that the effects 'can be not only severe' but also lead to 'death or liver transplantation.'
They also noted that drug-induced liver injury, also called drug-induced hepatotoxicity, specifically from supplements has increased and accounts for 20 percent of these injuries.
Additionally, the team cited research that found that liver transplants due to supplement-related injuries for 2010 to 2020 increased 70 percent compared to 1994 to 2009.
Some studies have suggested that these supplements are linked to liver problems, though most claim these complications are rare.
For example, a 2022 study in the American Journal of Medicine found that turmeric could be linked to drug-induced liver injury, though the association is not clear.
The new study had several limitations, namely not explaining the exact risk of liver injury from taking these six supplements. Additionally, ingredients in supplements vary widely, as these are not regulated by the FDA.