Doctors warn of liver damage risks from natural supplements

Doctors have warned of a rise in cases of liver damage and acute liver failure linked to natural dietary supplements, particularly those containing concentrated plant extracts or a combination of multiple ingredients.

According to the Daily Mail, the doctors explained that turning natural substances into concentrated extracts can increase their risks, as supplements often contain much higher levels of active compounds than are found in food.

The case of Tilda Bateman, a 72-year-old retired nurse from Nottingham, highlights the dangers of these products. In January 2022, she began taking supplements including green tea, turmeric, black seed, ginseng, melatonin, and ashwagandha, hoping to ease post-COVID-19 symptoms.

After three weeks, she suffered from severe fatigue, pain, constipation, and noticed yellowing of her eyes and palms. Tests revealed she had acute liver failure, and she was transferred to a specialist hospital in Cambridge, where she underwent an emergency 14-hour liver transplant.

Professor Guruprasad Aithal, a consultant hepatologist, noted that most of her liver cells had died, and with other causes ruled out, supplements were considered the likely cause of her liver failure.

Doctors explained that some supplement ingredients can produce toxic compounds that harm liver cells, while others may trigger the immune system to attack the liver. Certain cases are also linked to genetic factors, such as the HLA-B*35:01 mutation.

Turmeric and green tea extract are among the products of greatest concern. Adding piperine to curcumin increases its absorption, while high doses of EGCG, a compound in green tea extract, can be toxic to the liver.

Supplements for weight loss, bodybuilding, and detoxification are also particularly worrying, as they often contain multiple ingredients, some of which may be undisclosed or illegal.

Studies have shown an increase in liver damage cases linked to dietary supplements. A multinational study found that herbal and dietary supplements account for about 7% of confirmed drug- and supplement-related liver injury cases.

A US study revealed that cases of supplement-related acute liver failure among patients on liver transplant waiting lists rose more than eightfold between 2003 and 2020.

Doctors warn against assuming that "natural" products are necessarily safe, stressing that supplements are classified as foods and are not subject to the same regulations as medicines.

In Tilda's case, she required kidney dialysis and a ventilator after her liver transplant, but gradually recovered and was able to resume her daily life.