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 A decade ago, less than one in 10 cases could be linked to
supplements, researchers report in the journal Hepatology.
Up to half of U.S. adults consume supplements that contain
ingredients such as vitamins, minerals, teas and proteins to improve
diet, as well as illegal anabolic steroids, which are synthetic
versions of testosterone used to boost athletic performance, the
study found.
“Overall, liver injury from supplements is rare,” said lead study
author Victor Navarro, chair of hepatology at Einstein Healthcare
Network in Philadelphia.
“However, if overused, or used in combination with other
supplements, or used for very prolonged periods or in combination
with conventional medications, they may become harmful,” Navarro
added by email.
Hundreds of prescription medicines are associated with liver damage,
and serious side effects in the liver are a common reason that drugs
fail in development or get recalled after they go to market.
Part of the problem with liver complications is that damage can
sometimes take months or years to develop, and patients often don’t
notice symptoms until the injury is advanced. As damage progresses,
patients may initially notice fatigue, itching, nausea and then go
on to experience yellowing skin, fluid accumulation, bleeding and
mental confusion.
The risks with prescription drugs are one thing, because these
medicines have a proven benefit for patients, the authors argue. But
many supplements have no proven benefit, only a potential risk.
“Consumers have free access to these supplements, often with
inferred promises to improve health, enhance appearance,” Navarro
said. “It is seductive to think that someone can impact one's health
or appearance without the need to involve a trained healthcare
provider.”
To assess the scope of liver problems caused by supplements,
researchers reviewed data from several previously published studies,
much of which was also presented at a 2015 conference sponsored by
the U.S. National Institutes of Health. They also looked at 130
cases of supplement-related injuries reported over eight years in a
U.S. registry of drug-induced liver injuries.
Steroids, which have long been linked to liver damage, accounted for
more than a third of those cases in the U.S. registry.
The remaining 85 cases, however, were attributed to 116 different
products, often containing multiple ingredients, that left few clues
as to which individual ingredient might be the culprit, the study
found.
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Non-steroid supplements included green tea, mixtures labeled as
“Chinese herbs,” “Korean herbs,” or “Ayurvedic medications,” as well
as vitamins and dietary supplements.
Many cases were tied to products marketed under various company
labels, including six from Slimquick, four apiece from Herbalife and
Hydroxycut and two apiece from Move Free and Airborne.
One limitation of the study is that product labels may not provide a
complete list of ingredients, making it difficult to determine
patterns in the supplements linked to liver damage, the authors
note.
Complications from supplements may also go undetected because
consumers don’t tell doctors they are using the products and
therefore aren’t being monitored for side effects, the authors also
point out.
Not all supplements are bad, said Samantha Heller, a nutritionist at
New York University Langone Medical Center who wasn’t involved in
the study. For example, people may need them to address certain
nutritional issues tied to diseases or caused by medications.
But shoppers should be wary of products that make extreme claims and
too-good-to-be-true promises, and understand they can’t necessarily
detect any unsafe ingredients, Heller said.
“There is no miracle in a bottle that will build muscle, detoxify
your system, cure cancer, or cause rapid, long lasting weight loss,”
she said by email. “At best it is a waste of money. At worst you
could die.”
SOURCE: http://bit.ly/2dulx1p Hepatology, online September 27, 2016.
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