Liver Injury from Herbal and Dietary Supplements

supplementSupplement production is the new gold mine in the American economy.

Now healthcare programs advertize to reimburse supplements with some life extension hope.

It is not always clear for all that supplements are not medicine.

They are not regulated,  they are not mandate to label the content, describe how it is produced , only few have a label of Good Laboratory Practice (GLP)

I try to explain to low income people how it is a waste of money if not worst.

I have to convince wealthy people that their personal trainers or the self distributors of international brands are making a good living by selling mysterious supplements, when it would be better to ask their medical practitioners .

I need to say that I am a clinical researcher, to justify that I have no conflict of interest to be a graduated Medical Doctor and also a PhD. I made a living with expert work to evaluate the toxicity of chemicals for public health and I spent these last years to develop an artificial heart for rescue and neonates.

liver3A decade ago, less than one in 10 cases of liver damage could be linked to supplements, today one in five cases of chemical-induced liver damage come from herbal and dietary supplements, researchers report in the journal of Hepatology at Einstein Healthcare Network in Philadelphia.d151fd6370e8d974591cd42b2888c4c2-1

The major implicated agents include anabolic steroids, green tea extract, and multi-ingredient nutritional supplements (MINS).

Anabolic steroids marketed as bodybuilding supplements typically induce a prolonged cholestatic, but ultimately self-limiting liver injury that has a distinctive serum biochemical as well as histological phenotype. Steroids, which have long been linked to liver damage, accounted for more than a third of those cases in the U.S. registry.

Non-steroid supplements included green tea, mixtures labeled as “Chinese herbs,” “Korean herbs,” or “Ayurvedic medications,” as well as vitamins and dietary supplements.

Green tea extract and many other products, in contrast, tend to cause an acute-hepatitis like injury.

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.

Currently, however, the majority of cases of HDS-associated liver injury are due to MINS, and the component responsible for the toxicity is usually unknown or can only be suspected.

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.

As damage progresses, patients may initially notice fatigue, itching, nausea and then go on to experience yellowing skin, fluid accumulation, bleeding and mental confusion.

Induced liver diseases has clinical and pathological pattern with latency period as stated in acute hepatitis, cholestasis or mixed presentations.

Patients often don’t notice symptoms until the injury is advanced.

These supplements have free access and the ads are promising the improvement we are dreaming of.

The customer pays the product not the practitioner.

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.

“There is no miracle in a bottle that will build muscle, detoxify your system, cure cancer, or cause rapid, long-lasting weight loss. At best it is a waste of money. At worst you could die.”

We have to reconsider how we must feed our body.

All these herbs were prepared with devotion in the past and still in tribal population who are still using them.

They were delivered by wise persons for special purposes and limited time.

Respecting these 3 points will take you on the healthy path.

References :

Liver Injury from Herbal and Dietary Supplements  (to be published November 3 2016)

Victor Navarro M.D, Ikhlas Khan Ph.D, Einar Björnsson M.D., Ph.D.,
 Leonard B. Seeff M.D, Jose Serrano M.D., Ph.D , Jay H. Hoofnagle M.D

drug-induced-liver-injury  (click here to read the article )

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