The short answer is: if they are high quality brands, probably not.
It’s easy to get sucked into believing an article without investigating, especially if you don’t have a strong science background to help you do a proper analysis. A patient came to me, concerned that the turmeric (curcumin) that helps reduce their arthritis pain might be causing liver damage after reading this article. https://www.medicalnewstoday.com/…/6-popular-herbal… I was instantly curious to learn more, and to make sure I wasn’t recommending a medicine that was dangerous for my patients.
After diving into the article, I found a few interesting points. When I read the statistic of “liver injury due to botanical products has been on the rise from 7% in 2004-2005 to 20% in 2013-2014”, I was instantly suspicious. Whenever a percentage increase/decrease is mentioned, I like to learn what the absolute number of events are as looking at percentages in this way can be used to manipulate how results appear, while absolute numbers can’t. For these numbers, I looked into the research rather than the sensational article written about it.
Here’s the research itself: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502701/). In the article, it clarifies that it is 20% of all drug induced liver injury cases. When supplements spiked with drugs are removed, the number drops to 14%. Supplements spiked with drugs? Yes, poor/low quality supplements without appropriate testing can be adulterated with all kinds of things, including medications. Okay, so 14% of drug induced liver injury cases are connected to supplements- how many of these cases are there? The actual number of these cases is low. Interestingly, the article only had population based estimates from another study, suggesting about 3 events of supplement-related liver injury per 100,000 persons using them. This is a very low number of adverse events when compared to most medications.
At first pass, this article seems to suggest 20% of us are experiencing liver damage from herbs, the reality is that 0.003% of us might have liver damage from supplements. That’s many factors of magnitude different!
The primary souce of supplements that cause adverse effects are from the bodybuilding and weight loss industries. These industries are notorious for poor quality, contaminated supplements and shoddy research.
According to this article, these products cause about half of the supplement-induced liver damage. It’s likely that the reason for liver damage is that these supplements are poor quality, may not contain the dosage listed on the bottle, may not even contain the INGREDIENTS listed on the bottle!
A telling quote: “Chemical analyses of HDS products associated with confirmed liver toxic effects show frequent discrepancies between product labels and detected ingredients”. This means that negative effects on the liver was connected to using poor quality, adulterated products- a huge difference from saying that turmeric causes liver damage.
I also looked at a related article listed as a reference. An interesting detail from this article caught my eye: https://jamanetwork.com/…/jamanetwo…/fullarticle/2821951
“Laboratory parameters were generally similar, but at-risk botanical users had significantly lower triglyceride and alkaline phosphatase levels (Table 2). However, there was no significant difference for glycated hemoglobin, serum aminotransferase levels or liver elastography parameters.” FYI: serum animotransferases are your LIVER ENZYMES. If you have a metabolic panel run as part of your bloodwork ALT and AST are often included- these are two aminotransferase enzyme. When there is liver damage, your liver makes more animotransferases, and your levels go UP. This article says that users of herbal supplements did NOT have signs of elevated ALT and AST. Hmm!
My take-home message from investigating this topic is that there’s no significant evidence that high quality supplements are causing liver damage.
There is evidence that poor quality supplements adulterated with medications and other substances may be connected to liver damage.
Be careful what you buy, don’t be swayed by advertising- particularly for weight loss or muscle building supplements. Check in with your doctor before starting new supplements. At Qwibil we exclusively use high quality supplements with all our patients to ensure the best results, and least possibility of harm.