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A new study from the University of Michigan researchers has found that millions of American adults consume herbal supplements contning potentially liver-toxic botanicals. The team focused on five specific ingredients commonly found in popular dietary supplementsturmeric, green tea extract, ashwagandha, black cohosh, garcinia cambogia, and red yeast riceand discovered that 4.7 of the participants surveyed during the National Health and Nutrition Examination Survey from 2017 to 2020 were regularly taking supplements with at least one of these ingredients.
Published in JAMA Network Open this month, Estimated Exposure to 6 Potentially Hepatoxic Botanicals in US Adults sheds light on a largely unseen aspect of the supplement industry. The lead author and clinical assistant professor at U-M, Alisa Likhitsup, M.D., M.P.H., explns that their interest was piqued by reports of liver toxicity caused by herbal supplements used in ongoing studies like DILIN funded by the National Institutes of Health.
However, identifying the prevalence and reasons for supplement use had been a challenge. The mn takeaway from our study is the surprising number of Americans using these products; with an estimated 15 million adult Americans consuming them regularly, says Dr. Likhitsup, also a transplant hepatologist at U-M.
Previous research has established that these botanicals can be potentially toxic to the liver when consumed in high doses or over exted periods. The researchers' focus on lack of government regulation, inadequate medical scrutiny, and frequent mislabeling as significant concerns for their study.
We found alarming levels of mislabeling through our previous work, shares Dr. Robert Fontana, a hepatologist at Michigan Medicine and senior author of the paper. In one study conducted by our team, we discovered that there was about a 50 mismatch between the stated ingredients on supplement labels and what they actually contned.
Mislabeling is enabled by regulatory gaps in oversight for dietary supplements. Clinicians often overlook asking patients about their supplement use during medical consultations due to insufficient attention from healthcare providers.
Our study has shown us how many people are taking these potentially risky products, says Dr. Likhitsup, emphasizing that awareness among health professionals remns limited.
The researchers found the highest rates of consumption for turmeric 2 followed by green tea extract and ashwagandha at 1, and lower levels for black cohosh and garcinia cambogia.
Turmeric contns curcumin, a potent antioxidant known to have anti-inflammatory properties but can also cause liver damage in high doses. Green tea extract provides caffeine and catechins that are beneficial but can potentially harm the liver under excessive use. Ashwagandha is an adaptogenic herb with stress-relieving effects; however, it could lead to liver toxicity when taken in large amounts.
Dr. Fontana's team plans further research into supplement safety as their findings rse significant concerns regarding potential risks associated with common dietary supplement usage by Americans.
For more detls on this study and related health tips, please visit the Health Lab’s two newsletters: Health Wellness and Research Innovation.
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