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Liver Injury Associated with Sporting Activities.

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Athletes using supplements for performance may face severe liver injury. Certain supplements, including green tea extract, can cause acute liver damage, leading to potentially fatal outcomes.

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Area of Science:

  • Hepatology
  • Sports Medicine
  • Toxicology

Background:

  • Exertional heat stroke can cause multiorgan failure, including acute liver failure, due to organ hypoperfusion and inflammasome activation.
  • Athletes frequently use herbal and dietary supplements for performance enhancement, strength, and weight loss.
  • Supplement use is linked to adverse hepatic effects, ranging from elevated liver enzymes to severe cholestatic hepatitis.

Purpose of the Study:

  • To review the association between athletic supplement consumption and exertional heat stroke.
  • To highlight the potential for hepatotoxicity from various supplements, including those containing anabolic steroids and botanical ingredients.
  • To discuss the specific risks of green tea extract derivatives like epigallocatechin gallate.

Main Methods:

  • Literature review of exertional heat stroke, supplement use in athletes, and associated liver injuries.
  • Analysis of case reports and studies linking specific supplement ingredients to hepatotoxicity.
  • Examination of mechanisms, including inflammasome activation and direct cellular injury.

Main Results:

  • Prolonged aerobic activity in warm environments can precipitate exertional heat stroke, leading to liver damage.
  • Bodybuilding supplements with androgenic anabolic steroids can cause significant liver injury.
  • Non-bodybuilding supplements, including green tea extract derivatives, are associated with idiosyncratic hepatotoxicity and acute hepatocellular injury.

Conclusions:

  • Supplement use among athletes poses a risk for severe liver injury, particularly in the context of exertional heat stroke.
  • Healthcare providers should be aware of supplement-induced hepatotoxicity when evaluating athletes with liver dysfunction.
  • Further research is needed to fully elucidate the mechanisms and prevalence of supplement-related liver injury in athletes.