Related Experiment Video
Updated: Aug 17, 2025
The Murine Choline-Deficient, Ethionine-Supplemented CDE Diet Model of Chronic Liver Injury
Published on: October 21, 2017
LIVER INJURY INDUCED BY HERBAL AND DIETARY SUPPLEMENTS: A POOLED ANALYSIS OF CASE REPORTS
Michelle Hoff de Assis1, Bruna Cherubini Alves2, Vivian Cristine Luft1,3,4
1Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Curso de Graduação em Nutrição, Porto Alegre, RS, Brasil.
Background:
The intake of dietary supplements and medicinal plants is very popular worldwide. However, these products are not innocuous, and their intake can cause severe damage to health, especially liver injury.
Objective:
This study aims to describe the clinical cases of dietary supplements-induced liver injury (DSILI) and herb-induced liver injury (HILI), identifying the main products involved and the clinical outcomes related to them.
Method:
A literature search was performed in PubMed, EMBASE, Google Scholar, and LILACS databases, using the search terms: "Chemical and Drug-Induced Liver Injury", "Dietary Supplements" and "Herbal" and their synonyms.
Results:
189 articles were included in the study, totaling 428 clinical cases of drug-induced liver injury. The most frequent agents of liver injury were Herbalife® products, associated with 50 cases, Polygonum multiflorum, with 25 cases, Hydroxycut® products, and green tea, both associated in 19 cases, and Oxyelite Pro® and kava tea, both associated with 16 cases. Most individuals required hospitalization (82.6%) and an important number of cases evolved to death (3.6%), liver transplantation (8.9%), or chronic liver disease (1.9%).
Conclusion:
The indiscriminate use of dietary supplements and herbal products was associated with an alarming number of cases of liver injury. The mechanisms through which each of the products causes liver damage still need to be better understood, but this review is a warning about the risk associated with the use of products considered harmless by a large part of the population.
Related Concept Videos
01:24Liver Regeneration
Cells of Liver
The liver comprises four major types of cells— hepatocytes, stellate, Kupffer, and sinusoidal endothelial cells. The hepatocytes are...
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:16Hepatic Drug Excretion: Influencing Factors
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...