Are supplements making you sick?

If you are one of the roughly half of Americans who use some sort of herbal or dietary supplement, you may be damaging your liver.

Most people believe that herbal and other supplements are safe and natural, and some even believe they are superior to modern medicine. It’s no wonder that Americans spend upwards of $30 billion each year on dietary and herbal supplements. However, the National Institutes of Health said that a major cause of liver damage in the US is supplement use.

“People think that because supplements are natural that they are safe to use,” said Rita Lepe, MD, transplant hepatology fellowship program director on the medical staff at Baylor University Medical Center at Dallas. “That is not always the case.”

Excessive intake of supplements or used in combination with prescription medications or other supplements can cause liver damage.

“Improper use can lead to slight abnormalities in liver tests and in severe cases, liver failure, which can be life threatening and could require a liver transplant,” Dr. Lepe said.

Understanding Supplements

Here are several reasons why supplements can be dangerous and how you should take precaution.

Regulation is not as strict

One main problem is that herbal supplements are not as strictly regulated as prescription medications. In fact, the division of the Food and Drug Administration (FDA) that oversees supplement regulation is the same one that handles veterinary medicine and foods. The manufacturers of the supplements are responsible for the safety of their products but are not required to obtain FDA approval before marketing.

“Some supplements have been found to be mixed with toxic chemicals, bacteria and other contaminants,” Dr. Lepe said.

Prescription diet suppressants have been found in weight-loss supplements, and sildenafil has been found in male enhancement supplements that claim to contain “all natural products.”

Although most of the problem is seen in supplements bought online, even the major drug store chains have had to recall products.

Your individual profile factors in

Your individual profile impacts how your liver tolerates a supplement. Are you taking prescription medications? Are you taking more than one supplement at a time? The more pills you take, the higher the chance for something to go wrong.

“The first thing to do to protect yourself is to talk to your doctors,” Dr. Lepe said. “They know which supplements might be a problem. They will be able to determine if a supplement might have an adverse interaction with the way a prescribed medication is processed in your body that could either make the drug not work or develop toxic effects.”

For example, birth control pills are in a “major” risk group for drug interaction with St. John’s wort, a supplement used to help treat mild-to-moderate depression. Black cohosh is used for “hot-flashes”, but may increase the liver toxicity associated with atorvastatin, acetaminophen and alcohol.

Supplements are not always necessary

“If humans really required all of the supplements available on the market, the human race would have died out long ago,” Dr. Lepe said.

Eating right and taking a multivitamin recommended by a doctor are more beneficial than many herbal supplements. If you are unsure about the contents of a supplement or want to check for drug interactions, talk to your doctor.

For more information about supplements, visit the FDA website at www.fda.gov and search for dietary “supplements”.