A recent survey study analyzing data from the National Health and Nutrition Examination Survey (NHANES) from January 2017 to March 2020 reveals significant concerns about the use of botanical dietary supplements (HDS) and their potential impact on liver health. Conducted by researchers, including Dr. Rajna Golubic from the University of Oxford, the study highlights the widespread consumption of these supplements and their association with liver injury.

The study found that over 7% of U.S. adults had used a botanical-containing HDS product within the past 30 days. Among these users, 4.7% specifically used one or more of six botanical products commonly linked to liver toxicity. The most frequently used products included turmeric or curcumin, green tea, ashwagandha, Garcinia cambogia, red yeast rice, and black cohosh.

Botanical supplement users displayed significantly higher levels of hemoglobin A1C and total cholesterol, though their triglyceride levels were lower compared to non-HDS users. Users of these supplements also had lower serum alanine aminotransferase and alkaline phosphatase levels, suggesting potential impacts on liver function. Despite these findings, there were no notable differences in liver stiffness measurements or controlled attenuation parameters between HDS users and non-users.

The study noted that users of potentially hepatotoxic botanicals were generally older, more educated, and more likely to have conditions such as arthritis, thyroid disorders, and cancer compared to non-users. Users were also more likely to be taking prescription medications and had a higher median number of HDS products used.

The study underscores the lack of regulatory oversight for botanical products, which often leads to inconsistencies between product labels and actual ingredients. The researchers advocate for increased regulatory measures to ensure safer manufacturing, marketing, and testing of botanical supplements. Clinicians are urged to obtain comprehensive medication and HDS use histories when evaluating patients with unexplained symptoms or liver abnormalities.

With an estimated 15.6 million U.S. adults consuming at least one potentially hepatotoxic botanical product, the study highlights a significant public health issue. The findings call for heightened awareness among healthcare providers and regulatory authorities to address the risks associated with these unregulated supplements. As the popularity of botanical products grows, ensuring their safety and efficacy becomes increasingly critical.