6 Popular Supplements Linked to Liver Damage: What You Need to Know

Dietary and herbal supplements often appear harmless, but a recent study has revealed that six widely-used supplements are associated with potential liver toxicity. According to survey data, more than 15 million adults in the U.S. consumed supplements over a one-month period that contained ingredients linked to liver damage. The culprits include turmeric, green tea, ashwagandha, garcinia cambogia, red yeast rice, and black cohosh.  

While the liver plays a critical role in breaking down both medications and supplements, the safety of many supplements is questionable due to inadequate regulatory oversight. Unlike medications, which undergo rigorous testing and receive proper warning labels from the Food and Drug Administration (FDA), supplements can be sold without proving their safety and efficacy. This lack of oversight raises concerns about potential risks.  

However, not everyone who takes these supplements will experience liver injury. "Not every liver will get injured. It also depends on each patient and what else they are taking, as well as other prescriptions they use. It’s really something that’s unpredictable," explained Dr. Alisa Likhitsup, clinical assistant professor at the University of Michigan Health and lead author of the study.  

Here’s an overview of the six supplements linked to liver toxicity.  

1. Turmeric  

Turmeric is often used to manage arthritis, digestive issues, and liver disease, but growing evidence suggests it may harm the liver. Specific supplements that contain black pepper to enhance turmeric absorption could pose additional risks. A 2023 study reviewed data from the U.S. Drug-Induced Liver Injury Network and found ten cases of turmeric-related liver injuries spanning 2004 to 2022, with six occurring after 2017.  

2. Green Tea  

Green tea supplements, marketed for weight loss and cancer prevention, may harm the liver when excessively consumed due to high levels of epigallocatechin gallate (EGCG). Regular tea consumption, however, is unlikely to pose the same risk due to significantly lower levels of EGCG found in dietary servings.  

3. Ashwagandha  

Ashwagandha is frequently used as an herbal remedy for stress and overall health. While low doses of traditional root powders are considered safe, higher doses of concentrated extracts have been linked to liver injuries. Experts advise discussing ashwagandha use with healthcare providers, especially for individuals with a history of liver disease.  

4. Garcinia Cambogia  

Garcinia cambogia supplements, known for claims of aiding weight loss, contain hydroxycitric acid (HCA), which may increase the risk of liver damage, especially when combined with other weight loss supplements. Consumers should approach garcinia cambogia cautiously, particularly if using multiple dietary aids.  

5. Red Yeast Rice  

Used for its cholesterol-lowering properties, red yeast rice contains a natural statin that has been associated with liver inflammation. Case studies show that higher dosages of this supplement may increase the risk, although inconsistent labeling means consumers cannot always determine exact intake levels.  

6. Black Cohosh  

Black cohosh, an herb used for managing menopause symptoms, has been linked to serious liver damage in some cases. Combining black cohosh with other medications or supplements may heighten the risk. Individuals are advised to consult healthcare professionals before use.  

Should You Avoid These Supplements?  

Experts stress the importance of scrutinizing all supplements before use—not just these six. Mislabeling within the supplement industry further complicates the issue, as consumers may not know which ingredients are actually present in a product. As noted by Nima Majlesi, DO, a medical toxicologist, "The reality is because this industry is so poorly regulated, we have no idea, actually, what’s in many of them."  

To minimize risk, individuals should consult healthcare providers about the supplements they take and prioritize safety when considering dietary aids or herbal remedies.