Social media influencers extol the virtues of everything from fashion and beauty to travel and technology. But when it comes to popular health trends related to dietary or herbal supplements, the best approach is take such information with a healthy dose of skepticism, according to experts at Yale New Haven Health.
A recent survey indicates that more than 50 percent of adults in the United States look for health information on social media, particularly related to wellness and holistic medicine. Various supplements are touted as providing physical, mental and emotional health benefits.
However, some of those herbal and dietary supplements can actually cause liver damage or other serious health problems, said Joseph K. Lim, MD, a hepatologist and gastroenterologist at Yale New Haven Health who specializes in treating liver diseases. Dr. Lim is also a professor of Medicine at Yale School of Medicine.
“It’s estimated that 20 percent of drug-induced liver injuries in the U.S. are related to herbal and dietary supplements,” Dr. Lim said.
Take turmeric, for example. The spice contains curcumin, a compound known for its anti-inflammatory and antioxidant properties. Turmeric is a popular dietary supplement promoted as a natural remedy to improve a variety of conditions including arthritis, digestive disorders, depression and allergies. While the spice itself is generally regarded as safe, turmeric supplements can cause liver damage if taken at high dosages.
“The World Health Organization recommends a daily turmeric dose of no greater than approximately 200 mg daily for a 150-pound individual or 270 mg daily for a 200-pound individual. Consuming turmeric/curcumin in dietary sources is unlikely to exceed these limits. However, the doses found in oral supplement tablets, capsules or gels often go well over these recommended doses – in some cases in excess of 2,000 mg daily,” Dr. Lim said.
What are the side effects?
“Megadosing” – taking a dose that is many times higher than the recommended daily allowance – can result in a range of side effects. “The most common side effects of turmeric include nausea, upset stomach and diarrhea, but it may also cause allergic reactions, rash/hives, dizziness and kidney stones,” he said.
People with diabetes should also be aware that turmeric can lower blood sugar, he added. Dr. Lim also recommends that women who are pregnant, breastfeeding or being treated for hormone-sensitive cancers and people with gallstones or kidney stones avoid taking turmeric supplements.
Other supplements that can cause liver damage when taken at high doses include:
- Vitamin A
- Glutamine
- Ashwagandha
- Green tea extract (Camellia sinensis)
- Garcinia cambogia
- Black cohosh
- Ma huang (Ephedra)
- Kava
- Skullcap
- Red yeast rice
What are the signs of liver damage?
According to Dr. Lim, the most common symptoms of liver damage include:
- yellowing of the eyes or skin (jaundice)
- dark urine (“Coca-Cola” color)
- pale-colored, white or gray stool
- whole-body itching
“Any of these symptoms should prompt you to call your doctor right away for timely medical attention,” he said. “While many cases of drug-induced liver injury may resolve with treatment and discontinued use, others may result in life-threatening liver failure.”
What should I know about taking supplements?
Vitamins and supplements are regulated as foods, not drugs. This means the Food and Drug Administration does not evaluate the quality of the supplement or assess its effect on the body before the product hits the shelves.
If you’re thinking about starting any new dietary or herbal supplements, talk to your doctor to make sure they are safe for you – especially if you have a health condition, are pregnant or lactating, or are taking any prescription medications.
“Individuals with chronic liver disease should take extra precaution to avoid supplements, as drug-induced liver injury may result in a higher risk for liver failure,” Dr. Lim said.
It’s also important to make sure you're not taking more than the recommended dose.
“Just because a vitamin or supplement is advertised as ‘natural’ you shouldn’t assume it is intrinsically safe,” Dr. Lim said. “Herbal and dietary supplements have the potential for both benefit and harm. They should be used with similar caution as for prescribed medications, and ideally under the supervision of a licensed health professional.”
If you have questions about supplements, talk to your doctor or call to speak with one of our Yale New Haven Health pharmacists: Retail Pharmacy - Yale New Haven Health
