A recent article published in Critical Reviews in Toxicology summarizes the latest facts on the hepatotoxic potential of certain health supplements and points out the industry’s shortcomings.
Health Supplements
A few reminders about supplements
Table of Contents
Food supplements are products intended to supplement a normal diet and consist of a concentrate of nutrients or other substances with a nutritional or physiological effect. They can be used to correct a deficiency, to maintain an adequate intake of certain nutrients (for example, vitamin B12 as part of a vegetarian or vegan diet), or to support a physiological function.
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Since the 1980s, interest in these substances has grown exponentially, so much so that nine out of ten people have taken supplements in their lifetime, mainly vitamin C, vitamin D, and magnesium. In the sports world, the most widely used supplement seems to be creatine, according to marketing data. Supplement manufacturers have obligations: to list the names of the nutrients, recommend the correct dosage, and warn about the effects of possible misuse. However several studies have reported irregularities in dosage, which is cause for concern.
Which supplements are at risk?
The authors of the article point to several supplements: green tea extract, rooibos, cannabidiol (better known as CBD), and turmeric. All of these supplements have already been the subject of worrying reports of clinical cases of hepatotoxicity or robust toxicological studies that demonstrate their hepatotoxic nature. The biochemical mechanisms that lead to liver damage are not always known and the risk is arguably underestimated, mainly due to widespread misconceptions on the part of the public that cause possible side effects to go unreported. These products are generally considered to be natural and therefore healthy, as they cannot cause any side effects. Of course, the responsibility lies not only with the consumer but above all with the lack of rigor and opacity of the food supplement sector.
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What will the future of the food supplement sector look like?
It seems difficult to imagine a sustainable future for the food supplements sector without a review of its activities and obligations. Firstly, as has been pointed out several times, manufacturers should have clearly demonstrated the efficacy of their products for specific indications, rather than relying on random marketing claims which are generally not supported by properly conducted clinical studies. There is a severe lack of serious clinical studies for these products and this needs to be addressed.
The authors also point out that, to avoid cases of hepatotoxicity, manufacturers of food supplements should pay more attention to the quality of their manufacturing processes to avoid overdosing of compounds or contamination with toxic substances and should be exemplary in recording cases of adverse reactions caused by their products. Without these measures, supplements will continue to be what they are today: substances of uncertain efficacy and safety.
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References
Fernando Rivero-Pino & Alfredo G. Casanova (2023) Hepatotoxicity due to dietary supplements: state-of-the-art, gaps and perspectives, Critical Reviews in Toxicology, 53:10, 601-610, https://doi.org/10.1080/10408444.2023.2282415
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