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Supplements: Good or Bad? Useful or Fraud?

Is the multi-billion dollar dietary supplement market villain or savior?

Supplements -- How should we think about these products?  What do you think the rate of liver damage caused by people taking supplements is?

Frequency of Liver Injury from Herbal and Dietary Supplements


In the study of drug-induced liver injury (DILI) from the NIH-funded analysis, supplements accounted for 16% of cases overall. Importantly, however, the proportion increased during the 8 years of the study from 7% in 2004-2005 to 19% by 2010-2012. Since then, the proportion of cases of liver injury attributable to supplements in the study has remained high and is, as of 2013-2014, 20% and climbing.

The biggest single category of people suffering liver damage are body builders taking anabolic steroids but the rest are average citizens buying over the counter supplements.  They are no doubt spurred on by vast amounts of advertising and false promises by the supplement manufacturers but clearly, in the context of the liver disease epidemic we face supplements are a clear and present danger.


Is this you? Are you lured by the promise of easy good health, just take our expensive little pill?

A research symposium sponsored by the American Association for the Study of Liver Disease and the National Institutes of Health found that herbal and dietary supplement induced liver injury now accounts for 20% of cases of hepatotoxicity in the United States. The major implicated agents include anabolic steroids, green tea extract, and multi-ingredient nutritional supplements.  I'm sure that if you are an herbal fan the green tea extract caught your attention.  The shout will be "Can't be, people have used green tea for centuries, it is healthy".  Indeed, but as with almost all things you might ingest dose is critical.  A cup of tea is one thing.  A shot of concentrated tea extract is quite another.  When you feed the factory that is your liver more of anything than it can handle you should know something is going to be damaged.

Think about the advertising for supplements. You hear the pitch that the Chinese have used it for thousands of years suggesting great power and safety.  They rarely mention that the same medicinal culture sells rhino horn and tiger penis to give men erections. Just sayin. Folk medicine may not be wrong but absent real research it is usually a song sung for profit and you take your chances with your health. Remember, the snake oil salesman motto, "Keeping you safe is not my job man".

Beyond the obvious failures by well intentioned people the supplement industry is ripe for thieves and other assorted criminals whose only goal is to steal your money. Phony ingredients are common and the actual strength of what you get can not be relied upon being what is claimed.  Fraudsters will happily walk with you to your grave as long as you can buy the pills.

Our advice, if you have a fatty liver, which is probably what brought you here, do not go down the supplement road. You are already at risk of ending up with end stage liver disease so your goal must be to be as kind to your liver as possible.  If you are overweight, make the lifestyle changes that you need to in order to not be fat.  If you are lean and still have trouble be concerned and examine your choices with the help of a doctor.  In all cases, however, a liver friendly diet will help you and you can find some information here.

Diet information and comparisons for different levels of concern

If you are interested in liver fibrosis and how diet affects your liver you might spend some time on this page.

If you are interested in the level of fraud in the supplement industry this report by the FDA is a good place to start.

From the FDA Beware of Fraudulent
‘Dietary Supplements’


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