Dietary and herbal supplements may seem harmless, but some common supplements are linked to liver damage, and you should be aware of them and consult your doctor if you have liver disease.

Below is a review of what to be cautious about and avoid excessive intake of supplements to maintain liver health, according to a report by Verywell Health, a health website.

Turmeric

Turmeric is a common dietary supplement for treating arthritis, digestive issues, and liver disease. However, some evidence suggests that turmeric supplements may harm the liver. Supplements containing black pepper may cause additional harm as it enhances turmeric absorption.

A study conducted in 2023 showed an increase in turmeric-related liver injuries in the United States. Researchers examined data from the US Drug-Induced Liver Injury Network between 2004 and 2022. Only 10 cases of turmeric-related liver injury were reported, six of which occurred after 2017.

Green Tea

Green tea supplements are marketed as weight loss and anti-cancer agents. Consuming large amounts of a specific compound in green tea — epigallocatechin gallate (EGCG) — may cause liver damage.

'Drinking tea regularly, about 3 to 5 cups a day, does not pose the same risk because the diet provides much lower levels of EGCG,' said Caroline Susie, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics.

Ashwagandha

Some people take ashwagandha to relieve stress or support overall health. Reports of ashwagandha-related liver injuries have been reported in the United States.

Susie said: 'The exact toxic threshold is unknown, but reported cases involve high-dose extracts, rather than traditional root powders.' She added that while high-dose extracts may cause harm, consuming small amounts of ashwagandha in the diet is generally safe.

It is important to consult a trusted doctor before taking ashwagandha, especially if you have a history of liver disease. Taking ashwagandha with other dietary supplements may cause additional harm.

Red Yeast Rice

Red yeast rice supplements are said to help lower cholesterol. These supplements contain a natural statin that may cause liver damage, according to Dr. Nima Majlesi, a medical toxicologist at Northwell Staten Island University Hospital in the US.

He added that people taking high doses are at greater risk, but due to lack of regulation, one does not always know the amount they are consuming.

Case reports have linked red yeast rice to liver problems. A case report published in 2019 showed that a 64-year-old woman developed hepatitis six weeks after starting red yeast rice supplements. Once she stopped taking the supplement, her liver enzymes decreased, indicating her liver was recovering.

Black Cohosh

Black cohosh is an herbal product used to relieve menopause symptoms. Some reports have linked supplements labeled 'black cohosh' to serious liver damage.

Taking black cohosh with other medications or supplements may cause liver damage. It is always important to consult a trusted healthcare provider about all medications and supplements you are taking.

In the United States, the Food and Drug Administration (FDA) does not regulate dietary supplements the same way it regulates prescription drugs, meaning some supplement products may not contain what is stated on the label. When choosing a supplement, look for products that have undergone independent testing, and consult a healthcare provider, registered dietitian, or pharmacist.

Should These Supplements Be Avoided?

It is important to consider the risks before taking any dietary supplement, not just these. Studies have also shown that supplements are often mislabeled, so you don't always know exactly what you are taking.

Experts said: 'All dietary supplements should be questioned. In fact, due to weak regulation of this industry, we don't really know what many of them contain.'

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