Trends in Herbal and Dietary Supplement Use Among U. S. Adults with Chronic Liver Disease

Trends in Herbal and Dietary Supplement Use Among U. S. Adults with Chronic Liver Disease

Khan A^a,b*, Mitsuhashi, S^a, Chauhan K^a, Mujumdar S^a, Erwin R^a, Zheng M^a, Yalamanchili S^a, Reddy S^a, Navarro V^c, Halegoua-DeMarzio D^a,b*

^a Thomas Jefferson University Hospital, Department of Medicine, Philadelphia, PA, USA; ^b Thomas Jefferson University, Department of Medicine, Division of Gastroenterology & Hepatology, Philadelphia, PA, USA; ^c Einstein Medical Center, Department of Medicine, Division of Gastroenterology & Hepatology, Philadelphia, PA, USA

Herbal and dietary supplements (HDS) are used by over 50% of Americans, but commonly their use is not reported to healthcare providers. The aim of this study is to determine the prevalence of HDS use among patients with Chronic Liver Disease (CLD), with a focus on those using supplements known to cause hepatotoxicity. We accessed 61,951 individuals polled in the NHANES database between 2001-2011, which represented a population size of 1,763,482,931. 573 respondents reported a history of CLD (population size of 19,998,331.655). Of those 573 respondents, 41 respondents (population size 1,399,884) endorsed using HDS that are associated with causing hepatotoxicity, which are listed under the NIH complied master list. Our study demonstrates the need for better counseling of patients on the potential risks of these readily available products.

Declaration of conflict of interest: The authors declare no conflict of interest.

Keywords: Herbal supplements; dietary supplements; Chronic liver disease; End stage liver disease; hepatotoxicity; Herbalife; Hydroxycut; Drug induced liver injury

Free Full-text PDF

How to cite this article:
Khan A, Mitsuhashi, S, Chauhan K, Mujumdar S, Erwin R, Zheng M, Yalamanchili S, Reddy S, Navarro V, Halegoua-DeMarzio D. Trends in Herbal and Dietary Supplement Use Among U. S. Adults with Chronic Liver Disease.Open Journal of Gastroenterology and Hepatology, 2022, 5:62. DOI: 10.28933/ojgh-2022-06-2905

References:

1. Seeff LB, Bonkovsky HL, Navarro VJ, Wang G. Herbal products and the liver: a review of adverse effects and mechanisms. Gastroenterology. 2015;148(3):517-32 e3.
2. Radimer K, Bindewald B, Hughes J, Ervin B, Swanson C, Picciano MF. Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999-2000. Am J Epidemiol. 2004;160(4):339-49.
3. Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary Supplement Use Among Adults: United States, 2017-2018. NCHS Data Brief. 2021(399):1-8.
4. Navarro VJ, Lucena MI. Hepatotoxicity induced by herbal and dietary supplements. Semin Liver Dis. 2014;34(2):172-93.
5. Ashar BH. The dietary supplement health and education act: time for a reassessment: comment on “acute selenium toxicity associated with a dietary supplement”. Arch Intern Med. 2010;170(3):261-3.
6. “FDA and Clinical Drug Trials: A Short History,” in A Quick Guide to Clinical Trials, Madhu Davies and Faiz Kerimani,: BioPlan Associates, Inc; October 2016.
7. Young AL, Bass IS. The Dietary Supplement Health and Education Act. Food Drug Law J. 1995;50(2):285-92.
8. Fontana RJ, Watkins PB, Bonkovsky HL, Chalasani N, Davern T, Serrano J, et al. Drug-Induced Liver Injury Network (DILIN) prospective study: rationale, design and conduct. Drug Saf. 2009;32(1):55-68.
9. CDC. National Health and Nutrition Examination Survey
10. Navarro VJ, Barnhart H, Bonkovsky HL, Davern T, Fontana RJ, Grant L, et al. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology. 2014;60(4):1399-408.
11. Ghabril M, Ma J, Patidar KR, Nephew L, Desai AP, Orman ES, et al. Eight-Fold Increase in Dietary Supplement-Related Liver Failure Leading to Transplant Waitlisting Over the Last Quarter Century in the United States. Liver Transpl. 2022;28(2):169-79.
12. Kwon J, Kim S, Yoo H, Lee E. Nimesulide-induced hepatotoxicity: A systematic review and meta-analysis. PLoS One. 2019;14(1): e0209264.
13. Maddukuri VC, Bonkovsky HL. Herbal and dietary supplement hepatotoxicity. Clin Liver Dis (Hoboken). 2014;4(1):1-3.
14. David S, Hamilton JP. Drug-induced Liver Injury. US Gastroenterol Hepatol Rev. 2010; 6:73-80.
15. Halegoua-De Marzio D, Kraft WK, Daskalakis C, Ying X, Hawke RL, Navarro VJ. Limited sampling estimates of epigallocatechin gallate exposures in cirrhotic and noncirrhotic patients with hepatitis C after single oral doses of green tea extract. Clin Ther. 2012;34(12):2279-85 e1.