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Rising Use of Supplements Linked to Surge in Liver Failure, Warn Experts

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A new wave of research highlights a troubling trend: more people turning to herbal and dietary supplements for perceived health benefits, and an alarming rise in severe liver injury and liver failure linked to these products. Health professionals warn that “natural” does not always mean safe, especially for the liver, the body’s key detox engine.

The trend mirrors a global shift toward wellness, including in Thailand, where fitness routines, organic diets, and vitamin and herbal remedies are increasingly common. Brands promise longer life, weight loss, or stronger immunity. Yet experts warn these products can harm health rather than help, a concern echoed by recent studies in the United States that may have global implications, including Southeast Asia.

The liver processes medications, alcohol, and various substances, including compounds in dietary supplements. When overwhelmed, it can suffer drug-induced liver injury, a form of toxic hepatitis. The Mayo Clinic describes this condition as liver inflammation that may improve with early treatment but can progress to cirrhosis or liver failure if ignored.

Recent data show growing use and rising risk. A 2024 survey from the Council for Responsible Nutrition found that up to three-quarters of U.S. adults take some form of supplement, with most preferring supplements over prescription or over-the-counter medicines. This marks a significant rise from 2017–2018, when only about 58% used a supplement in the prior month.

Even more concerning, a 2022 study in Liver Transplantation reported that the share of patients awaiting liver transplants due to supplement-related liver failure jumped from 2.9% in 1995 to 24.1% in 2020. Researchers warned of a substantial increase in acute liver failure cases linked to supplements.

Identifying specific ingredients is challenging because products often use proprietary blends. Yet a University of Michigan study published in 2023 linked six ingredients with toxic hepatitis: turmeric, green tea extract, ashwagandha, garcinia cambogia, red yeast rice, and black cohosh. These components appear in products consumed widely in the United States and are increasingly popular in Thailand, especially in herbal formulas for joint health, weight management, and menopausal symptoms.

Experts estimate that about 20% of liver toxicity cases in the United States now stem from dietary or herbal supplements. The primary driver appears to be weak regulatory oversight. In many markets, supplements do not undergo the same safety and efficacy standards as medicines. This gap means contaminants, incorrect dosages, and dangerous interactions may go unchecked.

Thailand’s herbal supplement market is thriving, rooted in tradition and strong marketing. Turmeric, green tea, and ashwagandha appear in various products sold from Bangkok pharmacies to Chiang Mai markets. While this reflects a cultural trust in natural remedies, it also raises risk through broader exposure and limited consumer education and regulation.

Thailand’s Food and Drug Administration has issued warnings about certain products following rising reports, but many supplements remain unchecked. A regulatory expert notes the market’s scale and rapid product turnover, urging people to seek medical advice before starting any supplement, especially if they have liver conditions or take other medications.

Early symptoms of supplement-related liver injury are subtle: fatigue, yellowing of the skin or eyes, loss of appetite, and abdominal pain. Left untreated, it can progress to cirrhosis or acute liver failure, where a transplant may become the only life-saving option—a heavy emotional and financial burden for families.

Public awareness of these risks is growing in the West, but in Thailand, community practices and family traditions can sometimes overshadow medical warnings. Access to specialist care can be uneven, particularly in rural areas, and self-medication remains a challenge.

Looking ahead, rising interest in wellness and the vast online marketplace may widen exposure to unregulated products. Thai consumers could see more patients with unexplained liver inflammation, particularly middle-aged and older adults with pre-existing conditions.

Practical guidance for Thai readers is clear: never assume safety because a product is natural or popular. Consult with a healthcare professional—ideally internal medicine or hepatology—before starting any supplement, especially ingredients such as turmeric, green tea extract, ashwagandha, garcinia cambogia, red yeast rice, or black cohosh. Report any unusual side effects promptly, scrutinize labeling and sources, and avoid self-medication. For those with existing liver disease, take supplements only under medical supervision.

To protect health, balance enthusiasm for natural wellness with cautious evaluation of products. Core health foundations—balanced diet, regular physical activity, and routine medical checkups—remain essential. A leading Bangkok hepatologist summarizes it well: there are no shortcuts; respect your liver, and it will serve you for life.

For further context, readers may reference general guidance on toxic hepatitis from reputable health institutions and consumer-safety information on dietary supplements. Local Thai authorities also provide warnings and safety resources to help consumers make informed choices about supplements.

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Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.