A wave of new research highlights serious risks from herbal and dietary supplements widely used for wellness. Millions, including many in Thailand, may be exposed to dangerous liver injury or even liver failure. Studies link familiar ingredients—often found in kitchen spice racks and health stores—to increasing cases of hepatotoxicity and, in some instances, transplant-needed liver damage.
Herbal supplements have surged in popularity across Western and Asian markets, promoted as natural solutions for immunity, weight control, and vitality. In Thailand, traditional remedies—turmeric, green tea, and blend formulas—are deeply embedded in daily health practices. Yet experts warn that “natural” does not automatically equal safe, especially at high doses or without medical guidance.
Data from recent research shows a sharp rise in supplement-related liver failure in the United States, with cases on liver transplant waitlists increasing dramatically between the mid-1990s and 2020. Other studies estimate that about one in five acute liver toxicity events nationwide may be linked to herbal and dietary supplements rather than prescription drugs. In Thailand, the lack of strict pre-market testing for many supplements means the risk could be even higher, given widespread use of traditional products.
Liver disease claims more than 50,000 lives annually in the United States, often from preventable causes. In Southeast Asia, where regulation of supplements varies and herbal medicine remains prevalent, similar risks are anticipated to be significant. Medical professionals emphasize that while people seek health benefits, dosing beyond recommended amounts can be dangerous — especially when supplements are used without oversight.
Common culprits linked to liver injury include turmeric, frequently used in Thai and Indian cooking, often taken in megadoses in supplement form. Other items on the risk list are black cohosh, red yeast rice, Garcinia cambogia, and concentrated green tea extract. Many of these are popular in Thai health shops and wellness circles.
Experts explain that culinary turmeric is generally safe, but supplement capsules may deliver far higher concentrations than food. When turmeric is used in food, risks are minimal; in pill form, doses can exceed 2,000 milligrams daily. The presence of black pepper, another common ingredient in supplements, can potentially amplify liver stress when combined with high doses.
Despite growing evidence, herbal products are frequently marketed as safe due to looser regulatory oversight compared with pharmaceuticals. In some countries, including Thailand, pre-market testing is not as stringent. Mislabeling and inconsistent ingredient content are ongoing concerns. Healthcare professionals note that label accuracy is not always reliable, underscoring a need for caution when purchasing supplements.
Patients often do not tell doctors about their supplement use, sometimes because they believe traditional remedies are inherently safe. In Thailand, open dialogue about herbal medicine with clinicians is not always routine, creating a blind spot in patient care.
Drug-induced liver injury can present with fever, fatigue, stomach pain, nausea, dark urine, and jaundice. Although these events are relatively rare, they can be severe and life-threatening, especially in those with genetic predispositions or interactions with other medications or alcohol.
The landscape of the global dietary supplement market continues to grow. In Thailand, the sector has surged, with the market valued at tens of billions of baht and expanding further. Traditional remedies remain woven into both urban and rural health practices, from turmeric beverages in northern towns to herbal capsules in city markets. However, uneven quality control has led to publicized cases of organ harm from adulterated or concentrated products.
Medical experts stress that moderate use of culinary herbs is generally safe, but unchecked consumption of high-dose supplements can be harmful. Public health voices stress the importance of awareness, stricter product regulation, and stronger communication between patients and clinicians.
In Thailand, risks are amplified by the common practice of using herbal remedies alongside prescription medicines without supervision. A recent global review highlights the challenge of distinguishing herbal-induced liver injury from other causes due to complex blends and inconsistent reporting. Rising cases of herbal-induced liver injury have been associated with ingredients such as green tea extract, turmeric, aloe vera, and kava.
Thailand’s cultural reverence for natural medicine—rooted in Buddhist principles of balance—remains influential. This trust, while valuable, must be balanced with rigorous safety practices. Health professionals urge Thai consumers, especially the elderly and chronically ill, to treat supplements with the same caution as medicines and to consult healthcare providers before starting any new regimen.
Looking ahead, experts advocate for enhanced public education, stronger product regulation, and better clinician-patient communication. There is a push for tighter laws and mandatory testing to verify ingredient accuracy, both globally and in Thailand, as herbal products become more embedded in daily routines.
Practical guidance for Thai readers:
- Consult a doctor or pharmacist before taking any herbal or dietary supplement, especially if you have liver concerns or take ongoing medications.
- Purchase only supplements registered with Thailand’s FDA.
- Follow recommended doses and avoid long-term high-dose use without medical supervision.
- Seek medical advice promptly if you notice signs of liver distress, such as fatigue, yellowing skin or eyes, dark urine, or abdominal pain.
- Disclose all supplements and traditional remedies to your healthcare team.
- Discuss supplement use with friends and family and research products thoroughly before buying.
- Monitor FDA advisories for safety recalls or warnings about herbal supplements.
In sum, while herbal remedies remain integral to Thai culture and health, current evidence calls for caution and rigorous evaluation. Public awareness and informed choices can help prevent severe liver injury and protect long-term wellbeing.