Supplements are often billed as "natural," "healthy" and "necessary," especially for detox purposes. But supplement-related liver failure has surged eightfold between 1995 and 2020, according to a Liver Transplantationstudy. Hepatologists are begging people to stop taking supplements so casually, even ones marketed as "good for you" and that everyone on social media seems to be taking.
"Most people think natural means safe, but your liver processes every supplement you swallow," points out Dr. James Park, MD, the co-director of the Center for Liver Disease and Transplantation at the Northwell Transplant Institute and the chief of hepatology at North Shore University Hospital, Long Island Jewish Medical Center and Lenox Hill Hospital.
It's ironic because supplements for liver health are often marketed as detoxes, when the large organ usually does just fine without help from a tablet or powder.
"The liver is one of the body’s hardest-working organs," Dr. Brian T. Lee, MD, a transplant hepatologist at Hoag, tells Parade. "It processes nutrients, helps remove harmful substances from the bloodstream, produces proteins needed for blood clotting, supports digestion and regulates energy storage."
Yet, Dr. Lee says that the liver's role in processing supplements (and medication) makes it extra vulnerable to injury if you take certain substances in excess amounts. Hepatologists are concerned that people are doing just that with a certain supplement, and it puts your liver at risk. Below, they reveal the common supplement they are begging people to stop taking so casually (and better ways to get the nutrient).
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Four hepatologists agree that it's dangerous to take high doses of vitamin A supplements, saying it's an established cause of liver injury.
"It can range from just the development of increased fat in the liver from high doses of vitamin A over long periods of time, to the development of liver cirrhosis, which is advanced scarring in the liver," says Dr. Varun Saxena, MD, a transplant hepatologist with Kaiser Permanente in San Francisco. "[It can even go] all the way up to complete liver failure, where the liver function deteriorates and patients need to be rescued with a transplant."
Vitamin A is a fat-soluble vitamin, and some people may become deficient in it, such as those who have pancreatic or bowel diseases, explains Dr. Abdul Nadir, MD, an HonorHealth hepatologist and gastroenterologist specializing in hepatology.
Dr. Nadir adds that malabsorptive surgeries, like gastric bypass to promote weight loss, can also cause deficiencies. These people may need to take a vitamin A supplement under a doctor's supervision—that's not hepatologists' concern.
"However, vitamin A, when used without any deficiency, can accumulate in the liver and result in fat deposition and inflammation in the liver," Dr. Nadir says.
High-dose vitamin A is classified as more than 10,000 international units (IU) or 3,000 micrograms (mcg) of Retinol Activity Equivalent (RAE). "If anyone is taking more than that, there is an increased risk of liver toxicity," Dr. says.
Dr. Lee says chronic, casual use of high-dose supplements is his top concern. One problem with vitamin A is that it's easy to exceed the limit when supplement stacking.
"[Liver injury] can also occur when people unknowingly combine several products, such as a multivitamin, a skin supplement and immune-support supplements, which each can contain preformed vitamin A," he warns.
Another thing to keep in mind, according to Dr. Saxena: everyone is unique. Just because one person claims that a supplement regimen is working great for them doesn't mean your liver will react the same way.
"It’s really important to understand that you just don't know what you're getting when it comes to supplements. Also, because the liver is responsible for metabolizing everything that we put in our mouths, it's really the liver that's going to be most susceptible to a bad reaction when it comes to supplements," he says.
Related:2 Supplements You Should Never Take if You Want To Protect Your Liver, According to Hepatologists
How Much Vitamin A Do I Need per Day?
"Recommendations from the FDA and from good research from decades are no more than 10,000 international units per day," Dr. Saxena says. "That doesn't mean people have to reach that level. In reality, just getting to half of that per day is plenty."
Dr. Lee adds that your needs can change if you're pregnant or breastfeeding. The good news? "Most adults who eat a varied, balanced diet can meet their requirements without a vitamin A supplement," he says.
Some of his favorite ways to get vitamin A through food are:
Sweet potatoesCarrotsPumpkinSpinachKaleRed bell peppersEggs (in the yolk)DairyFishGetting vitamin A through food is important. "Vitamin A supports normal vision, immune function, reproduction and healthy skin," Dr. Lee explains.
Related: The Cooking Oil To Avoid if You Have Fatty Liver Disease, According to Gastroenterologists
Hepatologists don't recommend taking supplements for liver health. "There really aren’t any safe supplements that are marketed towards liver health," Dr. Saxena says. "We have no good way of predicting if a patient will have that [specific] reaction that leads to significant liver injury and in some cases, liver failure and the need for a liver transplant."
Dr. Park is especially begging people to stop taking anything marketed as "liver cleanse" or "liver detox."
"Every year, I see a patient who comes in with a severe liver injury because they're taking something called 'liver detox' or 'liver cleanse,' thinking that it would be better for the liver," Dr. Park says. "Everything you consume—including supplements taken through the mouth— will be detoxified through the liver, and sometimes it can cause severe liver injuries."
Dr. Lee notes that it's always a good idea to talk to your doctor before taking any supplements, especially if you're on prescription medications or have other underlying conditions.
"Along with causing direct injury to the liver, supplements can interact with prescription medications and may be unsafe for people with existing liver disease or other health conditions," he says. "Bring the bottle or a photo of the ingredient label to your appointment. Include multivitamins, powders, gummies and other products."
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Sources:
Dr. Varun Saxena, MD, a transplant hepatologist with Kaiser Permanente in San FranciscoDr. Brian T. Lee, MD, a transplant hepatologist at HoagDr. James Park, MD, the co-director of the Center for Liver Disease and Transplantation at the Northwell Transplant Institute and the chief of hepatology at North Shore University Hospital, Long Island Jewish Medical Center and Lenox Hill HospitalDr. Abdul Nadir, MD, an HonorHealth hepatologist and gastroenterologist specializing in hepatologyEight-Fold Increase in Dietary Supplement-Related Liver Failure Leading to Transplant Waitlisting Over the Last Quarter Century in the United States. Liver Transplantation.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, Vitamin A. National Center for Biotechnology Information.Vitamin A and Carotenoids. Office of Dietary Supplements.Hence then, the article about the common supplement hepatologists wish people would stop taking so casually was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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