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Hepatotoxic potential of nutritional and dietary supplements


Authors: M. Jakabovičová 1;  Z. Ďurkovičová 1;  M. Ondrejkovičová 2;  X. Faktorová 1;  V. Mojto 1;  M. Szántová 1
Authors‘ workplace: Lekárska fakulta UK v Bratislave a Univerzitná nemocnica v Bratislave, Nemocnica akademika Ladislava Dérera, III. interná klinika LF UK a UNB, Prednosta: doc. MUDr. Viliam Mojto, CSc., MPH, MHA 1;  Gastroenterologická klinika Slovenskej zdravotníckej univerzity a Univerzitná nemocnica v Bratislave, Prednosta: doc. MUDr. Marian Bátovský, CSc. 2
Published in: Prakt. Lék. 2021; 101(2): 87-96
Category: Reviews

Overview

The growing trend in the consumption of herbal and dietary supplements is associated with increasing hepatotoxicity. Compared to conventional drugs, herbal and dietary supplements are a more common cause of acute liver failure. In addition, they can cause various types of damage ranging from hepatitis through hepatic fibrosis and steatosis to hepatic failure, cirrhosis, tumours, and death. They predominantly affect the female sex. In contrast to drug-induced hepatotoxicity, they more often cause a hepatocellular type of liver injury with markedly elevated transaminases, a more severe course, and more frequent unintentional rechallenge. In the United States, they account for 20% of all cases of hepatotoxicity. The paper provides an up-to-date review of the risks of herbal and dietary supplements with many clinical and research challenges in the diagnosis and identification of responsible constituents, treatment, and prevention. Compared to herbal products, patient compliance with pharmacotherapy is often different in favour of herbal products and dietary supplements. The myth of the safety of natural remedies is refuted by hepatotoxicity based on research data. Correction is possible only by comprehensive education of the professional public and awareness of potential risks.

Keywords:

herbal hepatotoxicity – Herb-Induced Liver Injury (HILI) – Herbal and Dietary Supplements (HDS) – epidemiology – RUCAM


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