Hepatotoxicity due to herbal dietary supplements: Past, present and the future

Bill J Gurley; Mitchell R McGill; Igor Koturbash

doi:10.1016/j.fct.2022.113445

Hepatotoxicity due to herbal dietary supplements: Past, present and the future

Food Chem Toxicol. 2022 Nov:169:113445. doi: 10.1016/j.fct.2022.113445. Epub 2022 Sep 29.

Authors

Bill J Gurley¹, Mitchell R McGill², Igor Koturbash³

Affiliations

¹ National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA. Electronic address: bjgurley@olemiss.edu.
² Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA. Electronic address: MMcgill@uams.edu.
³ Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA. Electronic address: ikoturbash@uams.edu.

PMID: 36183923
DOI: 10.1016/j.fct.2022.113445

Abstract

Dietary supplements (DS) constitute a widely used group of products comprising vitamin, mineral, and botanical extract formulations. DS of botanical or herbal origins (HDS) comprise nearly 30% of all DS and are presented on the market either as single plant extracts or multi-extract-containing products. Despite generally safe toxicological profiles of most products currently present on the market, rising cases of liver injury caused by HDS - mostly by multi-ingredient and adulterated products - are of particular concern. Here we discuss the most prominent historical cases of HDS-induced hepatotoxicty - from Ephedra to Hydroxycut and OxyELITE Pro-NF, as well as products with suspected hepatotoxicity that are either currently on or are entering the market. We further provide discussion on overcoming the existing challenges with HDS-linked hepatotoxicity by introduction of advanced in silico, in vitro, in vivo, and microphysiological system approaches to address the matter of safety of those products before they reach the market.

Keywords: Botanicals; Dietary supplements; Hepatotoxicity; Microphysiological system; Phytochemicals; Safety assessment.

Publication types

Review

MeSH terms

Chemical and Drug Induced Liver Injury* / etiology
Dietary Supplements* / toxicity
Humans
Plant Extracts* / toxicity
Plant Preparations
Vitamins / toxicity

Substances

Plant Extracts
Vitamins
Plant Preparations