Doctors in Louisiana link food additives to liver damage, failure. Here’s what you need to know.

In the seven years since that study, the dietary supplement market has grown. Americans will spend an estimated $45 billion on supplements by 2023 — up from $9.6 billion spent on herbal products in 2019 — and Grand View Research expects the market to grow.

The number of adults taking supplements has remained stable or increased since the COVID-19 pandemic in 2020 as people made efforts to strengthen their market forces with more marketed products. , according to the CDC’s National Center for Health Statistics in 2020.

Additional leads can be found anywhere – advertisements, social media influencers, neighbors, friends and family. With all the recommendations, choosing the right supplement, or deciding if a supplement is the answer, can be difficult.

The evidence varies widely about when supplements can help health and when they can be harmful.

Know when to hit the brakes.

Defining “supplement” is tricky – the term is often used as an umbrella term to refer to any edible substance used to replace nutrients in the body. Sometimes it’s in the form of thick pills like zinc or turmeric tablets, sometimes vitamin C gummies and multivitamins, botanicals and even green tea.

Knowing the risks is important. Dr. Brian Ting, a Tulane Health liver specialist who works at the University Medical Center in New Orleans, sees patients with liver failure, some even needing a liver transplant – many because they used supplements.

Ting compares how different people react to different supplements and how different people react to different things. Peanuts don’t bother most people, but for some they can be fatal.

The same is true of supplements – especially when they are in the form of a stable food supplement.

Black cohosh is a popular supplement that perimenopausal women use for symptoms such as hot flashes or to aid in being able to sleep at night. Black cohosh, a dietary supplement made from a flowering plant native to North America, is often effective in providing relief to perimenopausal women. Therefore, they often recommend it to their friends.

The problem is that some women have a reaction to black cohosh that others don’t. Ting says black cohosh has a “high concentration” of liver toxins.

“I find it difficult to blame my patient who I listed now for including the liver for taking black cohosh,” said Ting, “because the perimenopausal symptoms are breastfeeding.”

Black cohosh does not make every patient who takes it develop liver failure, but some patients do – and sometimes the first signs of problems are not obvious.

Sometimes patients with liver damage do not know there is a problem until it is too late.

“There are no early signs,” Ting said. “The more pale and itchy you are…”

Ting says there are indirect symptoms, such as fatigue, that point to health problems.

“But it’s hard for anyone taking a supplement to draw a straight line between fatigue and liver damage,” he said.

Ting recommends that patients be careful when starting each supplement and be careful to talk to their doctor about which supplements they are taking — and how long they have been taking them.

Just because a medication or supplement is over-the-counter doesn’t mean doctors don’t need to monitor the patient’s intake.

“If I had my way, I would say, without being too narrow, specifically studied ingredients like cranberry juice for the treatment of UTIs in women,” Ting said, ” people should not use supplements or be too good.

Not everything is dangerous

Despite a warning from a liver specialist, there are reasons why some supplements are so popular: Sometimes, they work.

Dr. Beth Floyd is an assistant professor and co-director of the Botanical Dietary Supplement Research Center at Pennington Medical Research Center in Baton Rouge.

“There are contributions that I think have good data that they’re working on,” Floyd said for the elderly. “It’s a unique blend of vitamins and nutrients that support eye health that have been shown to delay the onset of macular degeneration.”

ARENDS stands for “Age-Related-Eye-Disease-Supplement” and there is very good data, according to Floyd, that these supplements work to delay the onset of eye disease.

However, Floyd recommends proceeding with caution when it comes to supplement use.

“It’s very difficult for the consumer,” Floyd said. “I would say that for any dietary supplement that someone takes, their primary care provider needs to know that they are using it.”

Do the research

Supplements fall into a medical gray area for evaluation and regulation. Medicines must be approved, tested and reviewed by the Food and Drug Administration before they reach the market, let alone commercial use.

However, supplements often go beyond many of these steps.

Floyd and Ting use many online resources to organize hundreds of supplements on the market.

Ting uses an online database called LiverTox when discussing supplement use and liver toxicity with patients. LiverTox offers herbal and nutritional supplements based on the likelihood of a substance causing liver toxicity, and in some cases liver failure.

“It’s basically a dictionary of everything that can go wrong when you take medications or supplements,” Ting said of the National Library of Medicine site.

The US Pharmacopeia and the National Science Foundation test dietary supplements for active ingredients and issue certifications based on the results. Make sure the supplement bottle or tablet is certified before you take it home, Floyd recommends.

Both USP and NSF have websites for consumers to search for additional certifications. Floyd says the extra step and security checks are worth the effort.

The golden rule

When it comes to supplements, sticking to the golden rule of medicine is important: Talk to your doctor.

“I can speak for any dietary supplement that someone takes,” Floyd said. “Their primary health care provider needs to know they’re using it.”

Even supplements that may be beneficial to the patient can have negative side effects when combined with medications that a person may take.

“It’s very clear, there are ingredients in dietary supplements that are associated with some bad drugs, and the doctor will need to know what the person is taking when they start prescribing the drug,” Floyd said. .

The bottom line is that anecdotal evidence of a supplement that seems to fix a problem in one person doesn’t mean it will do the same for someone else — and worse, sometimes, the supplement the same can cause a more serious problem for someone else. another person.

“What works for your neighbor Joe,” said Ting, “won’t always work for you.”