Health and Me

Itisha Arya

5 Popular Herbal Supplements That Could Harm Your Liver

herbal supplement liver damage

Although herbs and plants have been used for medicinal purposes for thousands of years, they have recently gained a surge in popularity, partly thanks to TikTok posts where users highlight the benefits of supplements such as ashwagandha, turmeric, and green tea.

While many consider <span>herbal supplements</span> “natural,” this does not automatically make them safe. Unlike prescription medicines, they do not require approval or review from the U.S. FDA before hitting the market. Users may experience side effects, and some herbs can interfere with medications they are already taking.

<h2><span rel="noindex">Can Herbal Supplements Cause Liver Damage</span>?</h2>

Some herbal supplements can harm the liver. A recent study from the University of Michigan suggests that around 15.6 million adults in the U.S., about 5% took at least one herbal supplement in the last 30 days that may be harmful to the liver, known as hepatotoxic. This study was published in JAMA Network Open.

<h2>6 Potentially Hepatotoxic Botanical Products</h2>

Researchers analyzed data from over 9,500 U.S. adults, with an average age of 47.5, who participated in the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2020. They examined participants’ use of both prescription medications and herbal supplements.

The study focused on six herbal supplements previously linked to liver toxicity:

<ul><li>Ashwagandha</li><li>Black cohosh</li><li>Garcinia cambogia</li><li>Green tea extract</li><li>Red yeast rice</li><li>Turmeric or curcumin</li></ul>

“Potentially hepatotoxic botanical products contain plant-based ingredients that may contribute to liver damage,” explained Alisa Likhitsup, MD, MPH, a clinical assistant professor in the Department of Internal Medicine at the University of Michigan and lead author of the study.

“How these supplements cause liver injury isn’t fully understood, but it likely involves how the liver metabolizes these products,” she added.

Data from the Drug Induced Liver Injury Network show liver injuries linked to botanical products have risen from 7% in 2004–2005 to 20% in 2013–2014. 

<h2>‘Natural’ Doesn’t Always Mean Safe</h2>

After reviewing the study, Rosario Ligresti, MD, FASGE, chief of Gastroenterology at Hackensack University Medical Center in New Jersey, said that while hepatotoxic botanical products are derived from plants, the lack of oversight and testing means they may do more harm than good.

“They’re unregulated before reaching the market, so it’s not surprising that they pose significant health risks, especially to the liver. They can interfere with the liver’s ability to process and detoxify substances, potentially leading to toxin buildup, inflammation, cell death, and, in severe cases, liver failure,” Ligresti explained, as per Medical News Today.

One notable case involved a 57-year-old woman in New Jersey and New York who developed severe liver damage after taking 2,250 mg of turmeric daily since March 2025 which is far above the WHO’s safe limit of 0–3 mg per kg of body weight per day. She required hospital care for six days at NYU Langone.

Signs of liver damage can include fatigue, nausea, loss of appetite, stomach pain, and dark urine.

Ligresti emphasized that physicians should routinely ask patients about their use of herbal supplements and discuss potential liver risks.

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Although herbs and plants have been used for medicinal purposes for thousands of years, they have recently gained a surge in popularity, partly thanks to TikTok posts where users highlight the benefits of supplements such as ashwagandha, turmeric, and green tea.While many consider herbal supplements “natural,” this does not automatically make them safe. Unlike prescription medicines, they do not require approval or review from the U.S. FDA before hitting the market. Users may experience side effects, and some herbs can interfere with medications they are already taking.Can Herbal Supplements Cause Liver Damage?Some herbal supplements can harm the liver. A recent study from the University of Michigan suggests that around 15.6 million adults in the U.S., about 5% took at least one herbal supplement in the last 30 days that may be harmful to the liver, known as hepatotoxic. This study was published in JAMA Network Open.6 Potentially Hepatotoxic Botanical ProductsResearchers analyzed data from over 9,500 U.S. adults, with an average age of 47.5, who participated in the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2020. They examined participants’ use of both prescription medications and herbal supplements.The study focused on six herbal supplements previously linked to liver toxicity:AshwagandhaBlack cohoshGarcinia cambogiaGreen tea extractRed yeast riceTurmeric or curcumin“Potentially hepatotoxic botanical products contain plant-based ingredients that may contribute to liver damage,” explained Alisa Likhitsup, MD, MPH, a clinical assistant professor in the Department of Internal Medicine at the University of Michigan and lead author of the study.“How these supplements cause liver injury isn’t fully understood, but it likely involves how the liver metabolizes these products,” she added.Data from the Drug Induced Liver Injury Network show liver injuries linked to botanical products have risen from 7% in 2004–2005 to 20% in 2013–2014. ‘Natural’ Doesn’t Always Mean SafeAfter reviewing the study, Rosario Ligresti, MD, FASGE, chief of Gastroenterology at Hackensack University Medical Center in New Jersey, said that while hepatotoxic botanical products are derived from plants, the lack of oversight and testing means they may do more harm than good.“They’re unregulated before reaching the market, so it’s not surprising that they pose significant health risks, especially to the liver. They can interfere with the liver’s ability to process and detoxify substances, potentially leading to toxin buildup, inflammation, cell death, and, in severe cases, liver failure,” Ligresti explained, as per Medical News Today.One notable case involved a 57-year-old woman in New Jersey and New York who developed severe liver damage after taking 2,250 mg of turmeric daily since March 2025 which is far above the WHO’s safe limit of 0–3 mg per kg of body weight per day. She required hospital care for six days at NYU Langone.Signs of liver damage can include fatigue, nausea, loss of appetite, stomach pain, and dark urine.Ligresti emphasized that physicians should routinely ask patients about their use of herbal supplements and discuss potential liver risks.