I want everyone to have the choice of trying anything they like - so long as they are fully informed and all information is readily accessible.
Trouble is, a lot of information is hard to access for many reasons including language, paywalls, time, and having the required time and skills to get to the information and understand it. (There is an awful lot that, despite being in English, would not be intelligible to any but a tiny fraction.)
This paper discusses the following:
● Turmeric or curcumin
● Green tea extract
● Garcinia cambogia
● Black cohosh
● Red yeast rice
● Ashwagandha
I've already got an entry in my blog for one of these:
helvella - Red Yeast Rice
A short discussion about the claims for "natural" red yeast rice as an alternative to statins.
helvella.blogspot.com/p/hel...
And a questioning blog about the numerous "thyroid support" formulations - which very frequently contain Ashwagandha and others might contain Garcinia, Green tea extract or (possibly) others in this list - or not in the list but which are just as questionable but weren't included in this paper. (Not being in the list doesn't mean they are safe. This paper is very much focussed on one single avenue of toxicity.)
helvella - Thyroid Support Products
A short discussion about the various thyroid support formulas and similar products.
Last updated 18/07/2024
helvella.blogspot.com/p/hel...
Don't take this post as being totally against any of these substances. I don't know enough to take that position. But find out and be careful. And remember that the supplement vendors don't care about you at all. They will produce anything they believe will sell. And some will make false claims about efficacy, safety, and pretty much anything else in order to get your money.
Original Investigation
Complementary and Alternative Medicine
August 5, 2024
Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults
Alisa Likhitsup, MD, MPH1; Vincent L. Chen, MD, MS1; Robert J. Fontana, MD1
Author Affiliations Article Information
JAMA Netw Open. 2024;7(8):e2425822. doi:10.1001/jamanetworkopen.2024.25822
Key Points
Question What percentage of US adults consume at least 1 of 6 potentially hepatotoxic botanical products?
Findings In this survey study analyzing nationally representative data from 9685 adults, 4.7% of US adults reported exposure to 6 potentially hepatotoxic botanicals: turmeric was most frequently reported, followed in order by green tea, ashwagandha, Garcinia cambogia, red yeast rice, and black cohosh products. Botanical product users were significantly older, more educated, and more likely to have arthritis compared with nonusers.
Meaning The results of this study suggest that clinicians should be aware of possible adverse events from consumption of these largely unregulated products.
Abstract
Importance Use of herbal and dietary supplements (HDSs) accounts for an increasing proportion of drug hepatotoxicity cases. Turmeric or curcumin, green tea extract, Garcinia cambogia, black cohosh, red yeast rice, and ashwagandha are the most frequently reported hepatoxic botanicals, but their prevalence and reasons for use in the general population are unknown.
Objective To assess the prevalence and clinical characteristics of adult consumers of 6 potentially hepatoxic botanicals.
Design, Setting, and Participants This survey study analyzed nationally representative data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of the general US population. Prescription drug and HDS exposure data in the past 30 days were analyzed, and 2020 US Census data were used for population estimates. Data were analyzed July 1, 2023, to February 1, 2024.
Exposures Adult NHANES participants enrolled between January 2017 and March 2020.
Main Outcomes and Measures Baseline weighted characteristics of HDS users and users of 6 potentially hepatotoxic botanical products were compared with non–HDS users. Multivariable analysis was undertaken to identify factors associated with HDS use or at-risk botanical use.
Results Among 9685 adults enrolled in this NHANES cohort, the mean (SE) age was 47.5 (0.5) years, and 51.8% (95% CI, 50.2%-53.4%) were female. The overall prevalence of HDS product use was 57.6% (95% CI, 55.9%-59.4%), while the prevalence of using the 6 botanicals of interest was 4.7% (95% CI, 3.9%-5.7%). Turmeric-containing botanicals were most commonly used (n = 236), followed by products containing green tea (n = 92), ashwagandha (n = 28), Garcinia cambogia (n = 20), red yeast rice (n = 20), and black cohosh (n = 19). Consumers of these 6 botanicals were significantly older (adjusted odds ratio [AOR], 2.36 [95% CI, 1.06-5.25]; P = .04 for 40-59 years of age and AOR, 3.96 [95% CI, 1.93-8.11]; P = .001 for ≥60 years of age), had a higher educational level (AOR, 4.78 [95% CI, 2.62-8.75]; P < .001), and were more likely to have arthritis (AOR, 2.27 [95% CI, 1.62-3.29]; P < .001) compared with non–HDS users. An estimated 15 584 599 (95% CI, 13 047 571-18 648 801) US adults used at least 1 of the 6 botanical products within the past 30 days, which was similar to the estimated number of patients prescribed potentially hepatotoxic drugs, including simvastatin (14 036 024 [95% CI, 11 202 460-17 594 452]) and nonsteroidal anti-inflammatory drugs (14 793 837 [95% CI, 13 014 623-16 671 897]). The most common reason for consuming turmeric and green tea was to improve or maintain health.
Conclusions and Relevance In this survey study, an estimated 15.6 million US adults consumed at least 1 botanical product with liver liability within the past 30 days, comparable with the number of people who consumed nonsteroidal anti-inflammatory drugs and a commonly prescribed hypolipidemic drug. Given a lack of regulatory oversight on the manufacturing and testing of botanical products, clinicians should be aware of possible adverse events from consumption of these largely unregulated products.
Full paper is open access here:
Has anyone tried red rice yeast as a replacement for statins?
