In recent years, the use of herbal supplements has surged, thanks in part to social media platforms like TikTok, where influencers often promote their supposed health benefits. But despite their growing popularity, researchers are sounding the alarm about potential liver risks associated with some of these “natural” remedies. A new study from the University of Michigan reveals that an estimated 15.6 million U.S. adults could be unknowingly putting their liver health at risk by taking certain herbal products.

The study, published in JAMA Network Open, analyzed the use of six herbal supplements that have been linked to liver damage, or hepatotoxicity. The products in question include ashwagandha, green tea extract, black cohosh, Garcinia cambogia, turmeric (curcumin), and red yeast rice. While these herbs are often marketed as safe, natural alternatives to pharmaceuticals, the findings suggest they may pose significant health risks.

Herbal Supplements and Social Media

Herbal supplements are often touted as natural and beneficial, but this can lead to a dangerous misconception that they are always safe. Dr. Alisa Likhitsup, the study’s lead author and a hepatologist at the University of Michigan, notes that many people turn to these supplements without fully understanding the potential risks.

According to Likhitsup, platforms like TikTok have played a significant role in promoting these supplements, leading millions to try products like turmeric and green tea extract. “Social media has given these supplements a new life, especially among younger generations who may not be aware of the lack of regulation,” said Likhitsup.

Lack of Regulation in the Supplement Industry

One of the most concerning aspects of the study is the fact that herbal supplements are not subject to the same rigorous regulatory oversight as prescription medications. The U.S. Food and Drug Administration (FDA) does not require companies to prove the safety or effectiveness of their products before they are sold. This means that many consumers are taking supplements that have not been adequately tested for potential side effects, including liver damage.

Studies conducted by the FDA and other regulatory bodies have revealed that up to 50% of herbal supplements on the market may be mislabeled, containing ingredients that are not listed on the packaging or in different concentrations than advertised​. Without strict regulations, it’s difficult for consumers to know exactly what they are putting into their bodies.

The Six Potentially Harmful Supplements

The six supplements highlighted in the study have all been previously linked to liver damage in scientific research. Green tea extract, for example, has been associated with cases of acute liver failure, while turmeric, often praised for its anti-inflammatory properties, has been linked to elevated liver enzyme levels when taken in high doses​.

Ashwagandha, a popular herb used to reduce stress and boost energy, has also been implicated in liver toxicity, though cases are rare. Meanwhile, black cohosh, Garcinia cambogia, and red yeast rice, often used for weight loss or hormone regulation, have all been linked to significant liver issues, especially when used in combination with other medications​.

Widespread Use and Unseen Risks

The University of Michigan study found that about 5% of Americans—approximately 15.6 million people—have used one of these potentially harmful supplements within the last 30 days. This figure is similar to the number of people prescribed medications known to affect liver function, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and certain cholesterol-lowering drugs like simvastatin.

Dr. Rosario Ligresti, a gastroenterologist at Hackensack University Medical Center, emphasizes the need for physicians to ask patients about their use of herbal supplements. “Because these products are often marketed as natural, many patients assume they are completely safe,” said Ligresti. “But just because something is natural doesn’t mean it’s harmless. In fact, many natural substances can be toxic in large amounts, particularly for the liver.”

How Supplements Affect the Liver

The liver plays a central role in detoxifying the body, breaking down substances so they can be safely eliminated. However, this process can also turn some compounds into toxic byproducts, which may lead to liver damage. According to the researchers, the exact mechanism by which these supplements cause hepatotoxicity is still unclear, but it likely involves the liver’s metabolic processes​.

The study authors urge healthcare professionals to take these findings seriously and to discuss the potential risks of herbal supplements with their patients. For individuals already using supplements, experts recommend seeking medical advice and considering alternatives, especially if they are experiencing symptoms of liver issues, such as jaundice, fatigue, or abdominal pain.

What Consumers Should Know

With the growing popularity of herbal supplements, experts like Monique Richard, a registered dietitian, advise caution. “Before taking any supplement, it’s important to consult with healthcare professionals who understand the potential risks and benefits,” she says. “A food-first approach is often a safer alternative to supplements—there are many ways to incorporate beneficial herbs like turmeric and green tea into your diet without relying on pills or extracts.”

For now, the best advice for consumers is to be informed. While herbal supplements can offer benefits, they are not without risks, particularly for the liver. As the supplement market continues to grow, it’s more important than ever to approach these products with caution and awareness​.