Many Americans assume that herbal and dietary supplements are safe, but that faith is often misplaced.
The fact is, serious liver damage caused by these substances have doubled over the last decade according to a study published in the journal Hepatology.
One of the issues is lack of US Food and Drug Administration (FDA) oversight because marketing of herbals and dietary supplements such as vitamins, minerals, and amino acids require less safety documentation than conventional medicines.
The authors of the study found that injuries to the liver caused by these substances were serious enough in some cases to require liver transplantation, while injuries caused by conventional drugs led to such drastic measures much less often.
Middle aged women were more likely than men to require transplants.
While bodybuilding supplements often produced prolonged jaundice, they were not found to cause enough damage to result in liver transplants for either men or women.
The one exception to government oversight is when dietary supplements contain pharmaceutical ingredients which the FDA is required to regulate.
Another study published in JAMA tested dietary supplements for the presence of banned drugs following FDA recalls from 2004 to the present.
The authors found that two-thirds of recalled supplements available for purchase 6 months or more after FDA recalls contained banned ingredients that could cause serious adverse health consequences or even death.
While the authors recommend more aggressive enforcement of the law, in the meantime consumers need to be aware of the potential dangers.