Hepatotoxicity associated with Garcinia cambogia: A case report

Abstract

BACKGROUNDHerbal supplements (HS) for weight loss are perceived to be “safe” and “natural”, as advertised in ads, however, hepatotoxicity can be associated with consumption of some HS. Use of HS may be missed, as the patient may not report these unless specifically asked about these products, since they are often not thought of as medications with potential side effects or interaction potential.CASE SUMMARYWe reported a case of a 21-year-old female with morbid obesity who presented with abdominal pain for 1 wk associated with nausea, vomiting, anorexia and myalgias. She denied smoking tobacco, drinking alcohol, usage of illicit drugs, hormonal contraceptives, or energy drinks. There was no significant past medical or family illnesses. Her laboratory workup revealed acute liver failure. The workup for possible etiologies of acute liver failure was unremarkable. She was using a weight loss herbal supplement “Garcinia cambogia” for 4 wks. This case demonstrates the association of acute liver failure with Garcinia cambogia.CONCLUSIONMedical reconciliation of HS should be performed in patients with suspected acute liver failure and early discontinuation of HS can prevent further progression of drug induced hepatoxicity.

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

“…With 11,609 the largest HILI case number was published in 2019 ( Figure 3 ) as a consequence of the ongoing worldwide use of RUCAM for assessing causality in suspected HILI cases ( Table 4 ). In particular, contributing countries were in alphabetical order Australia [ 29 ], Brazil [ 183 ], China [ 48 , 196 , 197 , 198 , 199 , 200 , 201 ], Germany [ 213 , 214 , 215 ], India [ 217 ], Italy [ 222 ], Korea [ 103 ], Spain [ 115 , 117 , 240 , 241 , 242 ], Switzerland [ 244 ], and the US [ 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 , 254 ]. Most of the 11,619 HILI cases published in 2019 were from China [ 48 , 196 ] and Korea [ 103 ], with 6971 cases published by Shen et al [ 48 ], 2019 cases reported by Byeon et al [ 103 ], and 1552 cases provided by Chow et al [ 196 ].…”

Risks Associated with the Use of Garcinia as a Nutritional Complement to Lose Weight

“…In spite of this, other authors have reported toxic manifestations, including hepatotoxicity, acute pancreatitis, serotonin toxicity and psychosis after the consumption of Garcinia-containing products (either as an extract containing other components or pure). In 16 of the 21 cases described in Table 2 [ 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], these adverse effects have occurred after the intake of formulations which contained other ingredients besides Garcinia. One of these formulations is Hydroxycut™.…”

Current Evidence to Propose Different Food Supplements for Weight Loss: A Comprehensive Review

“…Although in short term trials GC has been proven as generally safe, it is noteworthy to underline that FDA urged consumers to avoid Hydroxycut, a natural product for weight loss containing GC and a variety of other ingredients, because of the report of twenty-three cases of hepatotoxicity associated with its use in 2009 [232]. Moreover, several hepatoxicity cases have been associated also with the use of pure GC extracts [233][234][235][236][237][238].…”