Profile of herbal and dietary supplements induced liver injury in Latin America: A systematic review of published reports

Abstract

Hepatotoxicity related to HDS is a growing global health issue. We have undertaken a systematic review of published case reports and case series from LA from 1976 to 2020 to describe the clinical features of HDS related hepatotoxicity in this region. We search in PubMed, Web of Science, Scopus and specific LA databases according to PRISMA guidelines. Only HILI cases published in LA that met criteria for DILI definition were included. Duplicate records or reports that lacked relevant data that precluded establishing causality were excluded. Finally, 17 records (23 cases) were included in this review. Centella asiatica, Carthamus tinctorius, and Herbalife® were the most reported HDS culprit products, the main reason for HDS consumption was weight loss. The clinical characteristics of HDS hepatotoxicity in our study were compared to those of other studies in the USA, Europe and China showing a similar signature with predominance of young females, hepatocellular damage, a high rate of ALF and mortality, more frequent inadvertent re‐challenge and chronic damage. This study underscores the challenge in causality assessment when multi‐ingredients HDS are taken and the need for consistent publication practice when reporting hepatotoxicity cases due to HDS, to foster HDS liver safety particularly in LA.

Increase water solubility of Centella asiatica extract by indigenous bioenhancers could improve oral bioavailability and disposition kinetics of triterpenoid glycosides in beagle dogs

“…Centella asiatica (Linn.) is commonly found in many areas around the world, especially in tropical areas of Asia, Africa, and the Americas 1 – 3 . This plant belongs to the Apiaceae family and has been developed into several phytopharmaceutical products.…”

Complementary and Alternative Therapies for Weight Loss: A Narrative Review

“…As claimed by Santos and colleagues, 74 the safety information is disputed due to a lack of empirical evidence of efficacy and toxicity despite the widespread belief that dietary supplements are natural and safe. Indeed, there has been growing concern regarding the potential hepatotoxicity following herbal products’ consumption, ranging from acute hepatitis to fulminant liver failure requiring transplantation or lead to death.…”

“… 75 The most frequent single herbal ingredients involved in hepatotoxicity were Camellia sinensis and Centella Asiatica species, with 20% reported cases. 74 The various multi-ingredient products such as Herbalife, Oxy ELITE Pro and Hydroxycut have also been linked to severe liver injury cases. 76 Although the consumption of average amounts of GTE appears to be safe and harmless, this belief is often inaccurate and excessive doses have been associated with catechin-induced hepatocellular injury.…”

“…Of note, several adverse events induced by multi-ingredient products with a high score of RUCAM scale (highly probable) were reported. 74 For example, the intake of Herbalife supplements has been reported with acute liver injury cases. 79 , 80 As Herbalife composed of complex mixtures of plants and herbs, this hinders the identification of the exact ingredient causing the hepatotoxic effects.…”

Efeitos da sinefrina em associação com cafeína na indução de citotoxicidade, danos no DNA e modulação da expressão de genes relacionados à apoptose em células de hepatocarcinoma humano in vitro

“…Uma série de riscos à saúde associados à ingestão de suplementos termogênicos foi descrita, como a ocorrência de lesões citotóxicas do sistema nervoso central e lesões hepáticas (GALNARES-OLALDE et al, 2019;SANTOS et al, 2021). De acordo com Santos et al (2021), a hepatotoxicidade relacionada ao consumo de suplementos dietéticos, incluindo os termogênicos, é um crescente problema de saúde global.…”