Unveiling the hidden risk: Herbal and dietary supplement consumption in liver disease patients.

INTRODUCTION

The use of herbal products and dietary supplements (HDS) carries a potential risk of liver toxicity. Data on HDS consumption among patients attending liver disease clinics remain unexplored.

OBJECTIVE

To determine the frequency, types and reasons for HDS consumption in patients attending a specialized liver disease outpatient clinic.

METHODS

Prospective study including consecutive patients attending the hepatology outpatient clinic at the Hospital Clínic of Barcelona from June 2023 to October 2023. Following a standard medical visit, a trained nurse conducted a structured interview to assess HDS consumption.

RESULTS

A total of 150 patients were included, with a median age of 59 (IQR: 49-67) and male predominance (56%, n=84). Only 12 patients (8%) reported HDS consumption during a standard medical interview, while the number increased to 92 (61%) after nurse-led structured interview. The primary reasons for dietary supplements use included vitamin supplementation (43%), fitness improvement (10.5%) and hair/nail health (10.5%). For herbal products, the most common reason for use was pleasure (73%). Reported HDS products with potential hepatotoxicity (levels A and B) were green tea (n=16), turmeric with black pepper (n=11), aloe (n=2), greater celandine (n=1) and black cohosh (n=1).

CONCLUSION

HDS use is highly prevalent among patients with liver disease, but a structured interview is crucial to detect their consumption, as they usually forget spontaneous reporting. Importantly, a significant proportion of these products carry a risk of hepatic toxicity, underscoring the need for increased patient education and clinical vigilance.