title: Acute liver failure caused by 'fat burners' and dietary supplements: a case report and literature review.
abstract: Globally, people are struggling with obesity. Many effective, nonconventional methods of weight reduction, such as herbal and natural dietary supplements, are increasingly being sought. Fat burners are believed to raise metabolism, burn more calories and hasten fat loss. Despite patient perceptions that herbal remedies are free of adverse effects, some supplements are associated with severe hepatotoxicity. The present report describes a young healthy woman who presented with fulminant hepatic failure requiring emergent liver transplantation caused by a dietary supplement and fat burner containing usnic acid, green tea and guggul tree extracts. Thorough investigation, including histopathological examination, revealed no other cause of hepatotoxicity. The present case adds to the increasing number of reports of hepatotoxicity associated with dietary supplements containing usnic acid, and highlights that herbal extracts from green tea or guggul tree may not be free of adverse effects. Until these products are more closely regulated and their advertising better scrutinized, physicians and patients should become more familiar with herbal products that are commonly used as weight loss supplements and recognize those that are potentially harmful.
authors.affiliation: Division of Liver Diseases, Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY 10029, USA.
authors.forename: Radha K
authors.initials: RK
authors.lastname: Yellapu
authors.forename: Vivek
authors.initials: V
authors.lastname: Mittal
authors.forename: Priya
authors.initials: P
authors.lastname: Grewal
authors.forename: Mariaisabel
authors.initials: M
authors.lastname: Fiel
authors.forename: Thomas
authors.initials: T
authors.lastname: Schiano
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism; D000328:Adult; D001572:Benzofurans / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D028241:Camellia sinensis / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism; D029744:Commiphora / Q000009:adverse effects; D019587:Dietary Supplements / Q000009:adverse effects / Q000032:analysis; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D016031:Liver Transplantation; D008991:Monitoring, Physiologic; D009765:Obesity / Q000188:drug therapy* / Q000378:metabolism; D008517:Phytotherapy / Q000009:adverse effects*; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D053149:Plant Gums / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D013662:Tea / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
chemical_list: D001572:Benzofurans; D000960:Hypolipidemic Agents; D010936:Plant Extracts; D053149:Plant Gums; D028321:Plant Preparations; D013662:Tea; C073339:usnic acid; C018562:guggulu extract