title: Hepatotoxicity by Dietary Supplements: A Tabular Listing and Clinical Characteristics.
abstract: Dietary supplements (DS) are extensively consumed worldwide despite unproven efficacy. The true incidence of DS-induced liver injury (DSILI) is unknown but is probably under-diagnosed due to the general belief of safety of these products. Reported cases of herbals and DS-induced liver injury are increasing worldwide. The aim of this manuscript is to report a tabular listing with a description of DS associated with hepatotoxicity as well as review the phenotype and severity of DSILI. Natural remedies related to hepatotoxicity can be divided into herbal product-induced liver injury and DS-induced liver injury. In this article, we describe different DS associated with liver injury, some of them manufactured DS containing several ingredients (Herbalife™ products, Hydroxycut™, LipoKinetix™, UCP-1 and OxyELITE™) while others have a single ingredient (green tea extract, linoleic acid, usnic acid, 1,3-Dimethylamylamine, vitamin A, Garcinia cambogia and ma huang). Additional DS containing some of the aforementioned ingredients implicated in liver injury are also covered. We have also included illicit androgenic anabolic steroids for bodybuilding in this work, as they are frequently sold under the denomination of DS despite being conventional drugs.
authors.affiliation: Servicio de Farmacología Clíınica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), 29010 Málaga, Spain. mirengar1@hotmail.com.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. mirengar1@hotmail.com.
authors.forename: Miren
authors.initials: M
authors.lastname: García-Cortés
authors.affiliation: Servicio de Farmacología Clíınica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), 29010 Málaga, Spain. mrobles@uma.es.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. mrobles@uma.es.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Robles-Díaz
authors.affiliation: Servicio de Farmacología Clíınica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), 29010 Málaga, Spain. aida_ortega_alonso@hotmail.com.
authors.forename: Aida
authors.initials: A
authors.lastname: Ortega-Alonso
authors.affiliation: Servicio de Farmacología Clíınica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), 29010 Málaga, Spain. imcaliz@uma.es.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Medina-Caliz
authors.affiliation: Servicio de Farmacología Clíınica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), 29010 Málaga, Spain. andrade@uma.es.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. andrade@uma.es.
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Andrade
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology / Q000209:etiology*; D002986:Clinical Trials as Topic; D019587:Dietary Supplements / Q000032:analysis / Q000633:toxicity*; D005260:Female; D006801:Humans; D008297:Male; D028321:Plant Preparations / Q000737:chemistry / Q000633:toxicity; D010946:Plants, Medicinal / Q000737:chemistry / Q000633:toxicity; D045165:Testosterone Congeners / Q000737:chemistry / Q000633:toxicity
chemical_list: D028321:Plant Preparations; D045165:Testosterone Congeners
keywords: Herbalife products; Hydroxycut; Oxyelite Pro; anabolic steroids; dietary supplements; green tea; hepatotoxicity; liver injury; usnic acid; vitamin A