Can supplement intake cause liver damage? Here's all you need to know | Interview

Supplements are all the rage for various goals—from great hair to weight loss.

Dr. Pramod V Satya, Consultant - Internal Medicine, Manipal Hospital, weighs in on whether these can be taken just based on what advertising/social media/friends or the local chemist tell us.

Q/ What are supplements?

A/ Supplements or nutraceuticals are enhancers for various health-related goals like rapid weight loss, managing disturbed sleep, cognitive improvement, sports, or sexual performance.

They are rarely used for issues like knee pain, cramps, joint pain, and similar conditions. But, most of the supplements we use are not specifically made for or approved to treat these problems.

Q/ How much is too much?

A/ Any supplement we take must be digested or metabolised by the liver, and once its job is done, it is excreted by the kidneys.

Excess use of these supplements can cause adverse effects like hepatotoxicity (liver damage) or kidney problems. Hepatotoxicity is a common side effect of many supplements- for example commonly used weight loss agents like Herbalife and Hydroxycut. Other supplements like herbal products, which contain high-quality fibres and various natural ingredients, can put significant stress on the liver, leading to liver damage.

Q/ What are some adverse effects of Hepatotoxicity?

A/ Hepatotoxicity can result in vomiting, nausea, stomach pain, loose stools, abdominal pain, and, in some cases, joint pain. Sometimes, it can cause a severe acute liver cell injury, which may require a liver transplant, and in rare instances, can even lead to death.

Q/ What about energy boosters, vitamins, and more?

A/ The widespread use of, say vitamin D and magnesium, which many of us often consume without a prescription is also a cause of concern. While the US FDA defines the normal range of vitamin D levels as 30 to 90 ng/mL, the Indian Council of Medical Research (ICMR) suggests that a level between 7 and 12 ng/mL is sufficient for Indians to remain symptom-free.

Vitamin D plays a crucial role in calcium metabolism. It helps in the absorption of calcium from the intestine and reduces the urine and the loss of calcium. However, too much vitamin D can cause hypercalcemia (high calcium levels), which leads to headaches, nausea, confusion, abdominal pain, cramps, and in severe cases, cardiac arrhythmias and kidney damage. Therefore, vitamin D levels must be carefully maintained within the optimal range. Long-term overdose of vitamin D is more harmful than deficiency.

Q/ Could you provide a lowdown on sports supplements?

A/ Substance misuse is quite prevalent among sports enthusiasts who consider enhancers like creatine, amino acids, and partially digested protein supplements. Unlike the popular norm, taking these sports enhancers just before the exercise/gym session is not recommended, especially in large quantities.

High protein intake can put extra pressure on the kidneys, as proteins are metabolised into urea, uric acid, and other nitrogenous waste products, which must be excreted by the kidneys.

Although supplements like creatine are very well-studied and relatively safe when used appropriately, many protein mixtures in the market add other ingredients that may not be as well-studied and lead to proteinuria (excess protein in urine), a sign of kidney damage, and nephrotic syndrome where there is significant protein loss, water accumulation and swelling (edema) in the body, and progressive kidney damage.

The final word

Take supplements with caution when prescribed by a physician. Avoid over-the-counter medications.

Most of these nutraceuticals can be found in a balanced diet. If you eat a balanced diet and your intestines can effectively absorb nutrition, then you don't need any additional supplements.

If contemplating taking such products, visit an expert who can assess whether your liver, kidneys, and overall metabolism are functioning well to safely process and eliminate these substances.

Health