A new study has revealed a rising number of Australians are being hospitalised with severe liver injuries caused by herbal and dietary supplements, particularly those marketed for muscle growth or weight loss. Researchers from Royal Prince Alfred Hospital examined records of 184 adults admitted with drug-induced liver injury between 2009 and 2020, finding that cases linked to supplements increased from 15% of patients in 2009–11 to 47% in 2018–20.
The study, published in the Medical Journal of Australia, found that of 69 patients with non-paracetamol liver injury, 15 cases were linked to herbal and dietary supplements. Transplant-free survival was worse for these patients compared to those with paracetamol-related injuries. Co-author Dr Ken Liu noted a growing trend of liver injuries from bodybuilding and weight loss supplements, prompting the investigation.
Dr Liu and colleagues called for stricter regulatory oversight of supplements, highlighting that nearly half of the patients with supplement-induced severe liver injury were from non-European ethnic backgrounds, suggesting a need for culturally appropriate education. Public health physician Dr Ken Harvey warned that the study only captured severe cases, meaning the true rate of harm is likely higher.
The Therapeutic Goods Administration (TGA) introduced regulations in 2018 requiring complementary medicines to use approved indications, but critics say the industry was allowed to create the list, with 86% of indications justified by traditional rather than scientific evidence. Harvey noted that supplements purchased online from overseas evade Australian oversight, and called for more post-marketing surveillance and public disclosure of findings.
