Dietary Supplement and Liver (Organ) Damage

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Discussion Overview

The discussion centers on the potential risks associated with dietary supplements, particularly their link to liver damage and the regulation of these products by the FDA. Participants explore the implications of excessive vitamin intake, especially Vitamin D, and the lack of oversight in the supplement industry.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • Some participants highlight that dietary supplements account for a significant percentage of drug-related liver injuries, with a noted increase over the past decade.
  • Concerns are raised about the lack of regulation by the FDA regarding the safety and efficacy of dietary supplements, with manufacturers not required to register products or obtain approval before selling them.
  • Excessive intake of Vitamin D is discussed, with some participants noting that it can lead to hypercalcemia and potential organ damage, including to the liver.
  • One participant mentions that their wife's doctors recommended high doses of Vitamin D without warning about possible side effects, raising questions about medical advice and patient safety.
  • Another participant references a study indicating that many dietary supplements contain unlisted ingredients or contaminants, which could pose health risks.
  • There is a discussion about the phenomenon of hypervitaminosis, particularly in relation to walrus liver consumption, with some participants sharing anecdotal knowledge about dietary practices in certain cultures.

Areas of Agreement / Disagreement

Participants express concerns about the safety of dietary supplements and the potential for liver damage, but there is no consensus on the extent of the risks or the adequacy of current regulations. Multiple viewpoints regarding Vitamin D intake and its implications are presented, indicating ongoing debate.

Contextual Notes

Limitations include the lack of comprehensive studies on the majority of dietary supplements, the variability in individual responses to vitamin intake, and the potential for contamination in products. The discussion reflects a range of personal experiences and interpretations of available information.

Astronuc
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http://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html

New data suggests that his is not an isolated case. Dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from 7 percent a decade ago, according to an analysis by a national network of liver specialists. The research included only the most severe cases of liver damage referred to a representative group of hospitals around the country, and the investigators said they were undercounting the actual number of cases.

While many patients recover once they stop taking the supplements and receive treatment, a few require liver transplants or die because of liver failure. Naive teenagers are not the only consumers at risk, the researchers said. Many are middle-aged women who turn to dietary supplements that promise to burn fat or speed up weight loss.

. . . .
I'm aware that excessive vitamins can cause liver damage. Too much Vitamin D can be harmful to the liver.

“There unfortunately are criminals that feel it’s a business opportunity to spike some products and sell them as dietary supplements,” said Duffy MacKay, a spokesman for the Council for Responsible Nutrition, a supplement industry trade group. “It’s the fringe of the industry, but as you can see, it is affecting some consumers.” More popular supplements like vitamins, minerals, probiotics and fish oil had not been linked to “patterns of adverse effects,” he said.

The F.D.A. estimates that 70 percent of dietary supplement companies are not following basic quality control standards that would help prevent adulteration of their products. Of about 55,000 supplements that are sold in the United States, only 170 — about 0.3 percent — have been studied closely enough to determine their common side effects, said Dr. Paul A. Offit, the chief of infectious diseases at the Children’s Hospital of Philadelphia and an expert on dietary supplements.
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Astronuc said:
http://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html

I'm aware that excessive vitamins can cause liver damage. Too much Vitamin D can be harmful to the liver.

Thanks for the note on Vitamin D Astronuc. My wife's doctors have been trying to get her to take excessive amounts because her Vitamin D levels are under 30. However, not once have they warned us of the potential consequences of taking their recommended 5000 IU/day. Your note on too much Vitamin D inspired me to look at the Wikipedia article on it and the section on excessive Vitamin D intake was an eye opener.

In healthy adults, sustained intake of more than 1250 micrograms/day (50,000 IU) can produce overt toxicity after several months...

...hypercalcemia is a strong indication of vitamin D toxicity...

If hypercalcemia is not treated, it results in excess deposits of calcium in soft tissues and organs such as the kidneys, liver, and heart, resulting in pain and organ damage.

Kidney damage may be irreversible.
 
Dietary supplements are completely unregulated by the FDA for either safety or efficacy:
Generally, manufacturers do not need to register their products with FDA or get FDA approval before producing or selling dietary supplements. Manufacturers must make sure that product label information is truthful and not misleading.
(http://www.fda.gov/food/dietarysupplements/)

All the FDA does is make sure that dietary supplement manufacturers do not claim that their products treat specific diseases (even though plenty of others will make these claims).

Furthermore, a recent study found that most dietary supplements contain material not listed on the label (some of which like soy, wheat or nuts can be harmful to people with allergies) and some don't even contain the active ingredient!

Most (59%) of the products tested contained DNA barcodes from plant species not listed on the labels. Although we were able to authenticate almost half (48%) of the products, one-third of these also contained contaminants and or fillers not listed on the label. Product substitution occurred in 30/44 of the products tested and only 2/12 companies had products without any substitution, contamination or fillers. Some of the contaminants we found pose serious health risks to consumers.

Newmaster et al. 2013. DNA barcoding detects contamination and substitution in North American herbal products. BMC Medicine 11: 222. doi:10.1186/1741-7015-11-222
 
Borg said:
Thanks for the note on Vitamin D Astronuc. My wife's doctors have been trying to get her to take excessive amounts because her Vitamin D levels are under 30. However, not once have they warned us of the potential consequences of taking their recommended 5000 IU/day. Your note on too much Vitamin D inspired me to look at the Wikipedia article on it and the section on excessive Vitamin D intake was an eye opener.
My last blood test showed that I have hypercalcemia, all my doctor did was check my thyroid (which is fine). But I don't take vitamin D supplements, I guess I need to ask him to check my vitamin D levels, thanks Borg!
 
Borg said:
Thanks for the note on Vitamin D Astronuc. My wife's doctors have been trying to get her to take excessive amounts because her Vitamin D levels are under 30. However, not once have they warned us of the potential consequences of taking their recommended 5000 IU/day. Your note on too much Vitamin D inspired me to look at the Wikipedia article on it and the section on excessive Vitamin D intake was an eye opener.
My daughter and I were advised to take Vitamin D supplement, but only on the order of 1000 IU/day, or less, and would take that every other day. I think 5000 IU/day is excessive and unnecessary.

I knew about excessive Vitamin-D, from news story about walrus liver. Older walruses may have a diet such that they have high levels of Vit-D. It is possible to get hypervitaminosis from eating those livers.

Hypervitaminosis is a possibility if one overdoes (or overdoses on) vitamins.

http://en.wikipedia.org/wiki/Hypervitaminosis_D

http://en.wikipedia.org/wiki/Hypervitaminosis_A
 
Astronuc said:
I knew about excessive Vitamin-D, from news story about walrus liver. Older walruses may have a diet such that they have high levels of Vit-D. It is possible to get hypervitaminosis from eating those livers.

Where is walrus liver a popular dish? :)