Effects of dietary supplements on the liver

The current consensus among clinical and nutritional circles is that healthy people who eat a normal diet and take dietary supplements by themselves not only have no additional benefit to the liver, but have a probability of about 15% to increase unnecessary metabolic burden, and in severe cases can induce drug-induced liver damage.； However, for people with clear nutrient deficiencies or specific disease needs, supplementing compliant dietary supplements according to the dosage and dosage as prescribed by their doctor can help improve the metabolic state of the liver and reduce the risk of liver disease progression.

When I was rotating in the gastroenterology ward last year, I took in a 32-year-old e-commerce operator. When she came in, her sclera was as yellow as strong tea. When I checked, the alanine aminotransferase soared to 420, which is more than 8 times the normal value. After asking for medical history for a long time, she neither had hepatitis nor drank alcohol. She usually ordered light meals even for takeout. Finally, she rummaged through her bag and found a bunch of bottles and jars: grape seed essence, collagen peptides, milk thistle liver protection tablets, resveratrol anti-sugar pills, and a fat-burning tablet that was said to be "purely extracted from plants." She calculated that she had to take 11 supplements a day, which was more punctual than eating. The director in charge of the bed at that time shook his head and said that he had admitted seven patients with similar conditions to hers in the past six months, all of whom had liver damage caused by taking supplements blindly. Don’t think this is a low-probability event. Survey data published by Gastroenterology in the past two years show that 21% of patients with drug-induced liver damage in my country are caused by the abuse of dietary supplements, which is higher than traditional antibiotic-based liver damage.

Of course, this cannot be said to death. I have friends who have been taking multivitamins for five or six years, and their annual physical examinations show that their liver functions are normal. There are also many studies in the academic community that support the statement that "reasonable supplements will not damage the liver." For example, there is a group of scholars in the nutrition field who believe that as long as the ingredients of supplements are allowed by the state and the intake is controlled within 1.5 times the recommended daily intake (RNI), it will not cause additional burden on the liver of healthy people, especially people with inherent dietary deficiencies - such as vegans lacking B12, folic acid deficiency during pregnancy, and the elderly lacking vitamin D. Supplementing the corresponding nutrients at these times will not only not harm the liver, but can help reduce metabolic stress on the liver. When I was preparing for the medical examination two years ago, I stayed up late every day for three months eating takeout. A blood test revealed that my vitamin B complex level was less than half of the normal value, and I was also prone to fatty liver disease. The doctor asked me to take 10 mg of B6 every day. After taking it for two months, I rechecked. The critical transaminase dropped directly to the normal range, and my blood lipids also dropped a bit.

To be honest, most people who have problems with supplements essentially fall into two pitfalls: either they buy substandard products, or they increase their dosage randomly. I had a meal with a friend who was doing random inspections at the Provincial Food and Drug Administration. He said that at least 30% of Internet celebrity supplements on the market now, especially those "purely natural" ones purchased cross-border and sold privately by bloggers, have not undergone clinical trials for liver toxicity. Some products that claim to "protect the liver" even secretly add milk thistle. Pyrrolizidine alkaloids are a clear hepatotoxic ingredient. Eating them is equivalent to filling the liver with a bunch of dirty bowls stained with glue. Originally, it only needs to deal with the metabolic waste produced by your meals every day, but suddenly a bunch of chemical substances that it doesn't recognize are suddenly introduced. Doesn't it have to be exhausted? Some people think that "it's a supplement, it's okay to take two more pills." For example, some people take 8 pills of vitamin C a day for whitening, which is more than ten times the recommended amount. The excess VC needs to be metabolized by the liver. If you overeat for a long time, you may develop something wrong even if you take it too much.

In fact, the academic community is not fully aware of this matter. Last year, the New England Journal of Medicine published a study saying that healthy people will not benefit from taking any dietary supplements, but will increase the metabolic risks of liver and kidneys. However, another research team published a rebuttal article shortly after. According to research data on the former, 90% of cases of liver damage are caused by excessive dosage or illegally added substandard products. If regular and compliant dietary supplements are taken in the recommended amount, the risk of liver damage is less than 0.05%, which is lower than the risk of liver damage if you take cold medicine. Both sides have obtained large sample data, and no one can convince the other, but one thing is unanimous among all experts: if you can eat 1 catty of vegetables, 3 taels of meat, 1 egg, and half a catty of staple food every day, and do not drink alcohol or stay up late for a long time, then there is really no need to take any supplements. The nutrients you take in from food are enough, and any extra supplements will be an extra burden on the liver.

When the girl who suffered liver damage from taking supplements was discharged from the hospital last time, the first note I wrote to her was to "throw away all the supplements at home that I bought without the doctor's approval." Later, during the review, she told me that she now eats normally every day and doesn't take any supplements, but her complexion is better than before when she took anti-sugar pills every day. Oh, by the way, if you are really found to be deficient in a certain nutrient during a physical examination, or if the doctor asks you to take supplements, such as N-acetyl cysteine ​​for patients with fatty liver disease or vitamin E for patients with chronic liver disease, then take it as you should. Don’t stop taking it because you read a few articles saying that supplements harm the liver. After all, we have a thousand words to say, whether supplements are good or bad for the liver, the core is never the supplement itself, but whether the way you take it is right or not.