5 Everyday Medicines and Supplements That Can Seriously Damage Your Liver
Kamal Singh|Newsdesk7
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New Delhi: Alcohol is widely recognised as a major cause of liver disease, but it is not the only substance that can put the liver at risk. Some common medicines, bodybuilding products and herbal or dietary supplements can also cause drug-induced liver injury (DILI), particularly when taken in excessive doses, for prolonged periods or without medical supervision.
New Delhi: Alcohol is widely recognised as a major cause of liver disease, but it is not the only substance that can put the liver at risk. Some common medicines, bodybuilding products and herbal or dietary supplements can also cause drug-induced liver injury (DILI), particularly when taken in excessive doses, for prolonged periods or without medical supervision.
Importantly, there is no scientifically valid universal ranking showing that these substances are “more harmful than alcohol.” Their risk depends on the substance, dose, duration of use and an individual's health. Some can, however, cause severe or even acute liver injury in susceptible people.
Here are five important categories to know about.
1. Paracetamol (Acetaminophen)
Paracetamol is one of the most widely used painkillers and fever medicines worldwide. When taken at excessive doses, it can cause severe liver injury and acute liver failure.
The liver converts paracetamol into several metabolites. At high doses, a toxic metabolite called NAPQI can accumulate after the body's protective glutathione stores become depleted.
The risk can increase when people accidentally take multiple medicines containing paracetamol at the same time.
Key warning: Always check the active ingredients of combination cold, flu and pain medicines before taking additional paracetamol.
2. Bodybuilding and Anabolic Steroid Products
Products marketed for muscle building and performance enhancement can pose a serious risk to the liver, particularly those containing anabolic steroids or steroid-like substances.
Anabolic steroids have been associated with a characteristic form of liver injury that can cause cholestasis, jaundice and severe itching. The US FDA has also reported cases of serious liver injury requiring hospitalisation among users of bodybuilding products suspected of containing steroids.
Some products may also contain undeclared ingredients, making their potential risks difficult to predict.
3. Herbal and Weight-Loss Supplements
The word “natural” does not automatically mean “safe for the liver.”
Certain herbal and dietary supplements have been associated with liver injury. Green tea extract, particularly in concentrated supplement form, has been linked to cases of acute liver injury. Multi-ingredient weight-loss and nutritional products can also be difficult to assess because they may contain several active ingredients.
The risk is different from drinking ordinary green tea, since supplements may contain highly concentrated extracts.
Consumers should be particularly cautious with products making rapid “fat-burning,” “detox” or “body cleansing” claims.
4. Certain Antibiotics
Antibiotics are among the most important medication groups associated with drug-induced liver injury.
Amoxicillin-clavulanate, for example, is recognised as one of the more common causes of idiosyncratic drug-induced liver injury. Other antibiotics can also affect the liver in susceptible individuals.
In many cases, this type of liver injury is unpredictable and may occur even when a medicine has been taken at the prescribed dose.
That is why antibiotics should be taken only when prescribed and according to medical advice.
5. Certain Anti-Tuberculosis Medicines
Medicines used to treat tuberculosis can also affect the liver.
Isoniazid (INH) is among the medications associated with liver injury and can cause significant hepatocellular damage in some patients. Other anti-tuberculosis drugs may also require monitoring depending on the treatment regimen and patient's risk factors.
Doctors may therefore recommend liver-function monitoring during certain TB treatments.
Why the Liver Is Vulnerable
The liver processes many medicines and chemicals that enter the body. During this process, some substances can produce metabolites that may damage liver cells.
Drug-induced liver injury can take several forms, including:
Elevated liver enzymes Hepatitis-like inflammation Cholestasis and jaundice Fat accumulation Severe liver-cell damage In rare cases, acute liver failure
The reaction may be dose-dependent for some substances, while other drug-related liver injuries are unpredictable and can occur in susceptible individuals even at therapeutic doses.
Warning Signs of Liver Injury
People taking medicines or supplements should seek medical attention if they develop symptoms such as:
Yellowing of the eyes or skin Dark urine Unusual or persistent nausea Severe fatigue Loss of appetite Abdominal discomfort Persistent itching Pale-coloured stools
These symptoms can have many causes and do not automatically mean liver damage, but they warrant medical evaluation.
Should You Stop Your Medicines?
Do not stop prescribed medication on your own.
If you suspect that a medicine or supplement is affecting your liver, speak to your doctor. Some treatments are medically essential, and abruptly stopping them can create other health risks.
People should also tell their doctor about all supplements, herbal products, gym products and over-the-counter medicines they use.
Alcohol and Medicines Can Be a Risky Combination
Another important issue is combining alcohol with certain medicines.
Chronic heavy alcohol use can increase susceptibility to liver injury from excessive paracetamol use, among other factors.
This is one reason people should avoid assuming that an over-the-counter medicine is automatically harmless simply because it is easily available.
The Bottom Line
Alcohol is certainly an important cause of liver disease, but medicines and supplements can also cause serious liver injury.
Paracetamol overdose, anabolic-steroid-containing bodybuilding products, concentrated herbal supplements such as green-tea extract, certain antibiotics and some anti-tuberculosis medicines are among the substances associated with liver injury.
The key message is not to fear necessary medicines—it is to use medicines at the recommended dose, avoid unnecessary supplements and tell healthcare professionals about everything you are taking.
