Latest news with #RobertGrafton
Daily Mail
3 days ago
- General
- Daily Mail
Supplements taken by millions linked to deadly liver disease as victims share warning to others
A New Jersey father-of-five is warning people not to take herbal supplements after he was left fighting for his life due to a liver injury that he believes was caused by the remedy. Robert Grafton, 54, had been taking multiple natural supplements in an effort to improve his health, including one with turmeric in it. In early March, the former radiology technologist added something new to his regimen - a turmeric-based liquid supplement. He had seen it advertised for improving liver health on social media. However, a week later, Grafton noticed his urine had turned dark, he felt nauseous, lost his appetite and was constantly itchy. Believing his deteriorating health was tied to the supplements, he stopped consuming them and went to the hospital out of fear that he was suffering from liver failure. Testing revealed he had a drug-induced liver injury, or DILI, which caused damage to his liver due because of his excessive turmeric consumption. A DILI is often caused by any kind of medication or supplement that claims to promote muscle growth or reduce stress. These types of supplements often contain similar ingredients that can harm the liver when consumed in excess. Grafton told NBC: 'My liver enzymes were super elevated, my bilirubin (a yellowish pigment produced after red blood cell breakdown) was really high - all the signs of liver failure. 'I pretty much broke down, my wife as well. I was, at that point, thinking it was liver cancer, pancreatic cancer or something. 'It turns out I had something called a drug-induced liver injury, which came from my supplements.' The liver is responsible for numerous bodily functions, including filtering blood, processing nutrients and detoxifying the body of harmful substances, such as alcohol and drugs. It is also responsible for providing support to the immune system, clotting blood and producing bile, a fluid that helps digest fats and absorb nutrients. However, sometimes an excessive consumption of ultra-concentrated supplements, whether they are of natural ingredients or those chemically made, can cause an injury if the liver isn't able to effectively filter them out of the body, causing them to build up in toxic amounts. Dr Dina Halegoua-De Marzio, a hepatologist who treated Grafton told NBC: 'I think people assume these things are safe. 'The Number one reason we see people taking these are for good health or to supplement their health and so I don't think that they realize that there is a real risk here.' She noted that even though Grafton had stopped taking supplements after noticing he was sick, a turmeric overload had already occurred in his body and caused an injury. Grafton was taking turmeric pills that contained 2,250 milligrams of curcumin, a substance that comes from the root of the turmeric plant and black pepper extract. While it remains unclear which turmeric-filled supplement Grafton took, an average turmeric and curcumin supplement tablet brought at common convenience stores contains 500mgs of the spice. Experts claim a daily consumption of less than 2,000mgs of turmeric through supplements is considered safe. Dr Halegoua-De Marzio said: 'When you cook with turmeric, that could be really safe. But some of the supplements now are 2,000mgs plus, which is a very high dose of turmeric. 'Coupled with black pepper, the liver now has to break down that supplement and it can't. It could make it really sick.' Numerous studies have shown turmeric can improve liver health by decreasing inflammation, reducing the accumulation of fat and detoxifying the organ. However, other studies suggest natural supplements made with turmeric can also cause serious liver injury. A 2010 peer-reviewed study showed over 40,000 Americans report liver damage due to medications and supplements annually - out of which over 2,000 end up dying because of the severity of their condition. But despite scientific evidence, herbal supplements continue to become more popular. A 2024 JAMA Network study found that turmeric is the most commonly consumed supplement in the US, followed by green tea extract, ashwagandha, Garcinia cambogia, red yeast rice and black cohosh. The researchers found 15.6million Americans take supplements containing at least one of these six botanicals - mostly without a doctor's advice. The Food and Drug Administration considers herbal supplements as dietary supplements and does not regulate, oversee or approve them. Therefore, it is impossible for consumers to know whether they re actually consuming what is advertised or if it is safe. Grafton is not the only person to suffer from DILI or serious liver damage due to a supplement. In April 2025, Jenny Ramirez, experienced liver failure due to a typically innocuous ingredient called methylsulfonylmethane (MSM), which is in common over-the-counter vitamins that claim to improve hair, skin and nail health. Research has found MSM to be generally benign and even protective against liver damage. Some scientists have said, however, that MSM could exacerbate liver damage in people with pre-existing liver disease, though research and data are limited. Still, Ramirez became jaundiced, with yellowing skin and eyes. She also had to undergo surgery to remove her gallbladder because of hard deposits that had built up there, blocking the flow of bile through the liver and gallbladder. And in 2023, a 45-year-old woman was found to be suffering from herbal supplement-induced liver injury after she complained of gastric pain and nausea from consuming an herbal tea for three days to improve immunity. Responding doctors noted she showed no signs of jaundice, had a non-tender abdomen and showed signs of liver infection such as Hepatitis A. But after a series of tests and exams, they found that the presence of reishi mushroom, aloe vera and Siberian ginseng - all natural herbs - had caused her pain. As for Grafton, after finding out he had a liver injury, Grafton said his blood work had returned to normal within weeks of ceasing the supplements. Additional testing revealed no permanent damage to his liver. He said: 'The whole push with that is that you're getting a super-high, concentrated dose of turmeric and dandelion root and milk thistle, which I have always known from my medical past is good for liver health. 'It all sounded good, I thought I did enough digging.'
Yahoo
4 days ago
- Business
- Yahoo
Drug-induced liver injuries rise in the U.S. as supplements grow in popularity: What to know
It started with nausea and loss of appetite. Robert Grafton, of Turnersville, New Jersey, tried to convince himself he was just coming down with something one weekend in mid-March. Then came the itching and dark urine. Grafton, a former interventional radiology technologist whose wife is a nurse, recognized the hallmarks of liver failure. The otherwise healthy 54-year-old had a gut feeling that his herbal and dietary supplements were the culprit. 'I stopped taking everything, thank goodness,' Grafton said. 'If I hadn't known, if I was not in the medical field, I might have thought, 'Oh, I think I'm getting sick. I need to take some more of these supplements to help me feel better.'' When his symptoms had only worsened by midweek, Grafton visited his primary care physician. The doctor, he said, suspected hepatitis A, a liver infection that can be caused by consuming food or drink contaminated with the hepatitis A virus. Grafton's laboratory test results showed otherwise. 'My liver enzymes were super elevated, my bilirubin was really high — all the signs of liver failure,' Grafton said. 'I pretty much broke down, my wife as well. I was, at that point, thinking it was liver cancer, pancreatic cancer or something.' That Friday, less than a week after his symptoms had begun, Grafton was admitted to Thomas Jefferson University Hospital in Philadelphia, where he received a diagnosis. 'It turns out I had something called a drug-induced liver injury, which came from my supplements.' The liver is responsible for more than 500 functions in the human body, including filtering harmful substances from the blood. Some people's livers metabolize toxins more slowly than others, but too much of certain drugs can overwhelm even the healthiest liver. When taken in excess, acetaminophen, for example, the active ingredient in Tylenol, is among the most common causes of drug-induced liver injury, also called toxic hepatitis. Pharmaceutical products aren't solely the cause. Herbal and dietary supplements are causing liver damage with mounting prevalence. From 1995 through 2020, supplement-related liver failure requiring U.S. patients to be waitlisted for transplants increased eightfold, according to a 2022 study in the journal Liver Transplantation. In addition, a 2017 review in the journal Hepatology found that 20% of liver toxicity cases nationwide are tied to herbal and dietary supplements. Because 'multi-ingredient nutritional supplements' caused the majority of those cases, the authors said, it's hard to pinpoint which component(s) may be to blame. Whereas dietary supplements typically contain nutrients such as vitamins, minerals and amino acids from a range of sources such as fish oil, herbal supplements are a subset of dietary supplements composed of plant-based ingredients. Liver damage linked to supplements is rare. How rare is unclear. What is known is why cases are on the rise: More Americans are taking supplements. As many as 3 in 4 adults 18 and older take them, according to a 2024 survey by the Council for Responsible Nutrition, a trade group representing the dietary supplement and functional food industry. Almost 4 in 5 users said they prefer supplements to prescription or over-the-counter medications. By comparison, the 2017–2018 National Health and Nutrition Examination Survey showed that 58% of adults 20 and older had used a dietary supplement in the past 30 days. 'I think people assume these things are safe,' said Dr. Dina Halegoua-De Marzio, a Jefferson Health hepatologist who treated Grafton. 'The No. 1 reason we see people taking these are for good health or to supplement their health, and so I don't think that they realize that there is a real risk here.' Grafton was one such consumer. The father of five became more health-conscious when he hit 50, going to the gym and starting a supplement regimen that included fenugreek, DHEA, ashwagandha, L-carnitine and nitric oxide. He continued that cocktail, with few changes, for years without incident. About a month before he got sick, Grafton added turmeric pills to the mix, with the goal of reducing inflammation. Then Grafton saw the social media promo he said helped set his health crisis in motion. Ironically, he bought an advertised turmeric-based liquid supplement in part because it claims to support long-term liver health. Similar products are widely available. 'The whole push with that is that you're getting a super-high, concentrated dose of turmeric and dandelion root and milk thistle, which I have always known from my medical past is good for liver health,' Grafton said. 'It all sounded good. … I thought I did enough digging.' He fell ill within a week of adding the liquid supplement to his routine. Even though Grafton stopped the turmeric pills the day he started the turmeric drink, Halegoua-De Marzio said, turmeric overload most likely caused his liver injury. Not only was the drink ultra-concentrated; the pills contained 2,250 mg of curcumin, a substance that comes from the root of the turmeric plant. The pills also include black pepper extract, which Halegoua-De Marzio warned increases absorption twentyfold. 'When you cook with turmeric, that could be really safe. But some of the supplements now are 2,000 mg plus, which is a very high dose of turmeric,' she said. Coupled with black pepper, 'the liver now has to break down that supplement and it can't. It could make it really sick.' The supplement spectrum includes everything from powders that claim to promote muscle growth to gummies that promise to reduce stress. When it comes to herbal supplements, natural doesn't necessarily mean better or safer, Halegoua-De Marzio said. 'That's what I hear from patients all the time — 'Oh, I want something natural' — this fear of prescription medicines being unsafe,' she said, adding that while prescriptions bear their own risks, they've gone through rigorous clinical trials. Supplements aren't subjected to the same premarket testing. Among herbal ingredients tied to toxic hepatitis, turmeric is the most commonly consumed in the U.S., according to a study published last year in the journal JAMA Network Open. Following that are green tea extract, ashwagandha, Garcinia cambogia, red yeast rice and black cohosh. About 15.6 million Americans take supplements containing at least one of these six botanicals, the study found. Most reported doing so on their own, not under a doctor's advice. Prescription medications are tightly regulated and therefore more easily quantified; it's difficult to determine how many people consume supplements whose ingredients can cause liver damage. A goal of the JAMA Network Open research was to capture this magnitude — at least where herbal supplements are concerned — said co-author Dr. Robert Fontana, a professor of internal medicine at the University of Michigan Medical School. 'It's important for other doctors to know, for the general public to know,' Fontana said. 'The denominator of use is going up.' Fontana and Halegoua-De Marzio are part of the Drug-Induced Liver Injury Network, a research group backed by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. More than 1,800 patients have been enrolled since the program's 2004 inception, with 19% of cases tied to supplements. Previous research has estimated that the U.S. sees 44,000 cases of liver damage linked to medications and supplements annually, including 2,700 deaths. The actual incidence is likely higher, Fontana said. Liver failure symptoms can be vague, so some people may be unaware they have the condition. People who sought natural remedies in the form of supplements may be wary of seeing a doctor. Others, Fontana said, may be embarrassed about inadvertently harming themselves; botanical users in his 2024 research were older, wealthier and more educated than nonusers. 'When you're the patient, you're like, 'Why did this happen to me?'' Fontana said. ''What do you mean, this stuff isn't safe?'' For Joanne Slavin, a registered dietitian and professor in the department of food science and nutrition at the University of Minnesota, consumer education on the risks and rewards of supplements is critical. 'We really only know human data when something goes wrong,' she said. The Food and Drug Administration maintains a searchable database of recalls, market withdrawals and safety alerts but can't vet supplements for safety or effectiveness before they hit store shelves. Only once they're on the market does the agency have the authority to penalize 'adulterated or misbranded' products. That's thanks to the Dietary Supplement Health and Education Act of 1994, which limited the FDA's reach. The number of supplements on sale today is almost 20 times as many as three decades ago. Consuming supplements comes with risks, the FDA warns. 'Dietary supplements may contain ingredients that can have strong effects in the body, even if the ingredients are natural or plant-derived,' the agency said in a statement to NBC News. 'Adverse events are more likely to occur if consumers take supplements in high doses, take multiple supplements or take supplements instead of or in addition to medications.' According to the Council for Responsible Nutrition (CRN), dietary supplements can't make claims concerning the prevention, diagnosis, mitigation or curing of a disease. 'Dietary supplements can't say they can cure your cold, they can't say they can prevent your Alzheimer's or your cancer,' CRN President and CEO Steve Mister said. 'If you see (such) a product out there, it is blatantly illegal.' In short, he said, supplements are intended for healthy people who are trying to stay healthy. While everyone should ideally get all nutrients through a balanced diet, Slavin said, she recognizes that dietary supplements have their place. People who don't eat red meat, for instance, may need to seek an alternate source of iron. 'A supplement is fine, sure,' she said. 'But that's on the individual basis rather than the public health basis for the whole world.' Monitoring how many vitamins or mineral supplements are taken daily is straightforward, Slavin said. The federal Office of Dietary Supplements has established daily upper limits for nutrients, from vitamin A to zinc, which vary by age and sex. Calcium, for example, has an upper limit of 2,000 mg per day for adults 51 and older — including food, drink and supplements. Herbal supplements have no such boundaries and aren't as well studied. 'Everything can be toxic at a certain amount,' said Andrea Wong, CRN senior vice president of scientific and regulatory affairs. 'It's really up to the manufacturers and the researchers who are looking at these ingredients to determine what is the beneficial amount … then also look at what would be the amount where you start seeing some evidence of toxicity.' She said it's important to let your doctor know about any supplements you're taking or starting. Some supplements may interfere with prescription medications or each other, or be unsafe for people with certain medical conditions. For example, the FDA advises against taking any combination of aspirin, vitamin E, prescription warfarin or herbal supplement ginkgo biloba — all are blood thinners and may increase risk of stroke or internal bleeding. According to Fontana, some people are even genetically susceptible to supplement-induced liver damage. 'That means there's a biological basis as to why they were the one in 1,000, one in 10,000 people who took this and got into trouble,' Fontana said of supplements. 'The same thing is true for prescription drugs; we're finding genetic associations.' The federal LiverTox database is a free tool highlighting medicines and supplements linked to liver injury. The liver is usually a forgiving organ, Fontana said. Grafton's was. His hospital stay was brief, and he said his blood work had returned to normal within weeks of ceasing supplements. Additional testing revealed no permanent damage to his liver. He said he has a new lease on life and resumed his health kick — with one notable exception. 'I don't take any supplements whatsoever.' This article was originally published on
NBC News
4 days ago
- Health
- NBC News
Rates of liver injuries rise in the U.S. as supplements grow in popularity
It started with nausea and loss of appetite. Robert Grafton, of Turnersville, New Jersey, tried to convince himself he was just coming down with something one weekend in mid-March. Then came the itching and dark urine. Grafton, a former interventional radiology technologist whose wife is a nurse, recognized the hallmarks of liver failure. The otherwise healthy 54-year-old had a gut feeling that his herbal and dietary supplements were the culprit. 'I stopped taking everything, thank goodness,' Grafton said. 'If I hadn't known, if I was not in the medical field, I might have thought, 'Oh, I think I'm getting sick. I need to take some more of these supplements to help me feel better.'' When his symptoms had only worsened by midweek, Grafton visited his primary care physician. The doctor, he said, suspected hepatitis A, a liver infection that can be caused by consuming food or drink contaminated with the hepatitis A virus. Grafton's laboratory test results showed otherwise. 'My liver enzymes were super elevated, my bilirubin was really high — all the signs of liver failure,' Grafton said. 'I pretty much broke down, my wife as well. I was, at that point, thinking it was liver cancer, pancreatic cancer or something.' That Friday, less than a week after his symptoms had begun, Grafton was admitted to Thomas Jefferson University Hospital in Philadelphia, where he received a diagnosis. 'It turns out I had something called a drug-induced liver injury, which came from my supplements.' Rising rates of liver damage The liver is responsible for more than 500 functions in the human body, including filtering harmful substances from the blood. Some people's livers metabolize toxins more slowly than others, but too much of certain drugs can overwhelm even the healthiest liver. When taken in excess, acetaminophen, for example, the active ingredient in Tylenol, is among the most common causes of drug-induced liver injury, also called toxic hepatitis. Pharmaceutical products aren't solely the cause. Herbal and dietary supplements are causing liver damage with mounting prevalence. From 1995 through 2020, supplement-related liver failure requiring U.S. patients to be waitlisted for transplants increased eightfold, according to a 2022 study in the journal Liver Transplantation. In addition, a 2017 review in the journal Hepatology found that 20% of liver toxicity cases nationwide are tied to herbal and dietary supplements. Because 'multi-ingredient nutritional supplements' caused the majority of those cases, the authors said, it's hard to pinpoint which component(s) may be to blame. Whereas dietary supplements typically contain nutrients such as vitamins, minerals and amino acids from a range of sources such as fish oil, herbal supplements are a subset of dietary supplements composed of plant-based ingredients. Liver damage linked to supplements is rare. How rare is unclear. What is known is why cases are on the rise: More Americans are taking supplements. As many as 3 in 4 adults 18 and older take them, according to a 2024 survey by the Council for Responsible Nutrition, a trade group representing the dietary supplement and functional food industry. Almost 4 in 5 users said they prefer supplements to prescription or over-the-counter medications. By comparison, the 2017–2018 National Health and Nutrition Examination Survey showed that 58% of adults 20 and older had used a dietary supplement in the past 30 days. 'I think people assume these things are safe,' said Dr. Dina Halegoua-De Marzio, a Jefferson Health hepatologist who treated Grafton. 'The No. 1 reason we see people taking these are for good health or to supplement their health, and so I don't think that they realize that there is a real risk here.' Grafton was one such consumer. The father of five became more health-conscious when he hit 50, going to the gym and starting a supplement regimen that included fenugreek, DHEA, ashwagandha, L-carnitine and nitric oxide. He continued that cocktail, with few changes, for years without incident. About a month before he got sick, Grafton added turmeric pills to the mix, with the goal of reducing inflammation. Then Grafton saw the social media promo he said helped set his health crisis in motion. Ironically, he bought an advertised turmeric-based liquid supplement in part because it claims to support long-term liver health. Similar products are widely available. 'The whole push with that is that you're getting a super-high, concentrated dose of turmeric and dandelion root and milk thistle, which I have always known from my medical past is good for liver health,' Grafton said. 'It all sounded good … I thought I did enough digging.' He fell ill within a week of adding the liquid supplement to his routine. Despite Grafton stopping the turmeric pills the day he started the turmeric drink, Halegoua-De Marzio said, turmeric overload likely caused his liver injury. Not only was the drink ultra-concentrated, the pills contained 2,250 mg of curcumin, a substance that comes from the root of the turmeric plant. The pills also include black pepper extract, which Halegoua-De Marzio warned increases absorption twentyfold. 'When you cook with turmeric, that could be really safe. But some of the supplements now are 2,000 mg plus, which is a very high dose of turmeric,' she said. Coupled with black pepper, 'the liver now has to break down that supplement and it can't. It could make it really sick.' The supplement spectrum includes everything from powders that claim to promote muscle growth to gummies that promise to reduce stress. When it comes to herbal supplements, natural doesn't necessarily mean better or safer, Halegoua-De Marzio said. 'That's what I hear from patients all the time — 'Oh, I want something natural' — this fear of prescription medicines being unsafe,' she said, adding that while prescriptions bear their own risks, they've gone through rigorous clinical trials. Supplements aren't subjected to the same premarket testing. Among herbal ingredients tied to toxic hepatitis, turmeric is the most commonly consumed in the U.S., according to a study published last year in the journal JAMA Network Open. Following that are green tea extract, ashwagandha, Garcinia cambogia, red yeast rice and black cohosh. About 15.6 million Americans take supplements containing at least one of these six botanicals, the study found. Most reported doing so on their own, not under a doctor's advice. Prescription medications are tightly regulated and therefore more easily quantified; it's difficult to determine how many people consume supplements whose ingredients can cause liver damage. A goal of the JAMA Network Open research was to capture this magnitude — at least where herbal supplements are concerned — said co-author Dr. Robert Fontana, a professor of internal medicine at the University of Michigan Medical School. 'It's important for other doctors to know, for the general public to know,' Fontana said. 'The denominator of use is going up.' Fontana and Halegoua-De Marzio are part of the Drug-Induced Liver Injury Network, a research group backed by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. More than 1,800 patients have been enrolled since the program's 2004 inception, with 19% of cases tied to supplements. Previous research has estimated that the U.S. sees 44,000 cases of liver damage linked to medications and supplements annually, including 2,700 deaths. The actual incidence is likely higher, Fontana said. Liver failure symptoms can be vague, so some people may be unaware they have the condition. People who sought natural remedies in the form of supplements may be wary of seeing a doctor. Others, Fontana said, may be embarrassed about inadvertently harming themselves; botanical users in his 2024 research were older, wealthier and more educated than nonusers. 'When you're the patient, you're like, 'Why did this happen to me?'' Fontana said. ''What do you mean, this stuff isn't safe?'' FDA doesn't monitor supplement safety before sale For Joanne Slavin, a registered dietician and professor in the department of food science and nutrition at the University of Minnesota, consumer education on the risks and rewards of supplements is critical. 'We really only know human data when something goes wrong,' she said. The Food and Drug Administration maintains a searchable database of recalls, market withdrawals and safety alerts but can't vet supplements for safety or effectiveness before they hit store shelves. Only once they're on the market does the agency have the authority to penalize 'adulterated or misbranded' products. That's thanks to the Dietary Supplement Health and Education Act of 1994, which limited the FDA's reach. The number of supplements on sale today is almost 20 times as many as three decades ago. Consuming supplements comes with risks, the FDA warns. 'Dietary supplements may contain ingredients that can have strong effects in the body, even if the ingredients are natural or plant-derived,' the agency said in a statement to NBC News. 'Adverse events are more likely to occur if consumers take supplements in high doses, take multiple supplements or take supplements instead of or in addition to medications.' According to the Council for Responsible Nutrition (CRN), dietary supplements can't make claims concerning the prevention, diagnosis, mitigation or curing of a disease. 'Dietary supplements can't say they can cure your cold, they can't say they can prevent your Alzheimer's or your cancer,' CRN President and CEO Steve Mister said. 'If you see (such) a product out there, it is blatantly illegal.' Dietary supplements have their place In short, he said, supplements are intended for healthy people who are trying to stay healthy. While everyone should ideally get all nutrients through a balanced diet, Slavin said, she recognizes that dietary supplements have their place. People who don't eat red meat, for instance, may need to seek an alternate source of iron. 'A supplement is fine, sure,' she said. 'But that's on the individual basis rather than the public health basis for the whole world.' Monitoring how many vitamins or mineral supplements are taken daily is straightforward, Slavin said. The federal Office of Dietary Supplements has established daily upper limits for nutrients, from vitamin A to zinc, which vary by age and sex. Calcium, for example, has an upper limit of 2,000 mg per day for adults 51 and older — including food, drink and supplements. Herbal supplements have no such boundaries and aren't as well studied. 'Everything can be toxic at a certain amount,' said Andrea Wong, CRN senior vice president of scientific and regulatory affairs. 'It's really up to the manufacturers and the researchers who are looking at these ingredients to determine what is the beneficial amount … then also look at what would be the amount where you start seeing some evidence of toxicity.' She said it's important to let your doctor know about any supplements you're taking or starting. Some supplements may interfere with prescription medications or each other, or be unsafe for people with certain medical conditions. For example, the FDA advises against taking any combination of aspirin, vitamin E, prescription warfarin or herbal supplement ginkgo biloba — all are blood thinners and may increase risk of stroke or internal bleeding. According to Fontana, some people are even genetically susceptible to supplement-induced liver damage. 'That means there's a biological basis as to why they were the one in 1,000, one in 10,000 people who took this and got into trouble,' Fontana said of supplements. 'The same thing is true for prescription drugs; we're finding genetic associations.' The federal LiverTox database is a free tool highlighting medicines and supplements linked to liver injury. The liver is usually a forgiving organ, Fontana said. Grafton's was. His hospital stay was brief, and he said his blood work had returned to normal within weeks of ceasing supplements. Additional testing revealed no permanent damage to his liver. He said he has a new lease on life and resumed his health kick — with one notable exception.
