A survey has revealed a startling find: around 7% of U.S. adults, totaling more than 15 million, consume at least one of the six most popular botanicals that have the potential to harm the liver. Among these, turmeric is the most commonly used, followed by green tea, ashwagandha, Garcinia cambogia, red yeast rice, and black cohosh.

A research team led by Dr. Alisa Likhitsup, from the University of Michigan, Ann Arbor conducted the survey study by analyzing nationally representative data from 9,685 adults who are part of the National Health and Nutrition Examination Survey (NHANES). The results of the study were published in Jama Network Open.

The researchers found that over 11 million adults regularly take turmeric supplements for pain relief or arthritis, a figure close to 14.8 million who use NSAID pain relievers for similar purposes. However, despite turmeric's popularity, multiple randomized clinical trials have failed to show any real benefit for osteoarthritis, the researchers said.

Another 3 million adults take green tea extracts for their touted benefits of boosting energy and weight loss. However, the researchers noted that "multiple studies have failed to demonstrate any objective evidence of weight loss and sustained improvement in mood or energy levels" from catechins or polyphenols found in green tea extract.

Garcinia cambogia is often claimed to aid weight loss, black cohosh is said to ease hot flashes, and ashwagandha is touted for muscle building. However, many of these claims lack strong scientific evidence.

The researchers also observed that the lack of regulations for botanicals often leads to discrepancies between product labels and actual ingredients, which can mislead consumers. Driven by misleading claims, consumers may also overdose on these products.

"In this survey study, an estimated 15.6 million US adults consumed at least 1 botanical product with liver liability within the past 30 days, comparable with the number of people who consumed nonsteroidal anti-inflammatory drugs and a commonly prescribed hypolipidemic drug. Given a lack of regulatory oversight on the manufacturing and testing of botanical products, clinicians should be aware of possible adverse events from the consumption of these largely unregulated products," the researchers wrote.

The study noted that typical users of botanical supplements would be elderly White females with an average age of 52, often financially stable. Many of them had chronic conditions like arthritis, thyroid disorders, or cancer. Around two-thirds of botanical users were taking these supplements alongside prescription medications. The researchers cautioned that it is essential for these individuals to inform their doctors about their supplement use to avoid potential drug interactions and protect liver health.

A national database reveals a striking increase in liver toxicity cases linked to botanical use, with severe or even fatal instances nearly tripling from 7% in 2004 to 20% in 2014.

"Considering the widespread and growing popularity of botanical products, we urge government authorities to consider increasing the regulatory oversight on how botanicals are produced, marketed, tested and monitored in the general population," the researchers added.

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