herbal dietary supplements. Here are all the damage they can cause to the liver

bb333

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Supplementi dietetici e a base di erbe. Ecco tutti i danni che possono provocare al fegato - Quotidiano Sanità


herbal dietary supplements. Here are all the damage they can cause to the liver

An exhaustive review just published in Hepatology takes stock of the situation. The dock especially anabolic steroids of bodybuilders and the products made from extracts of green tea and other herbs for those who want to lose weight. Liver damage can be characterized by cholestasis or acute liver disease square up with fulminant hepatitis requiring liver transplantation in emergency


October 1 - In Western countries is more and more frequent the use of dietary and herbal supplements (HDS); Parallel to this increased consumption in the US is the growth of liver injury induced by HDS, so that now a case of hepatotoxicity of 5 in the US is attributable to HDS. The magazine publishes Hepatology these days the state of the art of liver damage from supplmenti.
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Among the most frequently implicated agents are counted anabolic, the green tea extracts and multi-ingredient nutritional supplements (MINS). Anabolic steroids, an old acquaintance of body builders, typically induce a prolonged cholestasis and liver damage self-limited, with histological and laboratoristiche peculiar characteristics.
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In contrast, extracts of green tea and many other products, tend to cause a like-epatitico damage.
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Most cases of liver damage by HDS currently remains payable to the multi-ingredient nutritional supplements and this often makes it impossible to identify the person in charge of the side component. A step forward was made with a more stringent regulation of OTC products to ensure the purity and safety of the constituents, but to identify the harmful ingredients you need to develop a synergy between doctors, pharmacologists and toxicologists. The ultimate goal of this joint effort is obviously to adjust in a severe potentially dangerous ingredients in order to promote public safety.


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The HDS (including vitamin supplements, minerals, dietary, herbal preparations, dietary supplements) are usually bought without a prescription and taken without medical supervision. In the US dietary supplements are considered the same way as the 'food', that the 'drugs' and are assumed to be healthy, until proven otherwise. They are under the FDA's control, through the Dietary Supplement Health and Education Act (DSHEA) of 1994, a regulation that obliges the manufacturer to notify the FDA every new dietary ingredient marketed after 15 October 1994, providing information on safety before it is placed on the market. But all this does not apply to dietary ingredients placed on the market before that date. Instead of the drugs it is also not compulsory to any evidence of the effectiveness of these supplements, but at the same time is prohibited manufacturers to advertise the product with a specific type of medical claim (eg. Effective against cholesterol or against hypertension) . And 'however it allowed in advertisements remain vague, saying for example that is an adjunct of weight control or that increases physical energy.
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However you look, it is clear that advertisers stars-and-stripes work well, given that 1/3 to half the American population takes dietary supplements, a habit that generates a turnover of 36.7 billion dollars (figures 2014 ). The typical consumer is most often a woman, white and affluent; the most popular products are the vitamin and mineral supplements.
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On the front side effects, as seen, a case of hepatotoxicity of 5 in the US today is attributable to the use of dietary supplements; Also in Europe the consumption of supplements is growing steadily and the Spanish Register of liver damage induced by drugs he attributes a 13% to supplements. A survey of the population conducted in Iceland attributed instead to HDS 16% of cases of liver side effects. Much worse things are in Asia, where liver damage by HDS are 70% of the total in Singapore, 73% in South Korea, 18.6% in China and a meager 2.5% in India; a surprising finding given that the use of alternative and traditional medicines is large-scale and almost similar in all these countries.
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Anabolic steroids: more that the class of HDS, should be incorporated into that of doping or hormonal compounds, since they are typically synthetic derivatives of testosterone.
The most common side effect in the short term is jaundice. E 'in particular the use of steroids 17-alpha alkylated to have been associated for some time to a particular form of liver injury characterized by an important and prolonged jaundice. Patients are typically 'Buff' young or middle-aged who develop jaundice and itching from 1 to 6 months after initiation of anabolic steroids. There is hyperbilirubinemia (up to 40-50 mg / dl) prolonged (even 2-4 months) but transaminases are usually just moves (from 1-3 times normal); the alkaline phosphatase levels are normal or slightly high at first but tend to increase over time. Liver biopsy shows signs of canalicular cholestasis with minimal necrosis and inflammation, a bland cholestasis pattern that can also occur with estrogen based treatments.
Fatal cases are rare but severe cholestasis may be accompanied at times with renal failure severe enough to require temporary dialysis support. The treatment is based on the watchful waiting and on the administration of symptomatic itching.
It is not clear what causes cholestasis but the pattern is similar to that of benign recurrent intrahepatic cholestasis, due to mutations of ATP8B1 gene, which encodes the canalicular transporters of bile salts.
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Multi-ingredient supplements: are responsible for about two-thirds of hepatic adverse events from supplements and is always very difficult to identify the real culprit in a '' forest of ingredients that can exceed 20. One of the most often represented ingredients in these supplements are the extracts of green tea, so suspected by experts as the causative agent of acute liver injury also.
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Green tea is one of the most widely consumed beverages in the world; every day hundreds of millions of people quench their thirst with the green tea. Extract of green tea, derived from the leaves of Camellia sinensis, are attributed medicinal properties and fat-burning. In vitro, green tea extracts have anti-oxidant activity, inhibit lithogenesis and stimulate different metabolic pathways. Small human studies would show a tendency to weight loss in regular users. For this is a normal part of the supplements sold as an aid to weight loss. From 2006 onwards there have been over 50 reports published in the literature of acute liver damage with jaundice, attributed to green tea extracts; This generally appears at 1-3 months after the beginning of taking these supplements. It is usually self-limited disease, but in 10% the outcome can be fatal. It is probably -concludono authors - an idiosyncratic reaction.
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Toxicity from herbal supplements: in many cases the liver damage is not caused by the herbs declared on the label but by contaminants with toxic elements, from other unknown herbs, when not by the addition of unlawful medicinal products (such as sildenafil, statins, corticosteroids , NSAIDs). The black list of Dilin database (Drug Induced Liver Injury Network) also include black cohosh, the Kratom, valerian, Artemisia herba-alba, the Uncaria tormenting, the Ganoderma applanatum, Fallopia multiflora, fermented red rice the Garcinia cambogia.
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OxyELITEPro®: is a product sold to lose weight and put on muscle mass, which in 2013 caused a real epidemic of severe acute hepatitis (jaundice with bilirubin in one case up to 41.6 mg / dl, marked elevation of transaminases , up to more than 3,000 U / L and alkaline phosphatase) in Hawaii and was then subsequently withdrawn from the market. Liver biopsies revealed a picture of acute hepatitis from toxic; one patient died and two others were saved thanks to an emergency liver transplant. Many of the survivors have developed as a result of auto-immune hepatitis, treated with corticosteroids.
The person in charge of these issues has been identified in the addition dell'Aegeline (the main alkaloid contained in the fruit of the bael (Aegle marmelos) in this product as of March 2013.
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Diagnosis of drug-induced liver injury. It is mainly based on clinical suspicion and on drug history. Latency onset of symptoms ranges from 1 to 4 months from initiation of the supplement and the resolution is typically within 1-2 months. The deaths, as seen, are very rare.
Liver biopsy helps to exclude a chronic liver damage and other liver diseases. Typical is the histological picture hepatopathy by anabolic (bland cholestasis with cholestasis and poor canalicular hepatocyte necrosis and inflammation).
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Maria Rita Montebelli

October 1, 2016
 
The_Old_Guy

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GTE: 50 people since 2006 = 5 per year. Look out! LOL. Probably won't read the complete study to look for conflicts of interest, funding, etc...
 
Driven2lift

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Not a large issue.

Difficult to achieve unintentionally, near impossible when following label directions.

Better self Education before popping piles of pills would prevent most if not all issues
 
justhere4comm

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What he said. :). ^
 

ma70

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GTE: 50 people since 2006 = 5 per year. Look out! LOL. Probably won't read the complete study to look for conflicts of interest, funding, etc...
GTE in specific has been discussed quite a bit on this board. Some are convinced that it's blown out of proportion (as you pointed out), others are convinced its because of sourcing (heavy metal toxicity), blah blah (insert more therories here). Either way, I wouldn't be too worried.
 
GreekTheBrick

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Luckily I only use AAS
 

Wagner83

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So green tea extract , huge proprietary blends and steroids can caus liver damage, that's ok with me from what they say the problem would be heavy metal for green tea and drugs or unknown herbs for others. It makes sense to be a cautious when one decides to use a new herb and to source it from trustable suppliers.
 

criticalbench

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Mehh.. ill pass
 
justhere4comm

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Is there an English language version?

Responding based on other comments. I am not really trusting in Pharma, or doctors
 

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