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In USA there are growing reports of liver injury from HDS, i.e. herbals and dietary supplements (vitamins, minerals, dietary, herbal preparations). HDS account for 20% of cases of liver toxicity in Usa, where 30% population consumes them regularly.
Hepatology published a full report. The products more often accused are:
Anabolic steroids: their most common side effect in the short term is jaundice.
Extracts of green tea: since 2006 there have been over 50 literature reports of acute liver damage with jaundice.
Multi-ingredient dietary supplements are responsible for about two thirds of liver problems. It is difficult to identify the component responsible for the side effect because the ingredients can be up to 20.
Herbal supplements: often the liver damage is not caused by herbal products declared on the label, but it is determined by contaminants with toxic elements, by other unknown herbs or illicit drugs.
The consumption of supplements grows even in Europe. The Spanish Register of liver injury by drugs attributes to them 13% of cases. A worse situation is found in Asia, where liver damage by HDS are 70% of the total in Singapore, 73% in South Korea, 18.6% in China.