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Today’s oncology rant is about dietary supplements and liver damage. Simultaneously one of my favorite and least favorite topics. Many (dare I say most?) patients come to me believing “natural” means safe and healthy. My breast cancer patients tend to be healthy #bcsm
Some are athletes, yoga instructors, vegan, what have you. Many are been enmeshed in some way with the wellness industry before their diagnosis. Many understand supplements won’t cure their cancer, but they certainly can’t hurt right? #MedTwitter #bcsm
Then we do their baseline labs and their liver function tests are sky high. So I ask what they are taking - I cannot tell you how often this happens (? Weekly?). Oh nothing, except turmeric, 10 different multi-vitamins, 6 different forms of CBD and some Chinese herbs.
So I tell them to stop everything. And I mean everything they are taking and they look at me in horror an disbelief. Their precious natural products surely could not be hurting their liver. I mean some were branded as a liver “detox,” it said it on the bottle!
We then have a long discussion about how most supplements are mostly not what they advertise because there are legal consequences for maintaining purity standards and many of these products are corrupt with useless or harmful ingredients and they don’t do what they advertise
As the hepatology community well knows, dietary supplements are becoming one of the fastest growing causes of complete liver failure and need for liver transplant in the US. That’s something the “wellness” industry tries not to advertise.
In addition there is evidence that certain antioxidant supplements can decrease the effectiveness of chemotherapy, leading to increased risk for relapse and death from breast cancer.
I will end this with some light reading material. https://www.medicinenet.com/dietary_supplements_can_cause_liver_damage/views.htm
