If you’re like nearly 80 percent of older adults, chances are, you took a supplement today.  Maybe it’s an insurance policy if your diet doesn’t cut it. Maybe it’s because you have joint pain and you want to ease the ache. Whatever your reason, the overarching goal is probably not to damage the liver.

Indeed, people with type 1 diabetes (T1D) can experience liver damage, including MASLD (Fatty Liver), Glycogenic Hepatopathy, and Autoimmune Hepatitis.

Unfortunately, the reality is that many popular supplements can do just that — and little else — causing repercussions as severe as liver failure. While there are several categories of supplements, including multivitamins, single-nutrients (such as omega-3s, vitamin D or calcium), and herbals (also called botanicals), it’s the herbal supplements that pose the biggest risk for liver damage.

About 5 percent of U.S. adults — that’s 15.6 million people — took potentially liver-damaging botanical supplements within the last month, according to a 2024 study published in JAMA Network Open, with middle-aged and older adults being some of the most likely groups to do so. In the study, six specific botanicals were singled out because data from the Drug-Induced Liver Injury Network identified them as the ones that are most likely to be associated with liver toxicity. These six supplements include: ashwagandha, black cohosh, gardinia cambogia, green tea extract, red yeast rice, and turmeric/curcumin.

While the six supplements above may be the ones most often implicated in liver injury, more than 1,000 medications and herbals are associated with liver damage.

How supplements can harm the liver:  The liver is the body’s clearing house. “Pretty much anything you ingest has the potential to be toxic to the liver,” says Dr. Don Rockey, a professor of medicine at the Medical University of South Carolina and an American Liver Foundation volunteer expert. “Everything you consume goes into the [gastrointestinal] tract, is absorbed, and the first place it goes is the liver,” he explains.

Hepatocytes — the main type of cells in the liver — detoxify your body, but they can be damaged. Age can contribute to the problem. Age-related changes in the liver make the organ less resilient to stress and less effective at metabolizing substances, potentially leading to greater damage.

Tips for staying safe with supplements

If you’re going to take a supplement, there are some steps you can take to help keep you safe.

• Research. Doing some research is a key first step — just be sure you’re using a trusted source. One resource to check out when researching supplements is the LiverTox database from the National Institutes of Diabetes and Digestive and Kidney Diseases.
• Talk to your provider. This is, by far, the most important thing you can do
• Be careful with herbals. 
• Look for third-party testing. Research suggests there are 80,000 herbal and dietary supplements on the market. With concerns about contamination and mislabeling, choose a product with independent, third-party testing from organizations like the NSF or USP.
• Skip liver supplements entirely. 
• Get regular blood work.

Read more: 10 Popular Supplements That Can Damage Your Liver