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Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network.

ABSTRACT: The Drug-Induced Liver Injury Network (DILIN) studies hepatotoxicity caused by conventional medications as well as herbals and dietary supplements (HDS). To characterize hepatotoxicity and its outcomes from HDS versus medications, patients with hepatotoxicity attributed to medications or HDS were enrolled prospectively between 2004 and 2013. The study took place among eight U.S. referral centers that are part of the DILIN. Consecutive patients with liver injury referred to a DILIN center were eligible. The final sample comprised 130 (15.5%) of all subjects enrolled (839) who were judged to have experienced liver injury caused by HDS. Hepatotoxicity caused by HDS was evaluated by expert opinion. Demographic and clinical characteristics and outcome assessments, including death and liver transplantation (LT), were ascertained. Cases were stratified and compared according to the type of agent implicated in liver injury; 45 had injury caused by bodybuilding HDS, 85 by nonbodybuilding HDS, and 709 by medications. Liver injury caused by HDS increased from 7% to 20% (P?

SUBMITTER: Navarro VJ

PROVIDER: S-EPMC4293199 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network.

Navarro Victor J VJ Barnhart Huiman H Bonkovsky Herbert L HL Davern Timothy T Fontana Robert J RJ Grant Lafaine L Reddy K Rajender KR Seeff Leonard B LB Serrano Jose J Sherker Averell H AH Stolz Andrew A Talwalkar Jayant J Vega Maricruz M Vuppalanchi Raj R

Hepatology (Baltimore, Md.) 20140825 4

<h4>Unlabelled</h4>The Drug-Induced Liver Injury Network (DILIN) studies hepatotoxicity caused by conventional medications as well as herbals and dietary supplements (HDS). To characterize hepatotoxicity and its outcomes from HDS versus medications, patients with hepatotoxicity attributed to medications or HDS were enrolled prospectively between 2004 and 2013. The study took place among eight U.S. referral centers that are part of the DILIN. Consecutive patients with liver injury referred to a D ...[more]

PMID: 25043597

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Project description:BackgroundUse of complementary and alternative medicine (CAM), including vitamins, minerals, herbals, and other dietary supplements, is widespread in the United States (ranging from 24% in Hispanics to 50% in American Indians). Pharmacists are an accessible source for healthcare information, but little is known about their use of CAM products and to whom they would recommend these products.MethodsA cross-sectional survey was sent via email to pharmacists licensed in one state in the United States in 2015. The survey included items about their use of 10 vitamins and minerals, and 21 herbal or other dietary supplements, as well as reasons for use, conditions used to treat, if they would recommend the product to patients, family, or friends, their perception of CAM safety and effectiveness, and four demographic questions. Descriptive statistics were used to summarize the data, and a chi-square test was used to determine differences between pharmacists' use of vitamins/minerals and herbals/other dietary supplements. The a priori alpha level was 0.05.ResultsA total of 639 pharmacists completed the survey. Female pharmacists used vitamins/minerals (p?=?0.031) and herbals/others (p?=?0.039) more than male pharmacists. Older pharmacists used herbals/others more than younger pharmacists (p?<?0.001). Fifty-nine percent thought the dietary supplements in the survey were safe while 32% reported they were effective. Seventy-eight percent of respondents reported use of any vitamin or mineral product versus 42% who reported use of any herbal or other dietary supplement. Commonly used products included: multivitamins (91%), vitamin C (71%), fish oil (65%), probiotics (53%), and fiber (53%). The most commonly reported reason for use was general health and wellness (17-90%). Pharmacists most commonly recommend fiber/psyllium (94%) and calcium (90%) to patients, family, and friends.ConclusionsPharmacists in this survey selectively used vitamins, minerals, herbals and other dietary supplements, and recommended some of the more commonly used products to patients, family and friends. This is valuable information given that pharmacists are frontline healthcare professionals who may be asked to provide advice about these products.

Dataset Information

Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network.

Publications

Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network.

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