The liver is a pretty incredible organ. It performs more than 500 vital functions, including filtering 22 gallons of blood every hour. So, it stands to reason that most people wouldn't do anything intentionally to put their liver at risk. However, by taking certain supplements, you could be unknowingly harming this powerhouse organ, which is why doctors are speaking out about a growing trend of turmeric supplement-induced liver damage.
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Turmeric supplements could cause liver damage, research shows.
Because the liver's primary job is to detoxify your body, taking in too much of certain substances, "including specific supplements...can interfere with this process," Alyssa Smolen, MS, RDN, a New Jersey-based registered dietician, previously told Best Life.
And there is research to support the potentially dangerous consequences of taking turmeric supplements—which contain the active compound curcumin and are typically used for their anti-inflammatory properties—in high doses.
A 2020 Italian study published in the British Journal of Clinical Pharmacology, pointed to 23 cases of acute hepatitis tied to high doses of turmeric supplements.
As Cleveland Clinic explains, "Hepatitis is inflammation in your liver. Inflammation is your body’s response to an infection or injury." In acute cases, symptoms come on suddenly but typically resolve within six months.
And according to a 2022 case study, "Data from 8 US centers in the Drug-Induced Liver Injury Network revealed that between 2004 and 2013, 15.5% (130/839) of hepatotoxicity cases were attributed to dietary and herbal supplements. Of the 130 cases, turmeric was associated with 32 of the single-ingredient products."
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Turmeric supplements are more dangerous when combined with black pepper.
A 2023 study published in The American Journal of Medicine concluded that "liver injury due to turmeric appears to be increasing in the United States." The researchers found that those affected with such liver injury experienced jaundice, nausea, and abdominal pain.
However, they also discovered that supplements containing black pepper as a secondary ingredient (or taking turmeric supplements in conjunction with black pepper supplements, which are also used to reduce inflammation) posed a greater risk because black pepper greatly increases the body's absorption of turmeric.
Study author Jay Hoofnagle, MD, director of the Liver Disease Research Branch in the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Division of Digestive Diseases and Nutrition who oversees the U.S. Drug-Induced Liver Injury Network (DILIN), explained to Medical News Today that your body doesn't absorb turmeric and black pepper when they're ingested in spice form.
However, he said he and his fellow researchers believe "these modern products of turmeric have been altered so that they are absorbed."
To his point, NBC News recently shared the story of Robert Grafton, an otherwise healthy 54-year-old who was hospitalized for drug-induced liver injury caused by herbal supplements including turmeric.
"My liver enzymes were super elevated, my bilirubin was really high—all the signs of liver failure," Grafton told the outlet. "I pretty much broke down, my wife as well. I was, at that point, thinking it was liver cancer, pancreatic cancer or something."
Grafton first started taking supplements that contained 2,250 mg of curcumin, as well as black pepper. He then swapped the capsules for a liquid turmeric supplement that was also highly concentrated.
"When you cook with turmeric, that could be really safe. But some of the supplements now are 2,000 mg plus, which is a very high dose of turmeric," Dina Halegoua-De Marzio, MD, a Jefferson Health hepatologist who treated Grafton, told NBC.
She added that black pepper increases the absorption of turmeric "twentyfold," so that "the liver now has to break down that supplement and it can’t. It could make it really sick."
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Other herbal supplements pose a risk to the liver, too.
As opposed to dietary supplements that contain concentrated amounts of vitamins and minerals, herbal supplements are made from "botanical compounds found in plant roots, leaves, seeds, berries, and flowers," as Best Life previously explained. But both dietary and herbal supplements are not regulated by the U.S. Food and Drug Administration (FDA), meaning they don't undergo the rigorous testing and safety reviews that medications do.
That's why a 2024 study published in the Journal of the American Medical Association(JAMA) reviewed more than 80,000 commercially available herbal and dietary supplements.
The researchers identified six "potentially hepatotoxic botanical products," which lead author Alisa Likhitsup, MD, MPH, a clinical assistant professor at the University of Michigan, described to Medical News Today as "the products that contain plant-based ingredients which have been implicated as potential causes of liver damage."
In order from the most to least commonly taken, they are:
- Turmeric
- Green tea
- Ashwagandha,
- Garcinia Cambogia
- Red yeast rice
- Black cohosh
"How these products cause liver damage is not yet known but it is likely due to metabolism that occurs in the liver after the products were consumed," Likhitsup shared.
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Is there a safe dose of turmeric supplements?
Raj Dasgupta, MD, chief medical advisor for Fortune Recommends Health, previously told Best Life that turmeric supplements are "widely considered safe to take regularly, especially at doses around 500 mg." However, he added, "It's important for consumers to look for products that list the actual amount of turmeric in their supplements. High doses of turmeric are not recommended due to the risk of side effects."
Dasgupta also noted that people with the following conditions should avoid turmeric supplements: bleeding disorders, liver or bile duct problems, stomach ulcers, GERD, hormone-sensitive conditions, arrhythmias, pregnant or breastfeeding women, and those taking blood thinners.
If you're ever considering adding a new suppplment to your routine, speak to your healthcare provider first.
