|
 
Alcoholic and Toxic Liver Disease: Nutritional Considerations
- Vitamins and supplements with potential or suspected hepatotoxicity
should be avoided.
In particular, high doses of preformed vitamin A can cause hepatitis
or cirrhosis with doses of more than 100,000 IU per day. However,
rare cases have occurred with dosages of 25,000 IU per day, and
alcohol use increases the toxicity of vitamin A. Note that, although
beta–carotene produces vitamin A in the body, it is not associated
with this type of toxicity. Niacin also has hepatotoxic potential,
although this may be limited to sustained–release formulas.
- Several
herbal supplements can be hepatotoxic. Kava, a botanical used
for anxiety, was withdrawn from the market after suggestions
of hepatotoxicity. Certain herbal products that are freely available
to consumers (e.g., pennyroyal, skullcap, and chaparral) and
Chinese herbal formulas that are not commercially distributed
are associated with hepatotoxic effects.
The U.S. Food and Drug Administration has issued warnings regarding
the hepatotoxicity of certain formulas touted for weight loss,
such as LipoKinetix, although the active hepatotoxins in this
product have not yet been identified. A surprising number of
patients with acute hepatitis or acute liver failure have no
identifiable cause of illness other than the use of herbal
weight–loss products. Ephedra, which has been used for weight
loss by millions of people, is associated with severe liver
disease and has since been removed from the U.S. market.
- A botanical
extract, called milk thistle, has shown promise to protect the
liver, but has yet to be proven effective in clinical trials.
Silymarin, the active compound in milk thistle, has antioxidant,
anti–inflammatory, and liver–regenerative effects. However,
the scientific evidence is not yet clear on whether milk thistle
should be used as a nutritional supplement.
|
