Imagine a healthy, non-drinking man diagnosed with cirrhosis out of the blue. That’s what happened to one woman’s father after years of daily Ayurvedic “immunity” tonics. Doctors began to ask questions – could these herbal supplements be to blame? Growing evidence says it’s possible. Experts warn that “natural” doesn’t guarantee safe: unlike FDA-approved medicines, dietary supplements aren’t tested for safety before sale.In fact, a recent US analysis found about 5% of adults had taken at least one high-risk herbal product (like ashwagandha or turmeric) in the past month. Hepatologists report seeing supplement-induced liver injuries – some so severe they required emergency transplantation.

Signs that all is not well with your liver

What happened?

On social media, Dr. Mansafa Bepari (MBBS, Women’s Health Coach) recently shared a startling story about her father. He had no history of alcohol consumption, no diabetes, and no prior symptoms of liver disease. Yet when he was rushed to Goa Medical College for urinary complaints and prostate enlargement, doctors found that he also had cirrhosis. The discovery left the family shocked, how could this happen to a man who had never touched alcohol?Dr. Bepari eventually connected the dots. Since the COVID pandemic, her father had been consuming a wide range of over-the-counter Ayurvedic supplements marketed for “immunity boosting.” Their home had practically turned into an Ayurvedic store, stocked with bottles and powders of every kind. For years, he consumed these products without realizing the risks.It was only after this hospital admission that the family realized the possible connection between his liver disease and long-term herbal supplement use. If his prostate problem had not brought him to the hospital, his supplement use might have continued unnoticed until it advanced to decompensated cirrhosis or even liver cancer. Her warning was blunt: “Ayurvedic drugs are not only useless but have a high risk of liver injury and other dangerous effects. Do not consume it.”

Ayurvedic herbs and liver injury: What studies show

Scientific reviews have documented the spectrum of liver problems linked to Ayurvedic herbs. In one comprehensive 2020 review, researchers found that Ayurvedic medicines can cause everything from mild enzyme elevations to advanced cirrhosis.

Well-known Ayurvedic ingredients, ashwagandha, aloe vera, guggul, gotu kola, turmeric, and others, have all been implicated in cases of hepatitis, cholestasis or even acute liver failure.In the United States and Europe, cases have been rare but are increasing. A US hospital study described three patients who developed acute hepatitis after taking Ayurvedic products (for example, giloy Tinospora cordifolia and complex herbal powders) for several months.All three patients’ liver enzymes spiked into the thousands, and they developed jaundice; after stopping the supplements, their livers recovered over weeks. Although these American patients eventually healed, they underscore that US doctors must ask about “herbal” use in unexplained liver injury.The US FDA similarly cautions that unapproved Ayurvedic pills “may contain heavy metals” and are not FDA-reviewed for safety.

Common culprits

Studies list several high-risk ingredients found in Ayurvedic products:Ashwagandha (Withania somnifera): Several reports link it to cholestatic hepatitis and even liver failureGreen tea extract: Often taken for weight loss, it can cause unpredictable liver injury

Turmeric/Curcumin: Generally safe in food amounts, but concentrated supplements have triggered autoimmune-like hepatitis in rare casesMulti-ingredient Powders: Many ayurvedic “formulas” mix dozens of herbs – some studies found unlabeled mixes with high arsenic and mercury levels, which were associated with death in liver patientsAyurvedic supplements are not guaranteed safe. Scientific studies and case reports make it clear that some Ayurvedic herbs can harm the liver, in rare instances causing acute liver failure or worsening chronic disease. They should not be seen as cure-alls. If you use herbal products, do so cautiously: buy only licensed products, stick to recommended doses, and tell your doctor about any supplements you take.