Overuse of supplements can harm the liver. Photo: Hoa Linh
Liver inflammation from over-supplementation
In recent years, the use of vitamins and dietary supplements has become increasingly common in Vietnam, promoted for benefits ranging from boosting immunity and improving skin to enhancing sleep and “detoxifying” the liver.
However, behind this seemingly harmless habit lies a growing risk: liver damage caused by supplement overuse.
A 41-year-old woman from Hoang Liet, Hanoi, was hospitalized with elevated liver enzymes. Doctors diagnosed her with acute hepatitis caused by excessive supplementation. Each day, she consumed dozens of different products in the belief that they would improve her health. Instead, her liver became overwhelmed, leading to cellular damage.
Dr. Nguyen Huy Hoang, a specialist in internal medicine and member of the Vietnam Society of Hyperbaric Medicine, explained that the liver functions as the body’s central processing plant. Everything entering the body – from food and alcohol to medications and vitamins – must pass through the liver for metabolism and elimination.
When the quantity and dosage of supplements exceed the liver’s capacity, it becomes overloaded. Notably, this damage often occurs silently, without clear symptoms in the early stages.
“Drug- and supplement-induced liver injury is becoming increasingly common in clinical practice, ranging from acute hepatitis to liver failure. In severe cases, patients may even require a transplant to survive. Ironically, many of these patients do not consume alcohol or toxic substances – they only use products marketed as beneficial for health,” Dr. Hoang said.
Four causes of liver damage
Prolonged high doses of vitamin A: This fat-soluble vitamin can accumulate in the liver over time. Excessive intake may directly damage liver cells and trigger fibrosis. Over time, liver tissue becomes stiff, function declines, and the condition may progress to cirrhosis, which is difficult to reverse.
High-dose vitamin B3 over extended periods: Often used to treat lipid disorders, excessive B3 can disrupt mitochondrial function in liver cells, interfering with energy production. When cells lack sufficient energy, they die in large numbers, leading to acute hepatitis with symptoms such as elevated liver enzymes, jaundice, and fatigue.
High concentrations of herbal extracts: Contrary to common belief, herbal products are not always safe. Concentrated green tea extract, often found in weight-loss products, has been linked to multiple cases of acute hepatitis. At high doses, EGCG – an active compound in green tea – can damage mitochondria, increase oxidative stress, and destroy liver cells, especially when taken on an empty stomach.
Using multiple supplements simultaneously: Many people begin their day with a multivitamin, take “liver detox” products at noon, collagen in the afternoon, and sleep aids in the evening. However, Dr. Hoang warns that each product contains different active ingredients, all of which must be processed by the liver. Combined, they may interact in complex ways, increasing toxicity or producing harmful intermediates.
A major concern is that most supplement-related liver damage shows no clear symptoms in its early stages. Many individuals only discover abnormalities during routine blood tests showing elevated liver enzymes. By the time symptoms such as jaundice, dark urine, or persistent itching appear, the condition is often more advanced.
Nutritional guidelines consistently recommend obtaining vitamins from natural foods, where they are accompanied by fiber and bioactive compounds that help regulate absorption and prevent overdose.
Therefore, Dr. Hoang advises that only specific groups truly need supplementation, such as pregnant women, the elderly, malnourished individuals, or those with malabsorption conditions. For healthy adults, long-term self-prescribed supplement use is not only unnecessary but also potentially harmful.
Experts recommend that if elevated liver enzymes are detected or supplement-related issues are suspected, all products should be stopped immediately.
Phuong Thuy