Opting for supplements or herbs to address health issues or optimize wellness can seem like the more conscious option than simply taking a prescription. In some cases, that can be true—but a team of liver doctors in India recently found major problems with some herbs and supplements, and we’re not necessarily immune to these issues in the United States.
Publishing their research in March 2026 in the medical journal Frontiers in Gastroenterology, eight hepatology (liver) doctors at the Liver Institute at Rajagiri Hospital in southern India examined the background on cases involving 91 patients who, in all, had taken a total of 386 supplements. These patients had presented at a healthcare setting with adverse liver events following the consumption of what the researchers call “complementary and alternative medicine,” such as herbal remedies. The study authors specify this means that the patients had taken an average of just over four supplements each. The average age of patients was 48, while 76% were male.
The doctors report a 40% incidence of “ACLF,” or acute-on-chronic liver failure, which suggests 40% of patients had an existing liver condition before the “acute” event seemingly related to the supplement occurred. Thirty-nine percent of mortalities occurred among this group, while 11% occurred among patients without chronic liver issues.
The team reports the following among their main findings:
Presence of heavy metals exceeded World Health Organization (WHO) limits in many products, most prominently mercury (34%), cadmium (25%), arsenic (21%), and lead (14%).
In particular, it appeared this degree of cadmium exposure showed a 76% association with acute-on-chronic liver failure.
“Undeclared pharmaceutical adulteration” were found in nearly half of these cases, meaning pharmaceutical medications were added but not stated; while 31% showed “animal-derived content.”
Ginger was among the most recognizable herbs associated with these issues. Others named were less common, such as haritaki, vidanga, long pepper, and bibhitaki.
Granted, this study took place in India where ayurvedic practices are relatively widespread. (Ayurveda is defined by Johns Hopkins as “a whole-body [holistic] system of medicine that began in India more than 3,000 years ago,” with herbs and other plants being used “often.”) That said, it’s important to remember that herbs and supplements are rarely monitored or regulated by the U.S. Food and Drug Administration. And while we urge readers to always check the labels, plenty of U.S. food and drug recalls demonstrate how often ingredients are left off of labels. This is one of the top two causes for recalls.
So where do these heavy metals come from to lurk in products we ingest? One 2021 paper reported “accumulation and absorption from soil and water.” No matter how we try to offset it: the more our environment suffers, the more our health will, too.
For daily wellness updates, subscribe to The Healthy newsletter and follow The Healthy on Facebook and Instagram. Keep reading:
