The liver is the primary detoxifying organ, continuously working to eliminate toxins and metabolic waste before they cause serious harm. Most health-conscious people often use over-the-counter products, especially dietary supplements, to enhance overall wellness. However, while many supplements support liver health, some even cause damage to the liver. 

The Food and Drug Administration does not closely regulate the manufacturing, production and content of various herbal and dietary supplements (HDS). As a result, they never undergo formal efficacy or safety tests.

Read more: Fatty Liver – Diet Plan, Symptoms & How to Reduce

Intake of such multi-ingredient nutritional supplements can lead to potentially severe, or even fatal, fatty liver, hepatotoxicity and liver damage.

Fatty Liver: An Overview

Hepatic steatosis, often known as a fatty liver, is when fat builds up in the liver. There are two main types: alcoholic and non-alcoholic fatty liver. It becomes problematic when fat makes up 5–10% of your liver’s weight. If the disease worsens, it will cause fibrosis (scarring) or perhaps cirrhosis, which is a sign of liver failure and calls for a liver transplant.

A fatty liver caused by supplements typically does not express symptoms in the early stages. However, persistent fatigue and abdominal pain on the upper right side of the torso are warning signs. 

Your doctor may do an ultrasound, CT scan, liver biopsy, or fibro scan of the liver to identify the condition. Remember to monitor your liver enzymes if you have existing liver disease. Seek medical attention if you experience any signs of liver damage, such as severe vomiting, jaundice, and abdominal pain, after taking any herbal and natural supplements. 

The HealthifyMe Note

Without FDA regulations, product manufacturing guidelines, and standardised chemical analyses, it is nearly impossible to determine the exact chemical makeup of supplements. For example, dietary supplements often promoted for muscle enhancement contain undeclared steroids, causing fatty liver. Hence, consuming over-the-table supplements for the liver can have detrimental effects on one’s health, especially when taking supplements without a doctor’s guidance. 

7 Dietary Supplements That Cause Fatty Liver

While there are a number of dietary supplements that can harm the liver. We’ve listed the most notorious ones for you: 

High Doses of Certain Vitamins

Vitamin A can harm the liver when consumed in high dosages or for an extended period. Similarly, niacin consumption for a lengthy period can cause fatty liver or damage in certain people.

Niacin can change into (nicotinamide coenzyme) NAD, which, in large doses, can be toxic to the liver. Energy drinks and shots often contain high levels of niacin. Excessive niacin consumption from energy drinks can trigger severe hepatitis.


The majority of kava supplements are in pill form. Several reports claim that the comparative efficacy and safety of kava for the liver are still unsure and can be damaging to the liver.

Some think combining kava and alcohol might harm the liver even in regular doses, increasing the risk for alcoholic fatty liver. 

Overall, it is still unclear how much liver damage kava alone may cause. However, those with liver issues are best off avoiding it until more research is available.


While valerian is generally safe for 4 to 8 weeks at recommended dosages it has many toxic compounds that can damage liver cells if consumed for longer periods.

There aren’t many studies on its liver-damaging effects, but there is possible contamination with germander, another herb with a history of liver toxicity.

Black Cohosh

Black cohosh often leads to autoimmune hepatitis and fatty liver. However, it’s unclear whether the black cohosh or product contamination is the cause for this.

One study found that two women who took black cohosh experienced acute liver necrosis. These are unusual instances. If you’re using black cohosh to treat hormonal imbalances, you should talk to your doctor and check your liver enzymes for possible fat buildup. 

Pyrrolizidine Alkaloids

The plant butterbur, which may help treat migraines and seasonal allergies, contains pyrrolizidine alkaloids, which are harmful to the liver. Plants synthesise pyrrolizidine alkaloids as secondary metabolites. According to data, more than 6,000 plants include over 600 PAs and PA N-oxides, and more than half are harmful to the liver.

PAs included in herbal medicines can harm the liver. However, it is still debatable whether utilising these herbs for limited periods is safe. Therefore, people with severe liver illness should avoid this herb for safety.


The herb kratom boosts energy, treats anxiety, mood swings and depression, relieves pain, and lessens opioid withdrawal symptoms. Kratom causes acute liver harm and fatty liver.

However, these incidents are uncommon since most people heal after stopping the supplement. Several kratom products contain lead contamination, so be cautious when using them.

Polygonum Multiflorum (Fo-ti)

The Chinese native plant Polygonum Multiflorum, utilised for digestive and anti-ageing properties, has been linked to liver damage in some cases. When administered alone or in Traditional Chinese medicine (TCM) formulations, the herb Polygonum Multiflorum is among the top five liver toxicants.

This herb can cause severe harm, including death, by affecting the liver. Studies indicate that most individuals recovered after stopping the supplement; however, up to 10% of cases were severe or deadly, requiring a liver transplant.


Although taking a few supplements daily is generally considered acceptable and possibly even beneficial for boosting your liver health, doing so in large quantities for a prolonged period of time can seriously harm the liver.

Using supplements without being aware of their solvents can cause fat buildup in the liver. Just because a supplement is labelled as “natural” doesn’t mean it’s necessarily healthy for you. The problem can worsen if you use multiple liver-acting drugs or herbs. It’s best to consult a doctor before starting with a supplement. 

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