From turmeric capsules to muscle-building powders like creatine, many people are turning to herbal and dietary supplements. While supplements are generally harmless when taken in moderation, some pose health risks, including unpredictable liver problems, especially when taken in large doses. For this reason, you should always talk to your doctor before taking them.

In this Q&A, Meena B. Bansal, MD, a Mount Sinai liver specialist, explains the risks of supplements, what to watch out for, and how to protect your liver while making informed choices about supplements.

We’ve been hearing more about supplements being linked to liver damage. What’s the connection?
This is a growing concern. Over the last 20 years, more people have started taking supplements like turmeric, curcumin, and ashwagandha. Because these are widely available online, more people use them than ever before. With that rise, doctors have seen more cases where these supplements cause liver injury.

Are supplements really that dangerous?
They can be. One big issue is that supplements aren’t regulated like medicines. The labels might say one thing, but there’s no guarantee the product is pure or safe. Some ingredients may be harmful in higher doses or when combined with other supplements.

Meena B. Bansal, MD

Does this mean something like turmeric, which is often praised for health benefits, could be harmful?
Using turmeric as a spice in food is safe and may have health benefits, but when it’s highly concentrated in pills, and the exact purity is unknown, it has the potential to cause liver injury.

What signs suggest a supplement might be harming your liver?
People usually find out from blood tests showing abnormal liver enzyme levels. These tests might have been normal months before. When doctors ask about new medications or supplements, many patients don’t realize supplements count as medicine and forget to mention them.

Are all liver injuries caused by supplements the same?
No. Some liver damage depends on the dose. One example is acetaminophen (such as Tylenol®), which is extremely safe when taken as directed but can harm your liver if taken in very large doses. Other cases are unpredictable and might happen because of a genetic predisposition. A thousand people may take a supplement without problems, but a few may have serious reactions.

Can liver damage from supplements be severe?
Yes. Mild cases show up as enzyme changes in blood tests. Severe cases can cause jaundice (yellowing of skin and eyes) and sometimes require a liver transplant, although this is rare. If you have symptoms, schedule an appointment with a Mount Sinai liver specialist: 212-241-7270.

Is there anything on supplement labels that can help me know if they’re safe?
Unfortunately, no. Supplements aren’t regulated, so companies can put whatever they want on labels. Even certifications from a “third party” agency or organization (companies that claim to check the purity of the ingredients) are not a full guarantee.

Is there an online resource that can help me identify whether a supplement is potentially harmful?
Yes—LiverTox®, a resource available through the National Institutes of Health, provides a trusted list of medications and supplements that are potentially harmful to your liver.

What if I want to keep taking supplements?
I discuss the risks and benefits with patients. If someone feels a supplement helps, I monitor their liver health closely. Sometimes we stop all supplements and add back just one or two, checking for any problems.

What about creatine, a popular muscle-building supplement?
While many use it without issues, I don’t recommend it. You get creatine naturally from eating meat and fish, which is safer. This may be challenging, however, for those on a vegan diet. There isn’t strong proof that creatine causes liver damage, but some people taking it have higher liver enzymes. Creatine can cause your serum creatinine, a marker of kidney function, to become elevated, but it does not necessarily reflect damage.  Those with pre-existing kidney disease should consult their doctor prior to use.

Therefore, overall, for healthy adults, standard doses of creatinine monohydrate (up to five grams daily) are probably safe, but people with liver and kidney problems should be cautious. Very high doses could be risky and should be avoided until more is known.

What other supplements are associated with liver problems?

Known ones include:

• Ashwagandha
• Green tea extract
• Turmeric (curcumin)
• Garcinia cambogia
• Kratom
• Black cohosh
• Red yeast rice
• Chaparral
• Ephedra
• Germander
• Kava
• Polygonum multiflorum

Multi-ingredient supplements marketed for weight loss or bodybuilding are also associated with liver problems, but the specific toxic component is often unclear due to product variability and mislabeling. Always consult a physician before taking supplements.

Are any supplements considered safe?
Multivitamins and common vitamins like vitamin D and C from trusted stores are usually fine. Be wary of products promising quick fixes like “liver detox” or “rapid weight loss.”

Can I tell if a supplement has harmful contaminants like heavy metals?
No, not without lab testing. Even third-party certifications can’t guarantee a product is free from contaminants.

Is it ever necessary to take supplements?
Some people with certain medical conditions may benefit from supplements, but should check with their physician first. Healthy people are better off getting nutrients from whole foods. Supplements can be costly and sometimes harmful.

When lunchtime comes around, most everyone wants something delicious. But few have the time to prepare a nutritious meal. The result: We often settle for standard fare that is high in calories and low in nutrition.

Taylor Stein, RD

But there is a simple option. Make some easy swaps to lighten up your lunch. Low in sugar and packed with gut-healthy nutrients, these swaps, recommended by Mount Sinai dietician Taylor Stein, are great for both adults and kids.

Swap: White Bread for 100 Percent Whole Wheat, Sourdough, or Sprouted Whole Grain Breads

Why: Refined carbohydrates found in white bread have had fiber and nutrients removed to increase shelf life and change flavor. This also causes faster digestion and absorption, leading to rapid blood sugar spikes and crashes. Whole grain options digest more slowly, supporting longer-lasting fullness and steady energy throughout the day—important for both kids in the classroom and adults at work.
Tip: Look for “100 percent whole wheat” or “sprouted grain” as the first ingredient.

Swap: Deli Meats for Diced/Shredded Chicken, Turkey, Salmon, or Plant-Based Alternatives

Why: Deli meats often contain high levels of sodium and saturated fat and are preserved with nitrates and nitrites, which are linked to increased cardiovascular disease and cancer risks. Including plant-based proteins, using ingredients such as chickpeas, lentils or tempeh—a fermented soybean dish that is a staple food in Indonesia—can boost fiber intake and support environmental sustainability. Homemade proteins allow full control over seasoning and offer fresher, more wholesome meals. For kids, varying textures and flavors can build curiosity and lay the foundation for healthy eating habits.

Tip: Pack diced or shredded homemade proteins like chicken breast, turkey, or salmon, or choose plant-based options such as chickpeas, lentils, or tempeh. Use your favorite seasonings for flavor.

Swap: Sugary Drinks for Fruit-Infused Water, Smoothies, or 100 Percent Juice

Why: Drinks with added sugars are absorbed quickly by the body, causing blood sugar spikes and crashes that can result in fatigue and poor focus—whether in school or during an afternoon meeting. Sugary beverages also contribute to tooth decay and alter taste preferences, especially in children, encouraging more sugar cravings. Healthier drink choices are naturally sweet, less processed, and can be portioned to support proper hydration without the sugar rush.

Tip: Replace sugary beverages with fruit-infused water, homemade smoothies, or 100 percent juice.

To make fruit-infused water: Add fresh, chopped fruit of your choice to a pitcher of cold water, refrigerate, and let steep for up to 24 hours; the longer the steep, the stronger the flavor.

Swap: Packaged Sweets for Whole Fruits and Non-Processed Snacks

Why: Highly processed, fried snacks, such as potato chips and tortilla chips, are engineered to be extra flavorful, which can lead to overeating. This is especially concerning in children, as early exposure to such snacks can influence eating patterns into adulthood. Minimally processed snack options that deliver satisfying textures—like crunch—without the health risks are better choices for both kids and adults. They help shape healthier taste preferences and encourage moderation.

Tip: Instead of chips, cookies, or candy, opt for whole fruits, snacks with reduced sugar and sodium (avoiding excessive artificial sweeteners), or baked, roasted, or dehydrated fruits and vegetables—such as edamame or seasoned and roasted chickpeas.

Look for snack products with labels that include: “High fiber”; “No added sugars”; “Whole Grains”; “Reduced sugar, fat, or sodium”; and “Good source of.” Learn more about reading food labels.

Viruses are in the air and all around us, from the common cold to COVID-19. Eating a healthy, balanced diet primes and activates your immune system to fight these pathogens, even before you get sick.

In this Q&A, Taylor Stein, Associate Researcher and Registered Dietitian at The Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, discusses what foods you should eat to support your immune system this cold and flu season.

How does nutrition affect my immune system?

If your diet contains a lot of saturated fatty acids, sugar, and refined carbohydrates, you will not have as strong of an immune response compared to someone consuming diets rich in micronutrients, antioxidants, and fiber. Certain nutrients—specifically vitamins A, D, E, and K—are fat-soluble, meaning they are stored in your fat and take time to accumulate, especially vitamin D. These vitamins support different functions of the immune system and are readily available to fight disease in advance.

Does this mean I need to consume these nutrients before I get sick?

Yes. When you are sick, your immune system is scavenging the body for nutrients, and if you don’t have enough fat-soluble vitamins stored, it can take you longer to get better. Additionally, being sick can affect your ability to eat and drink, so it is very important to have a balanced diet at all times to keep up your stores of these vitamins. Alternatively, vitamins that are water soluble, such as vitamin C and those in the B-complex group, cannot be stored, so you should strive to eat lots of these while you are sick. You also need to eat plenty of macronutrients—carbohydrates, proteins, fiber, and fats.

Taylor Stein, RD

What foods are good for my immune system, and why?

Immune system health largely depends on five food groups:

• Animal meats, fish, dairy products, legumes, nuts, and whole grains. Proteins are the building blocks of cytokines, small proteins that send signals to the immune system telling it where to send white blood cells to fight infections. Since cytokines require different amino acids, you need to eat a variety of protein both from animal and plant-based products. High protein foods contain B-complex vitamins, which are necessary for cell proliferation, which plays an important role in immunity.
• Brightly colored fruits and vegetables. Apricots, kiwi, blueberries, avocados, carrots, strawberries, Swiss chard, bell peppers, raspberries, red onions and other brightly colored produce are filled with both fat-soluble and water-soluble vitamins and are also a great source of fiber.
• Fortified dairy products, eggs, and salmon. These are a great source of vitamin D, which helps activate T cells and has other important functions that affect your immune system. You can also get vitamin D in smaller amounts from nuts and mushrooms. Sunlight is also a great source of vitamin D.
• Nuts, seeds, eggs, legumes, and fish. These all contain disease-fighting minerals, such as zinc, magnesium, and selenium. Pumpkin seeds, almonds, cashews, shellfish, tuna, chickpeas, and lentils are all good sources of these minerals.
• High-fiber, pre-and-probiotic, and fermented foods. These foods are good for your gut, where more than 70 percent of your immune cells live. High-fiber foods include legumes, fruits, and vegetables. Pre-and-probiotic and fermented foods include yogurt, kefir, and buttermilk. These gut-healthy foods are important in maintaining lymphoid tissue in the gastrointestinal tract that helps fight disease.

What are some easy ways to incorporate these foods into my daily diet?

A great way to get more of these foods is to eat them as snacks. For example, snacking on nuts and seeds, bean or guacamole dip, whole grain toast with avocado, and fruit and cheese are all easy ways to get more of the nutrients that prime the immune system. You also need to include them in your main meals. Each dish should include a good source of lean protein—meats, poultry, or fish—and plant-based proteins such as beans, as well as non-starchy vegetables. A simple rule is to fill one quarter of your plate with protein, one quarter with a whole grain or starchy vegetable, and the other half with brightly colored vegetables.

How do these foods compare to taking supplements?

When it comes to immune system health, it is good to have a food-first mentality. Whereas supplements typically provide only one nutrient, a balanced diet filled with whole foods contains all the micro and macronutrients you need. These nutrients work most optimally when they are paired together and are easier to digest than supplements. However, supplements can be a great tool for someone who struggles to eat a variety of foods or has a condition that reduces their ability to consume or prepare healthy food. Keep in mind that supplements are not regulated by the Food and Drug Administration, so it is important to get a doctor or dietitian’s advice on what supplements you should use.

What else is important for my immune system?

Getting plenty of sleep and exercise will also strengthen your immune system. Sleep plays a vital role in hormone production, regulation, and function, which strengthens the immune system, and plays a role in building cytokines. Exercise creates stress in your body and activates the same pathways that are triggered when you’re sick, and gets your body primed and ready for when it needs to fight a pathogen. Lastly, recent studies have found that mental health disorders are associated with decreased immune function, which leads back to sleep hygiene and physical activity. However, mental health can be the cause and effect of not getting enough sleep or exercise. In any case, physical activity, sleep hygiene, and managing mental health are all important to maintaining a healthy immune system.