Taking Supplements? Use This Guide to Make Smart Choices

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.
- While mostly safe, some supplements can cause liver injury, especially in high doses.
- Supplements aren’t regulated, and labels can’t guarantee safety or purity.
- LiverTox® (NIH resource) is a trusted tool for checking if a supplement has been linked to liver problems.
- Whole foods are safer sources of nutrients; supplements should ideally be taken with medical guidance.

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.



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