Herbal does not mean innocuous: Ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife® products

Schoepfer, Alain; Engel, Antoinette; Fattinger, Karin; Marbet, Urs A.; Criblez, Dominique; Reichen, Juerg; Zimmermann, Arthur; Oneta, Carl

doi:10.1016/j.jhep.2007.06.014

Cited by 171 publications

(163 citation statements)

References 19 publications

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“…However, envios businesses are at risk, given the increasing market penetration of nutrition companies in both the US and Mexico, such as Herbalife and Omnilife. These companies have well-developed social marketing programmes (Cahn 2008) that speak to women's needs for quicker food preparation and limited time to shop for fresh foods despite documented health risks such as liver toxicity associated with use of these products (Chen et al 2010, Schoepfer et al 2007, of which participants may be unaware.…”

Section: Discussionmentioning

confidence: 99%

Navigating changing food environments – Transnational perspectives on dietary behaviours and implications for nutrition counselling

Handley

Robles

Sanford

et al. 2012

Global Public Health

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Section: Discussionmentioning

confidence: 99%

Navigating changing food environments – Transnational perspectives on dietary behaviours and implications for nutrition counselling

Handley

Robles

Sanford

et al. 2012

Global Public Health

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“…Toxicity A critical analysis of the hepatotoxicity cases described in the literature related to Herbalife ® products 787 occurred in a minority of consumers, and the authors suggest that this may have resulted from a hepatotoxic ingredient, excessive consumption of a safe ingredient or contamination during product processing, in combination with individual predisposition (Elinav et al, 2007). Schoepfer et al (2007) described 10 cases of hepatotoxicity potentially involving Herbalife ® products in Switzerland. These cases occurred between 1998 and 2004, and were identified through a questionnaire sent to the departments of medicine of public hospitals, gastroenterology/hepatology and pathology divisions, and via the Swiss pharmacovigilance database.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, the authors alerted to the fact that the intake of these products is underreported by patients who believe that this type of product is not harmful to their health, rendering causality assessment even more difficult (Schoepfer et al, 2007). Chao et al (2008) described one case of a probable diagnosis of toxic hepatitis secondary to the consumption of Herbalife ® nutritional supplements, reported in Argentina.…”

Section: Resultsmentioning

confidence: 99%

A critical analysis of the hepatotoxicity cases described in the literature related to Herbalife (r) products

Zambrone¹,

Corrêa²,

Amaral³

2015

Braz. J. Pharm. Sci.

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The aim of this study was to assess the hepatotoxicity cases described in the literature, attributed to the consumption of Herbalife ® products, and to determine whether a causal relationship exists between the reported cases of liver injury and the use of these products. A literature search was performed on the PubMed, LILACS and PAHO databases. Seven publications reporting a total of 53 cases of hepatotoxicity linked to the use of Herbalife ® products were retrieved. All of the studies lacked sufficient information to some degree, whether related to patients' history, concomitant use of medication and/or other compounds (including alcohol), observations on interrupted use (dechallenge), results found with markers, viral serology and autoantibodies or observations concerning re-exposure to the products. In addition to these items, the lack of clear information on the type of products evaluated and their respective composition is an important factor to be considered. Furthermore, data quality was also questionable due to the presence of confounding factors, absence of proper exclusion of alternative explanations, and the use of questionable methods for attributing causality. Hence, an association between hepatotoxicity and consumption of these products cannot be proven based on the data collected and rigorous scientific analysis.Uniterms: Hepatotoxicity. Herbalife ® . Herbalife products ®/ consumption/hepatotoxicity. Dietary supplements. Causality assessment.Este estudo teve como objetivo avaliar os casos de hepatotoxicidade descritos em literatura, atribuídos ao consumo de produtos Herbalife ® , e verificar se é possível ou não estabelecer uma relação de causalidade entre eles. Realizou-se levantamento bibliográfico nas bases de dados PubMed, LILACS e PAHO e foram encontrados 7 manuscritos reportando 53 casos de hepatotoxicidade, relacionados ao uso de produtos Herbalife. Observou-se que todos trazem, de alguma forma, quantidade insuficiente de informações em relação ao histórico dos pacientes, ao uso concomitante de medicamentos e/ou outros compostos (incluindo álcool), às observações após a interrupção do uso (dechallenge), aos resultados referentes a marcadores e sorologia virais e autoanticorpos e às observações quanto à reexposição aos produtos. Some-se a estes fatos a falta de identificação clara e comprovada do tipo de produto envolvido, assim como sua composição. Além disso, a qualidade dos dados também é questionável devido à presença de variáveis de confundimento, ausência de exclusão adequada de explicações alternativas e ao uso de métodos discutíveis de atribuição de causalidade. Desta forma, a associação entre hepatotoxicidade e o consumo destes produtos não pode ser comprovada, após observar o conjunto dos dados coletados, utilizando-se rigor técnico-cientifico.

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“…Several cases of potentially life-threatening hepatotoxicity (leading to liver transplantation in some) attributed to Herbalife ® products (Los Angeles, CA) marketed for promoting energy, fitness and weight control were recently documented. 194 In an analysis of 20 herbal/dietary supplements marketed as natural slimming products, eight formulations contained sibutramine, five had sibutramine with phenolphthalein and one was adulterated with synephrine. 21 Sibutramine has a potential for abuse or addiction and elevates blood pressure and heart rate, posing significant risk to patients with heart disease, heart failure, arrhythmias or stroke, 195 while phenolphthalein is known to have carcinogenic properties.…”

Section: Inadequate Quality Control Measuresmentioning

confidence: 99%

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

Sultan¹,

Maria²,

Ali³

et al. 2015

Journal of Patient-Centered Research and Reviews

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Herbal does not mean innocuous: Ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife® products

Cited by 171 publications

References 19 publications

Navigating changing food environments – Transnational perspectives on dietary behaviours and implications for nutrition counselling

Navigating changing food environments – Transnational perspectives on dietary behaviours and implications for nutrition counselling

A critical analysis of the hepatotoxicity cases described in the literature related to Herbalife (r) products

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

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